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It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- not just Covid patients. That means we will likely start having an increase in deaths with multiple causes such as heart attacks and traumas which are cases that are usually automatically transferred to the larger hospitals. The closest out of state hospitals that previously took such patients are also full, so there is no where left to go. 
The slightly larger town nearest me that has a paid ambulance service is leaving an ambulance crew parked at the local nursing home so they are near when codes are called. 
While the rates of Covid infections and hospitalizations are increasingly dramatically  here like everywhere else, our state’s lack of medical facilities and personnel as become a big problem.

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It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- no

In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up

It is horrendous! I’ve seen a patient write a note to his wife on a whiteboard before he got intubated saying he loved her. She was outside his window looking in. His nurse took a picture of it just i

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I am truly struggling with judgment lately because of this. I have a friend who works as a nurse on a blood cancer floor. If one of her patients contracts COVID from her or another nurse, that patient might not make it.  Yet, I see people posting on social media that there is no way that they are not gathering as a family for Thanksgiving because "tomorrow is not promised to us" and they have "waited long enough to see family" etc.  The trouble is, some of these same people are out doing social things multiple times per week and generally not being cautious. It's not like they are locking down prior to Thanksgiving to protect their loved ones. So after Thanksgiving, it really looks like we will have even more people flooding our hospitals.  And even more spread in the community, which means nurses/doctors/dieticians/therapists/sanitation folks are all more vulnerable to picking up COVID.  

I just don't understand the blinders people have on where they think that their choices do not affect anyone else.  I really am trying to try to come to grips with the fact that people are very weary of this. I certainly am weary. But I have been much, much more cautious than the "they better not lock us down, because I just won't do it" crowd.  When the hospital systems themselves are saying, "please be careful because if you don't, we are going to have a crisis of healthcare workers being out sick," I think people should listen. But they are not, and it's making me so, so very sad. 

My mom is still going to the hospital weekly and has home health care once a week. At this point, I don't know realistically how long we can hope she will be able to do that without being exposed.

I am so sorry OP for what is going on in your area.  I feel so helpless to get people to change their thinking on this.  

Edited by cintinative
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26 minutes ago, City Mouse said:

It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- not just Covid patients. That means we will likely start having an increase in deaths with multiple causes such as heart attacks and traumas which are cases that are usually automatically transferred to the larger hospitals. The closest out of state hospitals that previously took such patients are also full, so there is no where left to go. 
The slightly larger town nearest me that has a paid ambulance service is leaving an ambulance crew parked at the local nursing home so they are near when codes are called. 
While the rates of Covid infections and hospitalizations are in reading dramatically here like everywhere else, our state’s lack of medical facilities and personnel as become a big problem.

Don't worry - people don't actually die of Covid. It's all a political game.  Carry on like normal and all will be fiiiiiiine.

Can you tell my sarcasm shines through when I'm aggravated? I am so sorry.  Sigh.

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1 hour ago, City Mouse said:

It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- not just Covid patients. That means we will likely start having an increase in deaths with multiple causes such as heart attacks and traumas which are cases that are usually automatically transferred to the larger hospitals. The closest out of state hospitals that previously took such patients are also full, so there is no where left to go. 
The slightly larger town nearest me that has a paid ambulance service is leaving an ambulance crew parked at the local nursing home so they are near when codes are called. 
While the rates of Covid infections and hospitalizations are in reading dramatically here like everywhere else, our state’s lack of medical facilities and personnel as become a big problem.

What state? 

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We already had that scenario last week  my state. I posted in another thread

https://www.stltoday.com/news/local/state-and-regional/running-out-of-room-st-louis-hospitals-forced-to-turn-away-patients-from-rural-areas/article_0e17fc93-3e67-5a49-9a33-0b346618b5c3.html

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 A 48-year-old married father of five, worried about his worsening headaches, walked Monday afternoon into the small emergency room at Texas County Memorial Hospital. Nurses discovered he had a quickly growing and dangerous mass in the middle of his brain, said hospital CEO Wesley Murray. The man needed surgery at a high-level trauma center. For the next 25 hours, frantic nurses called every Missouri health center they could. They even called hospitals as far as Memphis, Tennessee; Little Rock, Arkansas; Tulsa, Oklahoma; and Omaha, Nebraska, Murray said, but they were unable to find an intensive care bed open.

The man was losing consciousness. His blood pressure was increasing. Finally, a University of Iowa hospital was able to handle his case, sending a small plane to pick him up at nearby Fort Leonard Wood.

 

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1 hour ago, cintinative said:

I am truly struggling with judgment lately because of this. I have a friend who works as a nurse on a blood cancer floor. If one of her patients contracts COVID from her or another nurse, that patient might not make it.  Yet, I see people posting on social media that there is no way that they are not gathering as a family for Thanksgiving because "tomorrow is not promised to us" and they have "waited long enough to see family" etc.  The trouble is, some of these same people are out doing social things multiple times per week and generally not being cautious. It's not like they are locking down prior to Thanksgiving to protect their loved ones. So after Thanksgiving, it really looks like we will have even more people flooding our hospitals.  And even more spread in the community, which means nurses/doctors/dieticians/therapists/sanitation folks are all more vulnerable to picking up COVID.  

I just don't understand the blinders people have on where they think that their choices do not affect anyone else.  I really am trying to try to come to grips with the fact that people are very weary of this. I certainly am weary. But I have been much, much more cautious than the "they better not lock us down, because I just won't do it" crowd.  When the hospital systems themselves are saying, "please be careful because if you don't, we are going to have a crisis of healthcare workers being out sick," I think people should listen. But they are not, and it's making me so, so very sad. 

My mom is still going to the hospital weekly and has home health care once a week. At this point, I don't know realistically how long we can hope she will be able to do that without being exposed.

I am so sorry OP for what is going on in your area.  I feel so helpless to get people to change their thinking on this.  

I agree so much with this.   It really makes me angry.   Add that thinking/actions to my following list of issues:   People flying makes me extra furious.   Schools are opening back up here and allowing more and more students in, while at the same time decreasing social distance requirements.  I don't get it,  I know they are in a horrible position, but at this point I am so tired of worrying myself sick over keeping our family safe (we are all extremely high risk).  I so wish universities had only been online and not allowed students in dorms.  Having classes online but allowing students in dorms  is ridiculous.   Don't even get me going on the non-mask wearers (at least in my area people do seem compliant from the tiny bit I can tell, I am not out much).   All of these things add up and keep numbers rising and people dying.   Crawling off my soapbox now.

I am thinking about your mom and hope that she somehow manages to not be exposed and can continue to receive the care she needs. 

 

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My sister works in a hospital in another state.  The fear I have for her safety is so great.  All while trying to keep our 3 elderly loved ones safe and alive and us alive to be able to care for them (as they can't do it on their own).  I'm utterly exhausted by it all.  There is not one moment of any day that I am relaxed and not totally stressed out.  As my family has continued to stay in phase 1 lock down mode, we still wipe down our groceries and don't go in stores type of lock down, I am amazed at what I read people doing on my FB page.  Our schools just started back up in my county for Pre-K and K.  

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@mlktwins Our schools are phasing in classes. K-2 began last week, 3-4 will be in buildings by the end of the month. I am shocked and dismayed with these decisions. Our cases are rising, hospitals are full, restaurants are back to outdoor dining/pick up only, more restrictions are being put in place, so let's send our children to school.

Last week a nearby town was begging for substitute teachers at $150 a day for people with AA degrees. They are in dire straits due to teachers being out with + results or due to exposure. That school district announced they are going virtual as of this Wednesday because they can't staff the classes.

I, too, am shocked by what people are posting on FB. 

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23 minutes ago, Ditto said:

 I so wish universities had only been online and not allowed students in dorms.  Having classes online but allowing students in dorms  is ridiculous.  

Interestingly, when it comes to Covid infections, our university has consistently been doing much better than the general population in the area. Thanks to diligent focused students and aggressive contact tracing. It can be done.  We even have in-person classes, but everybody is masked and distanced.

Edited by regentrude
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2 minutes ago, regentrude said:

Interestingly, when it comes to Covid infections, our university has consistently been doing much better than the general population in the area. Thanks to diligent focused students and aggressive contact tracing. It can be done. 

Yes! The local LAC is doing much better than the town.

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My kid's big 10 university is doing much, much better than that state too.  School's positivity is at 3% now (after being below 1% for quite a while).  State's positivity is 38%.  We could all be living in that world had leadership taken early action on widespread test and trace and educating people on latest best practices to prevent spread.   His school will move to everyone using campus facilities next semester will be tested twice a week.  I think it will be tied into student/employee ID cards and building access.

I'm afraid this scenario is just going to repeat itself over and over.  😞  

Edited by FuzzyCatz
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Our hospital has been running an expanded Covid unit for a while. I think there were originally set up for 40 patients - they've been running 60 to 75 for the last few weeks. My town is 75k people. When I went for my surgery follow up, my doctor noted they are cancelling elective surgeries. She didn't mention turning away trauma patients. We're one of the largest ERs in the area.

When I had my surgery a few weeks ago, my room was the last room before one of the Covid units, the giant wall divider was visible from my door. I was so glad to get out there after one night. 

Found out this week that one of my IRL friends had Covid, not hospitalized. Our town is full of deniers and we're under a mask order. I've been out once in 3 weeks and probably won't go out again until Thanksgiving. My mom and son are isolating too, so they've been a part of our bubble since the beginning. 

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My husband's high school is is closed down for three days for the second time since going back full time last month. Teachers still have to go in, even though it's supposedly closed for deep cleaning and contract tracing, both of which seem like reasons that NO ONE should be in the buildings. He was out sick for a couple of days last week (mild covid-ish symptoms, but he's better now and tested negative), and there were no subs for him. He taught online from home (while using up his sick days) while teachers from other departments took turns babysitting his students. Meanwhile all the kids in my neighborhood are running around in a pack constantly, their parents are posting pictures of them at indoor restaurants and birthday parties, and then putting them on the bus again every day to go to school. I have outrage fatigue. I started to get into it on the school district's facebook page the other day, then stopped because it's too exhausting and useless. They'll close schools again when they can't staff them anymore (which probably isn't far off) and not before. They don't care how many people get sick.

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They closed down an overflow site a couple of weeks ago and people cheered.  Then the next Wednesday, ICUs were full, ERs were taking the overflows and vents were occupied across the metro area.  It was better last week but it’s precarious and terrifying.   The problem I see is that General people are not aware of this happening so they keep on gathering.

Most of the schools in the area are going back to remote learning except the largest district, but I suspect they’ll be there soon.  

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1 hour ago, The Accidental Coach said:

@mlktwins Our schools are phasing in classes. K-2 began last week, 3-4 will be in buildings by the end of the month. I am shocked and dismayed with these decisions. Our cases are rising, hospitals are full, restaurants are back to outdoor dining/pick up only, more restrictions are being put in place, so let's send our children to school.

There are public schools where the students are learning at home virtually, the teachers are coming to school to teach from their classrooms, and they are bringing their children with them to be in daycare on campus. I haven't figured out how they think that's ok.

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3 hours ago, City Mouse said:

It is secretly official (I think the info will go public this morning) That hospitals in my state are full and will no longer take transfer patients of any kind from the rural/small town hospitals- not just Covid patients. That means we will likely start having an increase in deaths with multiple causes such as heart attacks and traumas which are cases that are usually automatically transferred to the larger hospitals. The closest out of state hospitals that previously took such patients are also full, so there is no where left to go. 
The slightly larger town nearest me that has a paid ambulance service is leaving an ambulance crew parked at the local nursing home so they are near when codes are called. 
While the rates of Covid infections and hospitalizations are in reading dramatically here like everywhere else, our state’s lack of medical facilities and personnel as become a big problem.

What state are you in?  Do they have a covid field hospital set up? 

 

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1 hour ago, The Accidental Coach said:

@mlktwins Our schools are phasing in classes. K-2 began last week, 3-4 will be in buildings by the end of the month. I am shocked and dismayed with these decisions. Our cases are rising, hospitals are full, restaurants are back to outdoor dining/pick up only, more restrictions are being put in place, so let's send our children to school.

Last week a nearby town was begging for substitute teachers at $150 a day for people with AA degrees. They are in dire straits due to teachers being out with + results or due to exposure. That school district announced they are going virtual as of this Wednesday because they can't staff the classes.

Our gov has been mostly good, but he seems to be getting a bit schizophrenic on the school thing.  We now have a curfew and stricter mask mandate, now with an actual fine ($300), but they'll give you a warning first.  

BUT - he still says everyone should be doing more in-person school, places that are full-remote should try hybrid, places that are hybrid should go full-in.  Say what?  Fortunately, most local places are more conservative than he's being.  The mayor of Boston is like, NOPE, we're staying remote.

What you say about staffing and subs is what I've been saying all along.  How did they not see this coming?  I've subbed in the past, but NO WAY am I going into a Covid-infected school (and if they need subs for people out with Covid, then that's a given...).  What you list is twice our normal going rate, but still, NOPE, nohow, not for a sum much larger than that...  And rando subs with rando AAs, people?  I mean, that's just warehousing.  If you're going to not bother to teach anything in-person, then remote teaching is actually better on many levels, not just safety.

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1 hour ago, elegantlion said:


When I had my surgery a few weeks ago, my room was the last room before one of the Covid units, the giant wall divider was visible from my door. I was so glad to get out there after one night. 

Found out this week that one of my IRL friends had Covid, not hospitalized. Our town is full of deniers and we're under a mask order. I've been out once in 3 weeks and probably won't go out again until Thanksgiving. My mom and son are isolating too, so they've been a part of our bubble since the beginning. 

My daughter is an ICU nurse in an area where there is a large spread of covid. She has mentioned that the hospital has not canceled "non essential" procedures yet, which is why her hospital is more full than it was in March/April when very few "elective" procedures were happening. She said that when the hospital says it is full, it is not just covid, but all of the usual things that fill the ICU beds.  She has heard that her hospital will likely start limiting other procedures in the next few weeks, but there is pushback from doctors. 

I think it is a fine line. Hospitals need to have enough beds open for covid patients but they also want to be able to provide other services to their community. Having a large open unit ready for a big influx of covid patients is not financially feasible for most hospitals - but it is possible to stop providing other services and open up beds pretty quickly if needed. 

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The hospital my ambulance primarily goes to(we’re private  and don’t work for it but it’s the closest facility and do their transfers) has no more Covid beds. The hospital itself isn’t full but they dedicated one floor to Covid beds and that is full. They’ll admit Covid patients to other floors but are not accepting Covid patients from other facilities.

The ICU is at 50% capacity which is actually somewhat lower than normal times.

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15 minutes ago, Splash1 said:

Our state of Colorado spent $$$$ setting up overflow/field hospital and it sat empty all summer so this fall they dismantled it all just in time for the surge.  Awesome.

We had three surge hospitals in the spring (one of the hardest hit areas back then).  One is now reopening; I don't think they need it yet but they can see it coming.  They didn't every fully break any of them down, just kind of put them on standby.  Not like other stuff was allowed to go on the stadiums...

And as others have said, the sticking point on capacity is qualified people to staff the beds, not physical beds or even equipment.  Saying 'but the rest of the hospital isn't full' is not really relevant.  With the virus raging everywhere in the country, it's not like you can just move people around, and when people with expertise get sick, you can't just sub someone random in.  Some of the stories coming out of El Paso are hair-raising, like that story about "The Pit" where patients were pretty much left to wait to die.  A nurse had to be in there 12 hrs/day, but the docs wouldn't even come in the door.  The nurse said she'd never seen a single patient leave that ward alive.  I heard Doctors without Borders was considering coming to the US to help out, since we're now the biggest disaster...

Edited by Matryoshka
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2 hours ago, WendyLady said:

My daughter is an ICU nurse in an area where there is a large spread of covid. She has mentioned that the hospital has not canceled "non essential" procedures yet, which is why her hospital is more full than it was in March/April when very few "elective" procedures were happening. She said that when the hospital says it is full, it is not just covid, but all of the usual things that fill the ICU beds.  She has heard that her hospital will likely start limiting other procedures in the next few weeks, but there is pushback from doctors. 

I think it is a fine line. Hospitals need to have enough beds open for covid patients but they also want to be able to provide other services to their community. Having a large open unit ready for a big influx of covid patients is not financially feasible for most hospitals - but it is possible to stop providing other services and open up beds pretty quickly if needed. 

It's not that simple/straightforward. Covid beds need to be separate from non-Covid beds and they require infectious disease protocols, set up and staffing.

Also, concerns about capacity during a Covid surge are usually about available ICU beds and staffing (for ICU &, to a lesser extent, non-ICU), not about the total # of empty beds a hospital has in rooms. Non-ICU beds and ICU beds are somewhat apples and oranges - just because there are non-ICU beds left open for other care/procedures does not necessarily mean that those beds can be made available to ICU patients. Staffing for ICU care - especially for highly infectious ICU care - is an enormous issue, as even 'regular' (non-infectious) ICU beds require much more intense staff-to-patient ratio, as well as trained staff. Isolation from other hospital beds and other parts of the hospital, especially during a pandemic, is also an issue for trying to expand ICUs.... Cleaning protocols/procedures, waste disposal, food delivery, etc are just a few of the many  things that must be done differently.

Edited by Happy2BaMom
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I talked with my 78 year old mom this morning and when we talked about Thanksgiving and Christmas she started crying. They won't be coming to our house for either for the first time in decades. Right after that I saw a post on Facebook from an aunt that said to refuse a shutdown, get together with family anyway and "if you refuse to live your life because you're afraid you might die then you have already died." 😠 No, I'm not refusing to live my life, but I AM refusing to spread a disease that's deadly to a number of people, including people I care about.

My sister works for a hospital near my parents and she says it's really bad right now and the hospital is full. They have canceled all non-elective procedures. One of the hospitals in that area closed two years ago, so they're down one large hospital and it was the hospital that admitted all the people from the surrounding rural areas.

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4 minutes ago, BlsdMama said:

The problem is staff shortage over beds. 
 

https://dailyiowan.com/2020/11/15/with-cases-rising-university-of-iowa-officials-warn-iowa-hospitals-will-soon-be-overwhelmed/

 

I genuinely have respect for our governor but it’s high time to make meaningful changes because no one I know plans on changing their behaviors. 

I don't think our numbers are the same magnitude per population here as yours (I haven't checked to be honest) but our hospital officials are warning of the same thing here. We are going to run out of healthy workers before we run out of beds.   

I just don't know that the governor here is going to be successful in getting people to change their attitude. There is a total lack of understanding about the fact that their choices affect others in the community.  I have seen "Don't shut us down. Let us live our lives. Protect the vulnerable," but I don't think people have thought that through. So, all the people in healthcare from nurses to sanitatation workers need to lock down and not have a life so that you can go out and have a huge Thanksgiving? It's like they think that the only people that would need to isolate are the very old, but they ignore that the people in the nursing homes are locked down and they are still getting COVID from the staff that live outside the home.  When there is community spread like this, that just happens. And, when Uncle Ned has a heart attack and needs to use the hospital and it is too full, will you still be yelling, "Don't shut us down. Let us live our lives. Protect the vulnerable"? I know I am preaching to the choir here, but it just makes me so, so sad. 

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12 minutes ago, BlsdMama said:

I genuinely have respect for our governor but it’s high time to make meaningful changes because no one I know plans on changing their behaviors. 

That's because leadership matters immensely when significant change is needed, especially rapid change. Choosing not to lead during a crisis results in people doing whatever the h*ll they want.

It's not easy to mask up if you live in an area where there is a lot of social pressure against (& even mockery of) them. But when a governor (et al) chooses to lead and assume the role of "bad guy" with some hard lines (whether that's a mask mandate for the state, or just in certain areas, etc), then many more people will mask up, all while b*tching about the ridiculous governor who's a wanna-be-Hitler.

Although, in our governors' defense, it's become quite apparent that many Americans are perfectly willing to accept tens of thousands of additional excess deaths, as long as they personally retain the right to not wear a paper mask in public. Which makes it much harder to be a leader.

I do think there will be some softening among the undecideds as the hospitals fill up and stories of the ill and dead proliferate. (El Paso, for instance, has had to put 10 mobile morgues in place.)

 

Edited by Happy2BaMom
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My DH’s cousin just posted that her family has covid again- positive tests both now and in the spring. Her DH is much sicker this time. He went to the hospital yesterday but was sent home. It’s pretty scary- herd immunity isn’t going to work. Does anyone know if vaccine induced immunity should last longer? 
 

My parents are older and we want to see them but they won’t stop socializing!

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re universities managing to contain spread better than the communities they're in

23 hours ago, FuzzyCatz said:

My kid's big 10 university is doing much, much better than that state too.  School's positivity is at 3% now (after being below 1% for quite a while).  State's positivity is 38%.  We could all be living in that world had leadership taken early action on widespread test and trace and educating people on latest best practices to prevent spread.   His school will move to everyone using campus facilities next semester will be tested twice a week.  I think it will be tied into student/employee ID cards and building access.

I'm afraid this scenario is just going to repeat itself over and over.  😞  

 

22 hours ago, YaelAldrich said:

My husband's school is doing an absolutely terrific job.  If you have the desire, money, and capability (and punishments!), this can be done.  https://news.northeastern.edu/coronavirus/reopening/testing-dashboard/

It's possible.  If the will is there.

My son's university has managed to keep positivity below 3% in a part of PA where it's surging. Mandatory testing, mandatory quarantining of anyone positive, mandatory masking on every inch of campus including outdoor spaces, non-complying kids sent home immediately, one well-communicated instance of a tenured faculty was put on unpaid leave for the remainder of the year for not masking while with students.

My nearly-grown kids' attitude toward school has transformed. They (rightly) see the opportunity for IRL classes and IRL contact (albeit masked and spaced) with their peers as a privilege, a priceless gift for which they are deeply appreciative.  They know it is contingent on continued containment. They know their schools will shut down and close campus if they and everyone else don't do what it takes to make it work. They really really want to make it work.  They are *very happy* to mask up and space out and eat a lot of takeout meals outside with lots of layers on... to make it work.  Of course it's a bummer: but it is worth it to stay open.

If the wider population could take cues from the maturity and realism that their schools' leadership is promulgating, and their school communities are accepting as necessary to make it work, everyone would be better off.

 

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21 minutes ago, Paige said:

My DH’s cousin just posted that her family has covid again- positive tests both now and in the spring. Her DH is much sicker this time. He went to the hospital yesterday but was sent home. It’s pretty scary- herd immunity isn’t going to work. Does anyone know if vaccine induced immunity should last longer? 
 

My parents are older and we want to see them but they won’t stop socializing!

I have a friend who works for a company who is working on a vaccine. I can never remember which one due to lingering chemo brain. She told me that they think it will be like a flu shot that you get every quarter rather than every year. So when you get it, they would give you an appointment card to come back in 3 months.

She also said that they were working on a treatment for people with severe COVID. It has to be given over 5 days in an IV, so that means people have to stay in the hospital, but her company is trying to put the drug into an inhaler so that patients can take it home and free up hospital beds. She believes that the combination is really going to turn the tide. 

 

 

 

 

 

 

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On 11/16/2020 at 5:45 PM, Ellie said:

There are public schools where the students are learning at home virtually, the teachers are coming to school to teach from their classrooms, and they are bringing their children with them to be in daycare on campus. I haven't figured out how they think that's ok.

I'm assuming that's a risk reduction measure to make sure teaching can happen while minimising the amount of risk that's taken (since the only people who can get it from each other are people who came in). It's riskier than having everyone work from home, but if there are teachers whose homes would not permit work-from-home, and the school doesn't think teaching by email is an option (one of my local schools is doing this as a low-tech solution, even though it's currently also offering face-to-face teaching to the extent petmitted). Locally, no positive cases of students are being reported in schools, though the picture nationally indicates it's happening a lot. It is not clear what is being done differently here that's causing the effect.

There are quite a lot of COVID-19 vaccines in development, with different delivery mechanisms and requirements, of which 10 have done some sort of Phase 3 testing. I'm cautiously optimistic there's going to be a solution (and "a shot in every 3 months" is worth it if it keeps COVID at bay). We just need to get there... *glares at people taking silly risks*

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On 11/16/2020 at 12:15 PM, Ottakee said:

The biggest issue in our area is staffing.  They can open up overflow areas, have equipment, but they need the trained staff in order to run the units

It will be the same everywhere.  To expand hospital capacity one needs three main things:  Space, Stuff and Staff.  Space is easy, especially in a a pandemic when so many public gathering spaces are going unused.  Stuff is also rarely the limiting factor and usually just a matter of spending money  (though we saw difficulties with limited PPE and limited vents early in the pandemic, so sometime stuff is the limiting factor in the short term.   But supply chains are remediable in the medium term, and those shortages have mostly been addressed.). Staff is always the hardest to manage, and will be even harder this time (as compared to in the spring):  Both because there are limited numbers of qualified staff (and the absolute number of staff required nation-wide will be greater this time as there are so many more sick covid patients in so many more places than in spring -  deploying staff from unaffected areas is less of an option), and because of human factors - sick calls go up when people are stressed,  staff good-will is eroded (staff are suffering from pandemic fatigue and are good and tired of feeling used/abused by the rest of society.  Irresponsible behaviour, anti-masking rhetoric, provocative social media posts by both the public and certain prominent politicians feel like a daily slap in the face), staff with risk factors are reconsidering career options and transferring into lower risk roles or retiring.  And of course, we lose staff for the obvious increase in staff covid cases and staff in quarantine.

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On 11/17/2020 at 8:09 AM, Amy Gen said:

I have a friend who works for a company who is working on a vaccine. I can never remember which one due to lingering chemo brain. She told me that they think it will be like a flu shot that you get every quarter rather than every year. So when you get it, they would give you an appointment card to come back in 3 months.

She also said that they were working on a treatment for people with severe COVID. It has to be given over 5 days in an IV, so that means people have to stay in the hospital, but her company is trying to put the drug into an inhaler so that patients can take it home and free up hospital beds. She believes that the combination is really going to turn the tide. 

 

 

 

 

 

 

Every quarter?! 😮

That’s going to be a hard sell for the public. 

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2 minutes ago, sassenach said:

Every quarter?! 😮

That’s going to be a hard sell for the public. 

I can’t check right now, but one of the articles I read on one of the promising vaccines was an initial vaccine, then two weeks, then at 3 months.  Everything I’ve read has been clear this would provide boosters.

I have read a lot on immunity and it’s all over the place. Some say 3-7 months and some articles are insistent it’s years.  I think 3-7 months, in line with other corona viruses, is most likely. The vaccine will definitely not be a one and done.

I frankly think the vaccine will be a very hard sell to the public anyway. Even the non-crunchy, fully vaccinated people I know are saying they won’t get it until there’s more research.  And similar to other 3 or more part shorts, the compliance rate with all 3 is likely to be low.

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NYT had new info out about long term immunity being more hopeful, we'll see how the data rolls out.  I do think with the vaccine data rolling out and this type of info rolling out, we have reason to be optimistic.  Before general public starts getting vaxed we'll have 6+ more months of data and deaths to watch.  

https://www.nytimes.com/2020/11/17/health/coronavirus-immunity.html

The hill says vaccine willingness is up over a month ago, we'll see.  I do think when medical professionals are widely getting it and it still looks good more people will be willing.  If immunity is holding reasonably well in many people who've had it, we may not need to get quite as much compliance to get numbers down.  I don't think it's wrong people are skeptical.  We should all be following the science and data closely.   

https://thehill.com/policy/healthcare/526266-americans-willingness-to-get-covid-19-vaccine-rises-gallup?fbclid=IwAR0WyRq4o1iahNSdBj7P-QnhNFo4LFddNcpdg2tLfFel-YpxXUZ-XIkh5Nk

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On 11/17/2020 at 7:41 AM, Paige said:

My DH’s cousin just posted that her family has covid again- positive tests both now and in the spring. Her DH is much sicker this time. He went to the hospital yesterday but was sent home. It’s pretty scary- herd immunity isn’t going to work. Does anyone know if vaccine induced immunity should last longer? 
 

Like Fuzzycatz just shared, there was news yesterday suggesting immunity lasts far longer than thought—years to decades—but that’s clearly not matching your family experience. Impossible to know if they are just unlucky outliers (like people who get chicken pox twice) or if this new research won’t hold up. 

It is expected immunity via the vaccine will last longer than natural immunity with this virus, but again, it’s too soon to know that for sure. I haven’t heard of any three shot series yet myself. The ones I’m aware of are all one or two shots (I believe two is the most common, but don’t quote me on that—I will look it up). The vaccine results coming in are tremendously encouraging to me though. It looks like such high efficacy is going to be essential since there are a bunch of people unwilling to contribute to herd immunity via vaccination. 

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40 minutes ago, kand said:

Like Fuzzycatz just shared, there was news yesterday suggesting immunity lasts far longer than thought—years to decades—but that’s clearly not matching your family experience. Impossible to know if they are just unlucky outliers (like people who get chicken pox twice) or if this new research won’t hold up. 

 

I keep seeing people say that no, immunity really does last, but I've reached a point where I am skeptical. I don't believe it- I'm not usually one for conspiracy theories, but we're less than a year into this, it's only now spreading rapidly everywhere, and already so many people seem to have had it more than once. It feels like disinformation to prevent panic. Or maybe that is the damage that the leadership of this admin has done- now nobody believes anything even when we should. 

Would it make sense that the entire family of 4 were an unlucky outliers? The husband and wife don't share genetics. Coronaviruses aren't known for their lasting immunity either.

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30 minutes ago, kand said:

Like Fuzzycatz just shared, there was news yesterday suggesting immunity lasts far longer than thought—years to decades—but that’s clearly not matching your family experience. Impossible to know if they are just unlucky outliers (like people who get chicken pox twice) or if this new research won’t hold up. 

It is expected immunity via the vaccine will last longer than natural immunity with this virus, but again, it’s too soon to know that for sure. I haven’t heard of any three shot series yet myself. The ones I’m aware of are all one or two shots (I believe two is the most common, but don’t quote me on that—I will look it up). The vaccine results coming in are tremendously encouraging to me though. It looks like such high efficacy is going to be essential since there are a bunch of people unwilling to contribute to herd immunity via vaccination. 

That is what the trial results of both the Pfizer and Moderna vaccines seem to have indicated -- both of which use (new) messenger RNA technology: that immunity from getting the virus does not last as long as getting the vaccine.  But it's too soon to know for sure. 

Both of those are expected to require 2 shots about ~3 weeks apart.  (Pfizer released end-Phase III results today and expects to file for emergency use in the US tomorrow; here's their press release that specifies two doses; and here is Moderna's press release of its interim results released last week, that also specifies 2 doses.)

 

 

 

 

 

 

{Personally, as an aside: if I had to get jabbed 4x/year, and my mother also had to get jabbed 4x a year, for us to be able to see each other, we both happily would do so. If that's what it took we both would do it.

That is a private accommodation, though -- not a public health solution that allows the country as a whole to get back to normal.  For tourist sites, baseball games, movie theaters, restaurants, airline industry etc etc etc to get back to normal, there needs to be a public health solution, not just individual families making individual accommodations to see each other inside one another's houses.}

 

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49 minutes ago, Pam in CT said:

That is what the trial results of both the Pfizer and Moderna vaccines seem to have indicated -- both of which use (new) messenger RNA technology: that immunity from getting the virus does not last as long as getting the vaccine.  But it's too soon to know for sure. 

Both of those are expected to require 2 shots about ~3 weeks apart.  (Pfizer released end-Phase III results today and expects to file for emergency use in the US tomorrow; here's their press release that specifies two doses; and here is Moderna's press release of its interim results released last week, that also specifies 2 doses.)

 

 

 

 

 

 

{Personally, as an aside: if I had to get jabbed 4x/year, and my mother also had to get jabbed 4x a year, for us to be able to see each other, we both happily would do so. If that's what it took we both would do it.

That is a private accommodation, though -- not a public health solution that allows the country as a whole to get back to normal.  For tourist sites, baseball games, movie theaters, restaurants, airline industry etc etc etc to get back to normal, there needs to be a public health solution, not just individual families making individual accommodations to see each other inside one another's houses.}

 

Yes, there needs to be a public health solution.  And public health solutions work best when they are top down and don't involve individual choice (ie water treatment and sewage treatment, for example, or passive systems like airbags in cars.)  Next most effective are coercive measures (ie laws with teeth like highway traffic laws, or seatbelt laws that cause  poor individual choices to have unpleasant individual consequences).  Then incentive (pay people or give tax breaks/insurance discounts).  Relying on people to do the right thing out of the goodness of their hearts because the authorities say they should, even when it's hard, and especially when doing the right thing might worsen personal hardship, is, of course the least effective type of public health measure.  (Add in public squabbles and intentional pot-stirring for political gain by leaders, and rapidly changing and sometimes inconsistent public health guidelines - because this virus is new, and science is necessarily somewhat slow and messy - and you have an even bigger challenge.)    But America is all about personal choice aka "freedom".  Anything else is "government over-reach".  Hence the current state of affairs.

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In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up to the local government to do that. He is a spineless idiot who has shown no leadership during this time. I can’t tell you how much I despise him. Our local officials got so much pushback during the initial lockdown that I can not imagine them having the guts to do anything. I feel like we are just alone and no one is going to do anything to help us. I have never experienced anything like this in my 30+ years as a nurse.

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3 hours ago, Mrs Tiggywinkle said:

I can’t check right now, but one of the articles I read on one of the promising vaccines was an initial vaccine, then two weeks, then at 3 months.  Everything I’ve read has been clear this would provide boosters.

I have read a lot on immunity and it’s all over the place. Some say 3-7 months and some articles are insistent it’s years.  I think 3-7 months, in line with other corona viruses, is most likely. The vaccine will definitely not be a one and done.

I frankly think the vaccine will be a very hard sell to the public anyway. Even the non-crunchy, fully vaccinated people I know are saying they won’t get it until there’s more research.  And similar to other 3 or more part shorts, the compliance rate with all 3 is likely to be low.

I would be ok with an initial series, and then yearly. Every 6 months I would tolerate for awhile. Every 3 months is not a good plan.

I think there is just going to be a segment of people who won't be given a choice (HCWs, teachers, anyone going into an institutional setting like college or jail), they will study those groups for long term effects. I don't think I'll have a choice.

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14 minutes ago, TCB said:

In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up to the local government to do that. He is a spineless idiot who has shown no leadership during this time. I can’t tell you how much I despise him. Our local officials got so much pushback during the initial lockdown that I can not imagine them having the guts to do anything. I feel like we are just alone and no one is going to do anything to help us. I have never experienced anything like this in my 30+ years as a nurse.

I hear you loud and clear (and my area is nowhere near those levels yet).  HCW are burning out, and there won't be anyone left to replace them.  That will be a real disaster.  ETA it's already a real distaster of course.  It will become an even worse disaster, catastrophe, other noun of your choice for terrible terribleness.

Edited by wathe
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There's a nurse in South Dakota who has been all over the news after tweeting that the situation in her hospital is like a "horror movie that never ends." In interviews she says that the nurses and doctors are so depressed and demoralized by what they are seeing, so many people are still in denial even as they are literally dying of covid — people refusing to call their families to say goodbye because they insist they just have flu and will be fine, patients yelling at staff for wearing all that stupid PPE for no reason since covid doesn't exist, patients whose last words are "this can't be happening, it isn't real." 😥

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re exhaustion and horror of overwhelmed health care workers

27 minutes ago, TCB said:

In the ICU where I work 75% of the beds are now taken by Covid patients. We are all exhausted already and I think it is going to get worse. Our governor refuses to make any mandates and says it is up to the local government to do that. He is a spineless idiot who has shown no leadership during this time. I can’t tell you how much I despise him. Our local officials got so much pushback during the initial lockdown that I can not imagine them having the guts to do anything. I feel like we are just alone and no one is going to do anything to help us. I have never experienced anything like this in my 30+ years as a nurse.

I am so terribly sorry.

Thank you for your service.

(And I'm sorry as well that that phrase is so overworn as to veer into trite-ness. I truly mean it.)

 

re the magnification of that horror by patients' furious disbelief that COVID is "real"

11 minutes ago, Corraleno said:

There's a nurse in South Dakota who has been all over the news after tweeting that the situation in her hospital is like a "horror movie that never ends." In interviews she says that the nurses and doctors are so depressed and demoralized by what they are seeing, so many people are still in denial even as they are literally dying of covid — people refusing to call their families to say goodbye because they insist they just have flu and will be fine, patients yelling at staff for wearing all that stupid PPE for no reason since covid doesn't exist, patients whose last words are "this can't be happening, it isn't real." 😥

This is so awful.

Even back in March and April, when hospitals here were desperately overwhelmed and health care workers were exhausted and horrified and -- this was back in the days of wholly inadequate PPE -- terrified about themselves carrying COVID back to their own families...

... they didn't have to deal with patient denial and fury, at least. It was deadly serious and folks understood it to be deadly serious. 

I truly can't even imagine, plodding on trying to save lives in the face of that.

 

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