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Good morning from ground zero...

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  • Good morning from ground zero...

    We are doing ok here at ground zero. We have enough vents for now. We have enough beds. We have enough PPE, but I wake up at night worrying about our front lines and lack of sufficient PPE if this gets way out of control. We track PPE burn rates and our in-stock supply count daily. We got gouged by a vendor charging $10/N-95 instead of our usual $1 per mask. COVID test results are often delayed, best is 1 day, worst is 4 days and counting. We make clinical diagnoses based on history and imaging. Like 3rd world medicine as far as viral testing, except we have high resolution CT images.

    We have emergency preparedness meetings daily. We make contingency plans. Where to put overflow ICU patients if needed? We have extra vents lined up. And the ORs have extra vents as well. Where to put moderate pneumonia patients if the hospital were to get to 150% census? Almost all visitors are banned from hospital and ED. Tent outside is set up for screening away from other patients. Hospital lobby and waiting rooms are closed. Waiting room is in your personal vehicle if you have one. You get called on your cell phone when it is your turn to be seen. And so forth.

    The docs and nurses are gladiators, amazing dedication, but there is underlying fear as the data from China on the age prevalence doesn't seem completely accurate. Or maybe the virus has mutated. There are cases of younger adults who are quite sick with severe pneumonia.

    Please stay safe and protect yourself. I hope that many in our community are able to stay home. For every person who doesn't get sick now, we will save lives. Flatten the curve and this will be ok. Or continue life as usual and allow for a big acute illness peak and this will be very ugly with many excess deaths. Like in Italy. What a tragedy to be in the position of playing God, to have to extubate a senior citizen to save a younger patient by providing an otherwise unavailable ventilator.

    Remember the battle cry, "Flatten the Curve!" Yes, flatten the curve. Encourage everyone you meet to flatten the curve. We are the docs, the voices of reason and authority in our communities. Speak up, please!
    Click image for larger version

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  • #2
    Hello WB,
    That’s great to hear from you.
    Keep well old friend.
    Hopefully the curve is flattened.
    Look after yourself and stay alive.

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    • #3
      Thank you for the update. You and your patients are in my thoughts and prayers. Like Dont_know_mind said please take care of yourself also.

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      • #4
        Appreciate the update WB. Stay safe and take care.

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        • #5
          Stay safe. Protect yourself. Do not end up ona vent.

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          • #6
            White Beard Doc, how's it going with the PPE? Assuming you do have a beard, have you had to wear a CAPR system when treating patients or just N-95? Our facility wouldn't even fit test those with beards when the testing was done in the past because of the leaking caused by facial hair.

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            • #7
              as an outpatient doc, should i be turning away non essential procedures and patients to do my part?

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              • #8
                Originally posted by MoneyMoth View Post
                as an outpatient doc, should i be turning away non essential procedures and patients to do my part?
                Elective medical care should be on hold in areas of outbreaks.

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                • #9
                  Originally posted by FunkDoc83 View Post
                  White Beard Doc, how's it going with the PPE? Assuming you do have a beard, have you had to wear a CAPR system when treating patients or just N-95? Our facility wouldn't even fit test those with beards when the testing was done in the past because of the leaking caused by facial hair.
                  My beard is trimmed very short. I passed fit testing with a good seal. Of course, the official recommendation is to shave it all off.

                  So far no fever, no chills, no cough. All good.

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                  • #10
                    Originally posted by White.Beard.Doc View Post

                    Elective medical care should be on hold in areas of outbreaks.
                    I totally agree, and I wish more of the leaders on this issue would say so. Knee scopes, screening colons and mammos, yearly Echos and MPIs, etc. can wait until the current crisis passes.

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                    • #11
                      Actually, China saw deaths of young adults as well.

                      https://www.nytimes.com/interactive/...gtype=Homepage


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                      • #12
                        Where is ground zero?

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                        • #13
                          Originally posted by White.Beard.Doc View Post

                          Elective medical care should be on hold in areas of outbreaks.
                          thanks for the quick reply

                          should i be pushing my admin team to hold elective medical care even pre-outbreak?

                          We only have scattered cases in our area but we are also not testing. Would it make sense to try to “pre-emptively” flatten the curve by asking people to stay home and not mingle in our clinic?

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                          • #14
                            Should pediatricians still be doing yearly physicals?

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                            • #15
                              Actually this is ground zero

                              https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4797993/

                              Gotta do something about it. Kills the bats / stop eating exotic animals. Not sure. Next year: Super-Covid 20

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