wuhan - coronavirus

[Arcadia]

13 hours ago, CuriousMomof3 said:

 

I can't get past that firewall, not sure why since supposedly their COVID coverage is free, but from the title in the link, I can guess what it says, and I'm not really surprised.

“At the same time, as cardiologists are contending with the immediate effects of COVID-19 on the heart, they’re asking how much of the damage could be long-lasting. In an early study of COVID-19 patients in China, heart failure was seen in nearly 12% of those who survived, including in some who had shown no signs of respiratory distress.

When lungs do a poor job of delivering oxygen to the body, the heart can come under severe stress and may emerge weaker. That’s concerning enough in an illness that typically causes breathing problems. But when even those without respiratory distress sustain injury to the heart, doctors have to wonder whether they have underestimated COVID-19’s ability to wreak lasting havoc.
“COVID-19 is not just a respiratory disorder,” said Dr. Harlan Krumholtz, a cardiologist at Yale University. “It can affect the heart, the liver, the kidneys, the brain, the endocrine system and the blood system.”

...

“I think there will be long-term sequelae,” said Yale cardiologist Dr. Joseph Brennan, using the medical term for a disease’s downstream effects. 

“I don’t know that for real,” he cautioned. “But this disease is so overwhelming” that some of the recovered are likely to face ongoing health concerns, he said.

Another question that could take years to answer is whether the SARS-CoV-2 virus that causes COVID-19 may lie dormant in the body for years and spring back later in different form.

It wouldn’t be the first virus to behave that way. After a chicken pox infection, for instance, the herpes virus that causes the illness hides quietly for decades and often emerges as the painful affliction shingles. The virus that causes hepatitis B can sow the seeds of liver cancer years later. And in the months after the West African Ebola epidemic subsided in 2016, the virus responsible for that illness was found to have taken up residence in the vitreous fluid of some of its victims’ eyes, causing blindness or vision impairment in 40% of those affected.”

[Bootsie]

3 hours ago, TravelingChris said:

The thing I hope opens up very soon is the so-called elective surgeries.  I heard yesterday that includes cancer surgery, transplants, heart things like implanting something to stop arrythmias, etc.  ALl these things are  not elective and many more.  In a lot of orthopedic surgery- the risk of getting more serious problems from the surgery and less likely good outcome increases if surgery isn't done soon.

I have a friend who was scheduled for back surgery (it was a follow up to a back surgery several months ago where there were complications and they could not complete the intended surgery) that has been cancelled.  Now he is having to wait.  Some days he is in unbearable pain.  He is quickly losing the limited mobility he had, which is not good for long-term prognosis.  By the time these elective surgeries are allowed again, scheduling will be very backed up.

[math teacher]

7 hours ago, Bootsie said:

I have a friend who was scheduled for back surgery (it was a follow up to a back surgery several months ago where there were complications and they could not complete the intended surgery) that has been cancelled.  Now he is having to wait.  Some days he is in unbearable pain.  He is quickly losing the limited mobility he had, which is not good for long-term prognosis.  By the time these elective surgeries are allowed again, scheduling will be very backed up.

Meanwhile, my Fil had a skin cancer removed yesterday. I would have thought that would be re-scheduled. Then on the way home, he wanted a coke to go with his chips, so Mil went in the store without her mask to get him a coke. We're doing all we can to keep them home, but sometimes they won't stay.

[Pen]

1 hour ago, Math teacher said:

Meanwhile, my Fil had a skin cancer removed yesterday. I would have thought that would be re-scheduled.

 

Melanoma suspected? 

1 hour ago, Math teacher said:

Then on the way home, he wanted a coke to go with his chips, so Mil went in the store without her mask to get him a coke. We're doing all we can to keep them home, but sometimes they won't stay.

 

“Parents today.” 🥺😳

Sigh. 

 

[math teacher]

33 minutes ago, Pen said:

 

Melanoma suspected? 

 

“Parents today.” 🥺😳

Sigh. 

 

He has little skin cancers removed all the time, so I doubt it, but not sure.

[Pen]

1 minute ago, Math teacher said:

He has little skin cancers removed all the time, so I doubt it, but not sure.

 

It might add some unnecessary risk to your parents or the medical staff, but afaik the main “elective surgeries” that were shut down in many places to make room for potential CV19 surges and not to have other people at unnecessary risk of getting CV19 in hospitals were the type of surgeries that require hospital — and tiny skin cancers rarely involve a hospital. 

 

[Joker]

My brother just had a Covid test done at a local ER and was told he wouldn't have the results for three days. He's to go home and stay away from his family and other people until then. What upsets me is how difficult it was for him to even be seen. He has a cough and started having trouble breathing, especially at night, and he never has respiratory issues so it was scary. It took him several days and finally a local ER agreed to let him come in. They just moved so he doesn't have a regular doctor there yet. I keep hearing of a larger than normal amount of people dying in their homes and I wonder how many of them have tried to get seen to just be pushed aside. I'm hoping he doesn't get worse and if he does that it won't be as difficult to get help again. 

[math teacher]

1 hour ago, Pen said:

 

It might add some unnecessary risk to your parents or the medical staff, but afaik the main “elective surgeries” that were shut down in many places to make room for potential CV19 surges and not to have other people at unnecessary risk of getting CV19 in hospitals were the type of surgeries that require hospital — and tiny skin cancers rarely involve a hospital. 

 

 

1 hour ago, Pen said:

 

It might add some unnecessary risk to your parents or the medical staff, but afaik the main “elective surgeries” that were shut down in many places to make room for potential CV19 surges and not to have other people at unnecessary risk of getting CV19 in hospitals were the type of surgeries that require hospital — and tiny skin cancers rarely involve a hospital. 

 

Yes- that was my concern. Risk to them and also to dh and I. Inlaws both have COPD and other issues, dh and I are both immune compromised.

[Carrie12345]

Today, PA mandated that all employees and all customers (barring medical needs or under age 2) wear masks.  Glad to hear it!

[Pen]

19 minutes ago, Math teacher said:

 

Yes- that was my concern. Risk to them and also to dh and I. Inlaws both have COPD and other issues, dh and I are both immune compromised.

 

I guess You can’t stop adult parents from doing what they will do.  

But you Can presumably take a safety approach for yourself — such as tell them you cannot _____ (eg be in person with them) as long as they are _____ (doing risky things) nor for [2-4] weeks after they stop doing things that might result in infection.  

With my 18yo I had to take a similar approach— That was before state mandated Stay Home rules,  but for my own well being he had to decide whether to move out and do as he liked or live at home and basically isolate as I needed.  

[CAJinBE]

As expected, Belgium has extended the lockdown until May 3. Garden and hardware type stores are going to be allowed to reopen. No decision was made on schools yet. The odd thing is that they are going to start allowing one visitor per patient into nursing homes if that person has been symptom free for 14 days. I think that's kind of crazy. There's talk of masks being suggested for grocery shopping and public transportation but not yet required. 

[math teacher]

2 hours ago, Pen said:

 

I guess You can’t stop adult parents from doing what they will do.  

But you Can presumably take a safety approach for yourself — such as tell them you cannot _____ (eg be in person with them) as long as they are _____ (doing risky things) nor for [2-4] weeks after they stop doing things that might result in infection.  

With my 18yo I had to take a similar approach— That was before state mandated Stay Home rules,  but for my own well being he had to decide whether to move out and do as he liked or live at home and basically isolate as I needed.  

That is my intention-hopefully dh will agree.

[RootAnn]

5 hours ago, Joker said:

 I keep hearing of a larger than normal amount of people dying in their homes and I wonder how many of them have tried to get seen to just be pushed aside. I'm hoping he doesn't get worse and if he does that it won't be as difficult to get help again. 

From what I am reading, the first time people get into the ER, they are sent home & "get better" for a couple days, then (I'm assuming the cytokine storm kicks in and) they get really bad. When they come in the second time, they are admitted, ventilated, and many times don't recover. That's why the one hospital in California, I think it is, sends the people home with some meds (hydrochlor...whatever it is called) trying to get them better before it gets to the point of no return.

I hope he gets help and gets better.

[kbutton]

6 hours ago, Pen said:

It might add some unnecessary risk to your parents or the medical staff, but afaik the main “elective surgeries” that were shut down in many places to make room for potential CV19 surges and not to have other people at unnecessary risk of getting CV19 in hospitals were the type of surgeries that require hospital — and tiny skin cancers rarely involve a hospital. 

In our state, they've said over and over it's mostly about PPE. There was some changing over to make specific expanded respiratory ICUs, but if we had PPE, they would open up more medical stuff. Even still, they are saying that people who are in increasing pain, etc. should speak with their doctor about reclassifying their surgery. They gave a whole list of criteria they used for classifying things as elective, and they said that a patient's status as elective could become not elective if those things change/worsen, etc. 

Many small procedures don't exhaust the kind of PPE they are most worried about. 

[Harriet Vane]

7 hours ago, CAJinBE said:

As expected, Belgium has extended the lockdown until May 3. Garden and hardware type stores are going to be allowed to reopen. No decision was made on schools yet. The odd thing is that they are going to start allowing one visitor per patient into nursing homes if that person has been symptom free for 14 days. I think that's kind of crazy. There's talk of masks being suggested for grocery shopping and public transportation but not yet required. 

 Re visitors in nursing homes

I have given this a great deal of thought as my beloved father-in-law is staying with us for now. He has dementia. He had originally chosen a graduated care facility near my sister-in-law, but the shelter-in-place orders went into effect and we asked him to visit with us rather than transition into a new setting in which he would be confined to his own quarters without being able to see any of us.

The staff at nursing homes come and go each day. When they leave the facility, they interact with their families, who may have been to different workplaces all day themselves. They might go to the store or put gas in their cars or they may make poor choices on social distancing. Every single person who goes in and out of an extended care facility represents a danger of infection.

So if you refuse admittance to family members, you actually do NOT reduce the risk of infection, but you do substantially increase the risk of abuse because there are no concerned family members who will see bruises, who will notice theft, who will see neglect. Refusing all visitors places an extremely vulnerable population exclusively into the hands of people who are not nearly as motivated to protect them as their own family members are.

So I think, in the long run, emphasizing masks and hand washing and allowing a limited number of approved visitors access to loved ones will increase safety, ease the anxieties of isolation and lockdown for elderly residents, and will not significantly add to the infection risk.

Edited April 16, 2020 by Harriet Vane

[Pen]

9 hours ago, CAJinBE said:

As expected, Belgium has extended the lockdown until May 3. Garden and hardware type stores are going to be allowed to reopen. No decision was made on schools yet. The odd thing is that they are going to start allowing one visitor per patient into nursing homes if that person has been symptom free for 14 days. I think that's kind of crazy. There's talk of masks being suggested for grocery shopping and public transportation but not yet required. 

 

2 hours ago, Harriet Vane said:

 Re visitors in nursing homes

I have given this a great deal of thought as my beloved father-in-law is staying with us for now. He has dementia. He had originally chosen a graduated care facility near my sister-in-law, but the shelter-in-place orders went into effect and we asked him to visit with us rather than transition into a new setting in which he would be confined to his own quarters without being able to see any of us.

The staff at nursing homes come and go each day. When they leave the facility, they interact with their families, who may have been to different workplaces all day themselves. They might go to the store or put gas in their cars or they may make poor choices on social distancing. Every single person who goes in and out of an extended care facility represents a danger of infection.

So if you refuse admittance to family members, you actually do NOT reduce the risk of infection, but you do substantially increase the risk of abuse because there are no concerned family members who will see bruises, who will notice theft, who will see neglect. Refusing all visitors places an extremely vulnerable population exclusively into the hands of people who are not nearly as motivated to protect them as their own family members are.

So I think, in the long run, emphasizing masks and hand washing and allowing a limited number of approved visitors access to loved ones will increase safety, ease the anxieties of isolation and lockdown for elderly residents, and will not significantly add to the infection risk.

 

https://www.nationalreview.com/2020/03/coronavirus-outbreak-how-it-spread-nationwide-from-washington-state-nursing-home/

From

March 24, so situation is much different now as NYC, Boston, New Orleans, Detroit etc became main hot spots, but still interesting IMO and still relevant to Nursing home discussions.  Article starts: 

 

Nearly half of all American deaths from the novel coronavirus trace back to the Life Care Center in Kirkland, Wash. Its story is instructive.

Nearly half of all coronavirus deaths so far in the United States can be traced to a single nursing home in Kirkland, Wash., just east of Seattle. Life Care Center, a low-slung building in a quiet part of town, is now the epicenter of the pandemic spreading throughout the United States.

[Harriet Vane]

2 hours ago, Pen said:

 

 

https://www.nationalreview.com/2020/03/coronavirus-outbreak-how-it-spread-nationwide-from-washington-state-nursing-home/

From

March 24, so situation is much different now as NYC, Boston, New Orleans, Detroit etc became main hot spots, but still interesting IMO and still relevant to Nursing home discussions.  Article starts: 

 

Nearly half of all American deaths from the novel coronavirus trace back to the Life Care Center in Kirkland, Wash. Its story is instructive.

Nearly half of all coronavirus deaths so far in the United States can be traced to a single nursing home in Kirkland, Wash., just east of Seattle. Life Care Center, a low-slung building in a quiet part of town, is now the epicenter of the pandemic spreading throughout the United States.

I read the article. I am a little confused—I know about that nursing home and had read other egregious accounts of the lack of sanitation or controls. The thing is, even a locked down facility has the contagion risk from staff that I mentioned, so it does not seem that allowing a tightly controlled list of family visitors is any more dangerous. 

[CAJinBE]

I was wondering the same thing about the nursing home staff. If they are coming and going, the virus is probably going both ways as well. My mom is in a senior living, not nursing home, and she can't go anywhere or see relatives except they will allow her to see people at a distance outside recently. But the staff doesn't live there and she sees them every day. I know they are distancing and she doesn't receive any direct care, but there are still germs around everywhere. They are also making her food and delivering it to her door. I know they are trying their best under difficult circumstances, but this along with many other things about this virus mitigation doesn't make sense. 

[RootAnn]

Nurses suspended for refusing Covid-19 care without N95 masks. Just a couple snippets:

".. a handful of nurses told their managers they wouldn’t enter COVID-19 patient rooms without N95 masks. The hospital suspended them, according to the National Nurses Union, which represents them. 

Guidelines from the Centers for Disease Control and Prevention don’t require N95 masks for COVID-19 caregivers, but many hospitals are opting for the added protection because the infection has proven to be extremely contagious."

https://www.mail.com/int/entertainment/lifestyle/9858344-nurses-suspended-refusing-covid-19-care-without-n9.html#.1272-stage-ss1-2

I can't believe te CDC guidelines at this time don't call for more than surgical masks. That seems ignorant and irresponsible. I get that there is a shortage but that doesn't mean you don't admit how important it is to wear proper PPE when interacting with possibly very contagious individuals.

[Carrie12345]

I’m having a difficult time with the nursing home situation, particularly in NJ. I’m not going to link the story because it upset me too much, but there was a horrible issue in a particular facility that was absolutely not dealt with properly. On the same days as reading that, we came to learn that there was a positive case in my grandmother’s facility.

It’s a little weird, because I have been operating under the assumption that her place had at least one case; that seemed to be the general assumption from the state. Other people in the family don’t interpret things the way I do though, so it’s been strange to watch them all processing while I already did days ago.

[Teaching3bears]

A big chunk of the deaths and infections in my area are coming from nursing homes. It is everything StellaM said. Workers are working in more than 1 facility spreading the virus around and then spreading it in the community. They have just started telling them that they can only work in one place and paying them for lost wages. I hope this curbs the spreading. I do think we really have to pay attention to what goes on in nursing homes if we want to stop the pandemic and prevent death. And those poor residents are so vulnerable.

[TCB]

4 hours ago, RootAnn said:

Nurses suspended for refusing Covid-19 care without N95 masks. Just a couple snippets:

".. a handful of nurses told their managers they wouldn’t enter COVID-19 patient rooms without N95 masks. The hospital suspended them, according to the National Nurses Union, which represents them. 

Guidelines from the Centers for Disease Control and Prevention don’t require N95 masks for COVID-19 caregivers, but many hospitals are opting for the added protection because the infection has proven to be extremely contagious."

https://www.mail.com/int/entertainment/lifestyle/9858344-nurses-suspended-refusing-covid-19-care-without-n9.html#.1272-stage-ss1-2

I can't believe te CDC guidelines at this time don't call for more than surgical masks. That seems ignorant and irresponsible. I get that there is a shortage but that doesn't mean you don't admit how important it is to wear proper PPE when interacting with possibly very contagious individuals.

Our hospital is taking airborne precautions with Covid and suspected Covid patients. I’m sure the CDC guidelines are because of the shortages and that is horrendous. I don’t think we can be 100% sure about transmission yet but I can’t believe they are willing to say definitively  that it isn’t airborne.

[Paige]

4 hours ago, RootAnn said:

Nurses suspended for refusing Covid-19 care without N95 masks. Just a couple snippets:

".. a handful of nurses told their managers they wouldn’t enter COVID-19 patient rooms without N95 masks. The hospital suspended them, according to the National Nurses Union, which represents them. 

Guidelines from the Centers for Disease Control and Prevention don’t require N95 masks for COVID-19 caregivers, but many hospitals are opting for the added protection because the infection has proven to be extremely contagious."

https://www.mail.com/int/entertainment/lifestyle/9858344-nurses-suspended-refusing-covid-19-care-without-n9.html#.1272-stage-ss1-2

I can't believe te CDC guidelines at this time don't call for more than surgical masks. That seems ignorant and irresponsible. I get that there is a shortage but that doesn't mean you don't admit how important it is to wear proper PPE when interacting with possibly very contagious individuals.

I feel like hospitals probably have regulations that say they have to follow CDC guidelines. The CDC knows this and also knows ain't nobody going to follow CDC guidelines anymore! So they changed their guidelines so hospitals could say they are complying and we can all feel safe because, look- hospitals are protecting their nurses by following CDC guidelines. 

Spread in nursing homes reflects that policies and procedures were unsafe previously. I don't think the only choice is to lock them down and make them unsafe in other ways- honestly, if someone was in the same care home that my great grandmother was, it would be kinder to just euthanize than lock them up, unvisited, alone, for a year or more. There needs to be policies to reduce the risks of covid and the risks of abuse and despair. The way things have been don't have to be the way things become. 

[Pen]

5 hours ago, Harriet Vane said:

I read the article. I am a little confused—I know about that nursing home and had read other egregious accounts of the lack of sanitation or controls. The thing is, even a locked down facility has the contagion risk from staff that I mentioned, so it does not seem that allowing a tightly controlled list of family visitors is any more dangerous. 

 

I think that nursing homes need far more tight precautions—especially as states start to “open”—

it could include some tightly controlled family visitors, perhaps 4 visitors per 50 bed unit who can come repeatedly during a month with test for CV19 at start and restrictions on what they do, and visit and look at conditions for all residents, not just own family

plus tighter, not looser, cautions regarding caregivers and staff.  PPE, testing, protocols, single facility work ...  

visitors can very quickly not only cause all the problems of staff, but may also be from farther away such that a visitor from one city drives from, say, San Diego to Seattle and back, visiting friends and family (including elders in Nursing Homes) along the way, and quickly spreads infection along the route travelled

Especially if states have just opened and lots of people are antsy to visit their elders that could happen quite a lot.  And summer could easily bring both travel up down a major interstate, but also bicoastal travel in various ways, including from NYC and Boston to areas much further than Rhode Island.  And it becomes much more easy also to drive across Cascades/Sierras  and Rocky Mountains in summer, possibly spreading more infection into the current low case rate states, where any one case seeded into any one home can become another Kirkland...

My mother’s rural out of the way area became a CV19 area due to just one infectious traveller from NYC (~ 1000 miles away).  Had that infectious person visited a nursing home there could have easily been many more cases including ICU requiring ones, and there are no local to them ICU type beds at all for around 150 miles. 

 

Edited April 16, 2020 by Pen

[RootAnn]

It looks like worldometer's source for Sweden is https://experience.arcgis.com/experience/09f821667ce64bf7be6f9f87457ed9aa. 

I have no idea what is going on with their numbers no matter the source. I admit to being jaded on all the numbers knowing very few countries are testing enough, many places are undercounting their dead, and some places may be flat out lying. Plus, the tests may have false negatives and maybe even the rare false positive! Watch me throw my hands up in frustration!

I'm beginning to think people will get to the point that they won't stand for shutdowns, everything will open back up, and then most people will just get inured to the deaths. I am doubtful we will ever get enough testing to keep track of where outbreaks are. The testing guidelines are simply too narrow.

Edited April 16, 2020 by RootAnn

[Storygirl]

37 minutes ago, Pen said:

 

I think that nursing homes need far more tight precautions—especially as states start to “open”—

it could include some tightly controlled family visitors, perhaps 4 visitors per 50 bed unit who can come repeatedly during a month with test for CV19 at start and restrictions on what they do, and visit and look at conditions for all residents, not just own family

plus tighter, not looser, cautions regarding caregivers and staff.  PPE, testing, protocols, single facility work ...  

visitors can very quickly not only cause all the problems of staff, but may also be from farther away such that a visitor from one city drives from, say, San Diego to Seattle and back, visiting friends and family (including elders in Nursing Homes) along the way, and quickly spreads infection along the route travelled

Especially if states have just opened and lots of people are antsy to visit their elders that could happen quite a lot.  And summer could easily bring both travel up down a major interstate, but also bicoastal travel in various ways, including from NYC and Boston to areas much further than Rhode Island.  And it becomes much more easy also to drive across Cascades/Sierras  and Rocky Mountains in summer, possibly spreading more infection into the current low case rate states, where any one case seeded into any one home can become another Kirkland...

My mother’s rural out of the way area became a CV19 area due to just one infectious traveller from NYC (~ 1000 miles away).  Had that infectious person visited a nursing home there could have easily been many more cases including ICU requiring ones, and there are no local to them ICU type beds at all for around 150 miles. 

 

Although there is some logic in your suggestion here, I can promise that idea won't fly.

I would not be content with having a stranger that I don't know at all, and whose intentions and attention to detail I don't know, be responsible for checking on my mom. If I happened to be one of  the people charged with checking on everyone's family members, I would have no idea how to go about that, because I would have no knowledge from before of the state of health of those individuals. When I visit my mom now (or did visit, before restrictions), I would of course see the other residents. But seeing the other residents told me nothing about their health or the care they were receiving. On the other hand, I could tell things about what was happening with MY mom, because I know my mom.

Also, how would they choose the designated family members? And how will the designated people communicate with the other families? Who would want to take on such a role of responsibility for people they don't know? How angry will the family members who are left out be?

It opens up a can of worms, frankly.

A better first solution would be to have one person only from each family allowed to come in on a limited basis (perhaps by appointment; although for preventing abuse, it's best for visitors to be allowed to come any time, but appointments would be better than nothing), and to establish screening procedures for that person, similar to what they do for staff members.

I think we are quite a ways from that being allowed, but eventually permitting one family member to enter would be a first step to re-opening.

In our state, nursing homes are one common type of hot zone. My mother's nursing home has four cases. She herself was negative (just found that out this morning), but that only gives a small measure of comfort, because she could be exposed at any time, or it could have been a false negative test. So it's good news for now, but actually not good news, because there is spread happening there, and Mom remains at great risk.

[Arcadia]

San Francisco https://sanfrancisco.cbslocal.com/2020/04/15/coronavirus-san-francisco-school-officials-give-students-a-grades-closures/
“EASY A? 
Most San Francisco Unified School District board members expressed support at a meeting Tuesday night to giving all middle and high school students A’s for the remainder of the year due to coronavirus school closures affecting their education.“

[Spryte]

Nursing home question here.

For those with family in nursing homes, how are you finding out if there is a case at the facility?  We are in communication with the facilities, so if they announced something, we’d hear, but are they required to let us know?
 

Both of my ILs are in homes - one assisted, one nursing (don’t get me started on the necessity of separating a couple married for 64 years, gaaaah).  Both are locked down.

FIL’s facility has recently added more restrictions, though, that made us wonder about a possible case on another floor.  

If we ask directly, will they share that info, or is there a HIPPA concern here?  (Obviously we would not ask for a patient’s name!)

[Pen]

16 minutes ago, Storygirl said:

Although there is some logic in your suggestion here, I can promise that idea won't fly.

I would not be content with having a stranger that I don't know at all, and whose intentions and attention to detail I don't know, be responsible for checking on my mom. If I happened to be one of  the people charged with checking on everyone's family members, I would have no idea how to go about that, because I would have no knowledge from before of the state of health of those individuals. When I visit my mom now (or did visit, before restrictions), I would of course see the other residents. But seeing the other residents told me nothing about their health or the care they were receiving. On the other hand, I could tell things about what was happening with MY mom, because I know my mom.

Also, how would they choose the designated family members? And how will the designated people communicate with the other families? Who would want to take on such a role of responsibility for people they don't know? How angry will the family members who are left out be?

It opens up a can of worms, frankly.

A better first solution would be to have one person only from each family allowed to come in on a limited basis (perhaps by appointment; although for preventing abuse, it's best for visitors to be allowed to come any time, but appointments would be better than nothing), and to establish screening procedures for that person, similar to what they do for staff members.

I think we are quite a ways from that being allowed, but eventually permitting one family member to enter would be a first step to re-opening.

In our state, nursing homes are one common type of hot zone. My mother's nursing home has four cases. She herself was negative (just found that out this morning), but that only gives a small measure of comfort, because she could be exposed at any time, or it could have been a false negative test. So it's good news for now, but actually not good news, because there is spread happening there, and Mom remains at great risk.

 

It would be nice if you could get her out entirely if she is negative.

 In my state CV19 has tended to go through nursing homes much like it does cruise ships — with very high numbers of infected. Maybe that is lessening some as the problem has been realized.  

[Carrie12345]

8 minutes ago, Spryte said:

Nursing home question here.

For those with family in nursing homes, how are you finding out if there is a case at the facility?  We are in communication with the facilities, so if they announced something, we’d hear, but are they required to let us know?
 

Both of my ILs are in homes - one assisted, one nursing (don’t get me started on the necessity of separating a couple married for 64 years, gaaaah).  Both are locked down.

FIL’s facility has recently added more restrictions, though, that made us wonder about a possible case on another floor.  

If we ask directly, will they share that info, or is there a HIPPA concern here?  (Obviously we would not ask for a patient’s name!)

I don’t actually know how my family found out. My mom has POA, so I would think she’d be the person notified if my grandmother were actually sick, but my aunt is the one who shared the news, and she’s been out of state. So, no idea.

I know NJ’s governor had been using general privacy/respect reasoning rather than HIPPA to decline public announcements. Like, no one is revealing if someone at 123 Main Street in Anywhere, USA has tested positive, and it’s the same principle with revealing a care center because it’s people’s home.

[Spryte]

1 minute ago, Carrie12345 said:

I don’t actually know how my family found out. My mom has POA, so I would think she’d be the person notified if my grandmother were actually sick, but my aunt is the one who shared the news, and she’s been out of state. So, no idea.

I know NJ’s governor had been using general privacy/respect reasoning rather than HIPPA to decline public announcements. Like, no one is revealing if someone at 123 Main Street in Anywhere, USA has tested positive, and it’s the same principle with revealing a care center because it’s people’s home.

Thanks.  DH is POA for both, and we are the primary contact people, so if they are informing family, one would think we’d hear.  
 

It may be that someone is in quarantine without a confirmed case.  We don’t know, but suspect.

[Wheres Toto]

5 hours ago, Carrie12345 said:

I’m having a difficult time with the nursing home situation, particularly in NJ. I’m not going to link the story because it upset me too much, but there was a horrible issue in a particular facility that was absolutely not dealt with properly. On the same days as reading that, we came to learn that there was a positive case in my grandmother’s facility.

It’s a little weird, because I have been operating under the assumption that her place had at least one case; that seemed to be the general assumption from the state. Other people in the family don’t interpret things the way I do though, so it’s been strange to watch them all processing while I already did days ago.

I used to work at the facility that is currently in the news, as a CNA (only made it a few months working there).   Years ago but from what I've heard, not much has changed, if anything it has gotten worse.   They offer CNA training classes there, and you work shifts while undergoing training so a good portion of CNA's working there are unlicensed.  There are very few actual nurses working there, maybe one per floor during some shifts.   The balance of CNA's are usually bused in from the cities.  A lot of people doing the work because it paid better than most other flexible work, not because they wanted to care for people.  I had another CNA threaten physical violence because I reported patient abuse.  

[TracyP]

25 minutes ago, Spryte said:

Nursing home question here.

For those with family in nursing homes, how are you finding out if there is a case at the facility?  We are in communication with the facilities, so if they announced something, we’d hear, but are they required to let us know?
 

Both of my ILs are in homes - one assisted, one nursing (don’t get me started on the necessity of separating a couple married for 64 years, gaaaah).  Both are locked down.

FIL’s facility has recently added more restrictions, though, that made us wonder about a possible case on another floor.  

If we ask directly, will they share that info, or is there a HIPPA concern here?  (Obviously we would not ask for a patient’s name!)

My state is handling this a little different than some it sounds like. They list every congregate care facility in the state that has even one case, whether that is a staff member or a patient. So I don't think there are privacy concerns, but I suspect states/facilities aren't going to like sharing this info. Even though my state has been very proactive, there are a boatload of cases and roughly 75% of the deaths seem to be coming from nursing homes. This is a huge problem, imo.

Anyway, if you try to ask about possible cases at your FIL's facility, I would argue with them if they cite privacy as their reason for not sharing that info. 

[Storygirl]

1 hour ago, Pen said:

 

It would be nice if you could get her out entirely if she is negative.

 In my state CV19 has tended to go through nursing homes much like it does cruise ships — with very high numbers of infected. Maybe that is lessening some as the problem has been realized.  

Yes, it would be nice, but she can't be cared for at home, unfortunately. She has lived in the nursing home for 8 years, and requires intensive care.

[Storygirl]

1 hour ago, Spryte said:

Nursing home question here.

For those with family in nursing homes, how are you finding out if there is a case at the facility?  We are in communication with the facilities, so if they announced something, we’d hear, but are they required to let us know?
 

Both of my ILs are in homes - one assisted, one nursing (don’t get me started on the necessity of separating a couple married for 64 years, gaaaah).  Both are locked down.

FIL’s facility has recently added more restrictions, though, that made us wonder about a possible case on another floor.  

If we ask directly, will they share that info, or is there a HIPPA concern here?  (Obviously we would not ask for a patient’s name!)

The nursing home called my dad when they had a staff member test positive. They called him back yesterday with the results for my mom (negative). Our state has also added a chart online that lists how many cases are in every nursing home that has cases, so I was able to look it up and see that my mom's place has four cases.

I am not a primary contact for the nursing home, so the news comes through my dad. He is not, unfortunately, the best at communicating, so I get some of my information from my sister, who gets it from Dad or sometimes hears from the nursing home staff herself (she is the second contact person, since she lives in my hometown, and I do not).

Our state is now requiring nursing facilities to contact families if there is a positive case, but that is a new guideline. Our Governor stated that he made this decision based not on privacy laws, but on what he thinks is decent and what he would want if he had family in a nursing home. But they did have to run it by the lawyers, I think, so it took a few days to go into effect.

[Pen]

II thought it would help if Social Influencers helped to get public to embrace physical Distancing etc.  — then lost some hope for that when I saw Basketball star touching all the microphones and Gwyneth Paltrow (iirc) comments indicating she doesn’t seem to believe in the virus, or whatever— don’t recall details, just that I stopped thinking that would help.

 

But Finland did it, and looking at Finland as having lowest CV19 deaths per thousand population,(eta) of the relatively similar Scandinavian countries each doing things in somewhat different ways — maybe it has helped.

https://www.theguardian.com/world/2020/apr/01/finland-enlists-social-influencers-in-fight-against-covid-19

Edited April 17, 2020 by Pen

[Jean in Newcastle]

36 minutes ago, Pen said:

I thought it would help if Social Influencers helped to get public to embrace physical Distancing etc.  — then lost some hope for that when I saw Basketball star touching all the microphones and Gwyneth Paltrow (iirc) comments indicating she doesn’t seem to believe in the virus, or whatever— don’t recall details, just that I stopped thinking that would help.

 

But Finland did it, and looking at Finland as having lowest CV19 deaths per thousand population, maybe it has helped.

https://www.theguardian.com/world/2020/apr/01/finland-enlists-social-influencers-in-fight-against-covid-19

A couple of the channels I watch have celebrities encouraging people to basically "hang in there"  (CBS? has the "we're all in this together" campaign) and I've seen some others.  Just yesterday they had a bunch of people I didn't recognize giving the message.  I then realized that I didn't recognize them because they were Social Media Influencers (Instagram, Youtube etc.)  so obviously I wasn't their targeted demographic.  😉 

Edited April 16, 2020 by Jean in Newcastle
typo

[RootAnn]

2 hours ago, Arcadia said:

“EASY A? 
Most San Francisco Unified School District board members expressed support at a meeting Tuesday night to giving all middle and high school students A’s for the remainder of the year due to coronavirus school closures affecting their education.“

A couple of colleges have gone to this model. Either A or A- for everyone.

Edited April 16, 2020 by RootAnn

[Spryte]

1 hour ago, Plum said:

Same. My state added a new dashboard specifically for nursing homes and facilities. Of course we were also the state that had a care facility telling it’s staff to turn their masks inside out to reuse them. 
 

That’s a nice service.  I did some digging, and a week ago our state’s health dept refused to release names of facilities with positive cases, unless they specifically had the permission of the facility.  (Sigh)  They cited a specific state code.  So here, it seems that family and even some healthcare workers are only finding out through the grapevine or on the news if it gets out.  That’s disappointing. A lot of workers work at more than one facility.

FIL’s facility has been locked down for some time, but residents were allowed to ride the elevator to a different floor to get books or puzzles for their rooms, if wearing a mask.  They are no longer allowed on the elevators at all.  It’s a significant change, and the residents think there could be a case on another floor, but it’s not confirmed.

MIL’s facility has had that level of lockdown the whole time.  It’s possible that FIL’s home has just tightened up, but we don’t know.
 

DH and I will ask directly, but who knows if we will get a straight answer.  We have been dealing with another issue.  They were apparently short staffed over the weekend, and FIL didn’t get much care.  It’s very frustrating.  They told us several people were out sick. So, feeling concerned.

[Arcadia]

17 minutes ago, RootAnn said:

A couple of colleges have gone to this model. Either A or A- for everyone.

I can understand colleges doing that. We joked about compassionate As.
The school districts don’t grade the same way though so high school GPAs would be impacted differently even in the same city as San Jose, California for example is comprise of a few school districts. 

[Storygirl]

Our public school district put out a message saying that teachers would still be grading and giving feedback on assignments. But that remote learning grades would not lower any student's GPA; they will base the course grade upon last quarter, if the student's grades drop. So students can improve their grades ( I think), but they won't be penalized if their grades get worse.

My kids could read this message on their Chromebooks, and maybe they did, but I did not bring it to their attention. I have one child who would decide that he didn't need to do any work any more, so I didn't want him to notice the policy. My other kids are doing fine grade-wise, so the policy doesn't impact them, anyway.

[RootAnn]

Strain of the virus in India could show current vaccine work is futile.

However, the way I read it, the mutation might be less deadly in that it wouldn't bind to the ACE2 receptor the same way.

https://www.scmp.com/news/china/science/article/3079678/coronavirus-mutation-threatens-race-develop-vaccine

 

A coronavirus strain isolated in India carried a mutation that could upend vaccine development around the globe, according to researchers from Australia and Taiwan.

The researchers found that the mutation occurred in the spike protein’s receptor-binding domain (RBD).

A computer simulation shows that the RBD mutation, which was not found in other variants across the globe, could remove a hydrogen bond from the spike protein.

Without this bond, the virus may be less likely to bind with ACE2, or angiotensin converting enzyme-2, which is found in the lungs and other organs.

[RootAnn]

25 minutes ago, Seasider too said:

What about just using pass/fail? That way the credit is earned (or not) but the GPA is unaffected. That’s what some of our local public high schools are doing, where necessary. 

Some are doing this. Others don't want to disadvantage premed & students applying for grad school as certain prereq require a certain letter grade. It'll be a mess....

[DoraBora]

5 hours ago, Spryte said:

Nursing home question here.

For those with family in nursing homes, how are you finding out if there is a case at the facility?  We are in communication with the facilities, so if they announced something, we’d hear, but are they required to let us know?
 

Both of my ILs are in homes - one assisted, one nursing (don’t get me started on the necessity of separating a couple married for 64 years, gaaaah).  Both are locked down.

FIL’s facility has recently added more restrictions, though, that made us wonder about a possible case on another floor.  

If we ask directly, will they share that info, or is there a HIPPA concern here?  (Obviously we would not ask for a patient’s name!)

In Dallas County, facilities are required to notify residents, their families, and staff within six hours of learning of a confirmed case, and local news has reported names of numerous Dallas area facilities with virus clusters.

 

[Bootsie]

1 hour ago, Seasider too said:

 

What about just using pass/fail? That way the credit is earned (or not) but the GPA is unaffected. That’s what some of our local public high schools are doing, where necessary. 

Some licensing boards will not accept coursework that has been Pass/Fail toward meeting professional requirements.   Some employers who reimburse students for classes base the percentage on a final course grade.  Some students are working toward bringing their GPA up and worked very hard during the first half of the semester and giving them simply a "pass" would penalize them. 

[Arcadia]

@Pen 

Eugene School District 4J Facebook’s post (Oregon)

“😄While schools buildings are closed, high school students on the South Eugene Robotics Team are innovating creative solutions to a pandemic problem. Team members are working with their mentors and a UO biology researcher to design and fabricate face shields for front-line workers using just the tools they have at home. So far, they have created 38 shields for grocery store workers and veterinarians.

But, they got big news yesterday! The chief medical officer at Oregon Medical Group approved their design for medical use and has requested 200 face shields for doctors and other medical personnel who treat patients with respiratory symptoms. So, they are ramping up production.

The students 3D print the mask parts at home, mentors cut the polycarbonate shields and the UO researcher assembles them—all while following social distancing guidelines. A team approach! #4JBetterTogether”

[ElizabethB]

New Vitamin D paper, Dr Gareth Davies (PhD), Dr Joanna Byers (MBChB), Dr Attila R Garami (MD, PhD)

"Low Vitamin D occurs in 90% of patients with ARDS."  

Long, but shows mechanism of how D could help, also shows graph of deaths vs. latitude.

https://www.dropbox.com/s/ka7h4fbi7xdz9s9/Covid-19 and Vitamin D Information.pdf?dl=0

They have a poster for hospitals, they want tracking, testing, and treatment of all Covid patients' vitamin D levels, and recommend that all hospital staff take daily D3 supplements.  Poster: https://docs.google.com/document/d/1ROn9Si3jXQzfgAwijH4JMv-n7wYJwrAMAefIM4kULkg/edit

Vitamin D is correlated with many of the factors of COVID.

Age: https://www.health.harvard.edu/staying-healthy/time-for-more-vitamin-d

Obesity: https://www.livescience.com/26961-obesity-causes-vitamin-d-deficiency.html

Race: https://www.linkedin.com/pulse/vitamin-d-coronavirus-gap-liz-brown/

Edited April 17, 2020 by ElizabethB

[Pen]

8 hours ago, Storygirl said:

Yes, it would be nice, but she can't be cared for at home, unfortunately. She has lived in the nursing home for 8 years, and requires intensive care.

 

I’m so sorry.  That must be difficult for you both.

And depending on your State readiness to reopen and ability to progress successfully through showing success with a reopening, it might be quite a while before an irl visit is possible. 

Many of us may not get final irl visits with older relatives. 

 

[The Governess]

New figures: 

Worldwide Deaths

April 14 130,400 10 days to double (128000)

April 4 64700 7 days to double (64000)

March 28 31000 5 days to double (32000)

March 23 16500 6 days to double (16000)

March 17 8000 8 days to double

March 9 4000 20 days to double

Feb 18 2000

 

U.S. Deaths

April 14 29,800 6 days to double (29184)

April 8 14,800 5 days to double (14592)

April 3 7400 3 days to double (7296)

March 31 3900 3 days to double (3648)

March 28 2200 3 days to double (1824)

March 25 1030 2 days to double (912)

March 23 550 3 days to double (456)

March 20 250 3 days to double (228)

March 17 110 3 days to double (114)

March 14 57

It would have taken longer for US deaths to double, but New York reworked how they calculate deaths (I think there were many deaths at nursing homes, etc. that were never tested and not being counted), and including those bumped the overall numbers up by like 5,000 deaths. 😞

So, the slowing trend continues, but it hasn’t slowed that much, really. The next doubling will bring us to that 60k number the IHME model was projecting (I think they have since revised that up to 68k -  which we aren’t supposed to hit it until June....).

 

[TravelingChris]

On 4/15/2020 at 12:53 AM, StellaM said:

 

 

Parents here who want their children back in school for social reasons need to be doing some heavy duty lobbying of government to provide adequate health protection for teachers and support staff.

A basic here that needs to be met before sending kids back is that school cleaners need their contracted hours extended so they can spend more than 4 min per classroom as it is at my school atm. 

I am a bit tired of being told to work in unsafe conditions 'for the kids'.

A basic platform of worker's rights is safety at work.

If people choose to send their children into conditions where the workers are not safe, when they have the choice to do otherwise, it's akin to crossing a picket line. IMO.

 

Yes, over here in one of the earlier stages they are talking about opening up schools and daycares.  Kids tend to be the asymptomatic carriers.