Medical Discussion of Coronavirus

[Jaqen Haghar MD]

Our clinics are being overrun with omni, curious are hospitals being overrun yet(again)? How about mortality? Or are the vaccines the seatbelts we were all hoping for?

We are back to having new, record daily ED volumes. Every day is a new all-time volume record. Tons of COVID, but again, another shift and I haven’t admitted one during this new wave. The hospital is consistently adding COVID patients, but not close to the August delta surge admission numbers. We have about 1/4th to 1/5th of those COVID inpatient totals…. So far. Hopefully that holds.

[StarTrekDoc]

Yeah, we almost hit 6k for the county today. That's double our peaks and kind of surprised me.

We're seeing a bump in admissions now, but certainly not the rate of increase with the surge, but daily covid census is rising and skewing more unvaccinated even further.

Breakthroughs primarily with unboosted, but boosted also popping positive mostly with asx/common cold level symptoms.

The hard part is nursing impacts rising too and with rising census, putting a squeeze on things. Shifting to non-F2F again already for outpatient. No impact on surgical schedules yet.

[doctorbone]

We are back to having new, record daily ED volumes. Every day is a new all-time volume record. Tons of COVID, but again, another shift and I haven’t admitted one during this new wave. The hospital is consistently adding COVID patients, but not close to the August delta surge admission numbers. We have about 1/4th to 1/5th of those COVID inpatient totals…. So far. Hopefully that holds.

Do you guys have a fast track area in the ER for the Covid patients? Do you do any other work up besides the Covid test? What’s your PPE protocol? Stay well and happy new year!

[Tim]

We need a new game show for entertainment: CDC Says:

https://mobile.twitter.com/search?q=%23cdc%20recommends&src=typed_query

[Jaqen Haghar MD]

Do you guys have a fast track area in the ER for the Covid patients? Do you do any other work up besides the Covid test? What’s your PPE protocol? Stay well and happy new year!

We have a fast track area, but they end up all over, wherever there is a spot. Work up varies based on presentation, some need work ups, but it’s always nice to get slam dunk well-walkers….. quick pep-talk and exam… swab and immediate discharge. They check the results online. It’s common for people to present with just abdominal pain or chest pain that turns out to be COVID, or have all kinds of various symptoms that turn out to be COVID.

We probably have a PPE protocol on paper, but after 2 years, everyone pretty much does what they are comfortable with. Administration doesn’t mess with us too much. I wear an N95 and gloves. Some people wear industrial masks, some who’ve already had COVID just wear a surgical mask. You can wear a gas mask or scuba gear if you want, but you have to be able to move all day… and fast…. So I travel light.

[snowcanyon]

We have a fast track area, but they end up all over, wherever there is a spot. Work up varies based on presentation, some need work ups, but it’s always nice to get slam dunk well-walkers….. quick pep-talk and exam… swab and immediate discharge. They check the results online. It’s common for people to present with just abdominal pain or chest pain that turns out to be COVID, or have all kinds of various symptoms that turn out to be COVID.

We probably have a PPE protocol on paper, but after 2 years, everyone pretty much does what they are comfortable with. Administration doesn’t mess with us too much. I wear an N95 and gloves. Some people wear industrial masks, some who’ve already had COVID just wear a surgical mask. You can wear a gas mask or scuba gear if you want, but you have to be able to move all day… and fast…. So I travel light.

Ugh, you are lucky. They discourage us from wearing N-95s.

[StarTrekDoc]

Ugh, you are lucky. They discourage us from wearing N-95s.

Your body. Your choice.

[Tim]

Well, monoclonals are being prioritized. Welcome to a state health departments setting the prioritization based upon race. It is not "official policy" to use race as a reason to deny treatment,
"Non-white race or Hispanic/Latino ethnicity should be considered a risk factor, as longstanding systemic health and social
inequities have contributed to an increased risk of severe illness and death from COVID-19".

https://coronavirus.health.ny.gov/system/files/documents/2021/12/prioritization_of_mabs_during_resource_shortages_20211229.pdf

I received this as a text when I was assisting a relative in San Diego. I immediately dismissed it as "disinformation". In San Diego, only 27 slots are available per day. With 6000 new patients testing positive per day, the need to for prioritizing is obvious. The official position is "whites" need not apply in New York.
@Lordosis , the unconscious bias or bias discussions no longer matter. Racial bias is the "official policy" of the state of New York.Department of Health is promoting racism. No other way to state it.I have no idea what the other states are doing, the "woke culture" is disgusting.

[CordMcNally]

We are back to having new, record daily ED volumes. Every day is a new all-time volume record. Tons of COVID, but again, another shift and I haven’t admitted one during this new wave. The hospital is consistently adding COVID patients, but not close to the August delta surge admission numbers. We have about 1/4th to 1/5th of those COVID inpatient totals…. So far. Hopefully that holds.

What's your LWBS rate look like? Ours is terrible and higher than we ever thought possible.

[triad]

Ugh, you are lucky. They discourage us from wearing N-95s.

what?! for what possible reason.

[pulmdoc]

I like anything that skews unvaxxed, I guess!
Any commonalities of the vaxxed admits/ICU players?

Old. Right now we are slowly climbing in the ICU; there is an explosion of outpatients (urgent cares out of test kits, fun!) which means next week will be the proof of how bad its going to get. Unvaccinated in ICU are all 20-55 obese, dying; the one vaccinated pt is 85 and already improving after a few days on high flow O2.

[Jaqen Haghar MD]

What's your LWBS rate look like? Ours is terrible and higher than we ever thought possible.

Our normal LWBS is basically undetectable and a patient in the waiting room for an hour would be a national emergency. But these days, people are motivated and will stick it out for 2+ hours to be seen. A bunch have bolted the past 2 weeks though. Will find out how many in our January meeting.

[Jaqen Haghar MD]

Ugh, you are lucky. They discourage us from wearing N-95s.

F-that. I’m not Covid paranoid and I’m no PPE role model, but I’d be pretty clear that if anyone is telling any staff to minimize PPE use, they’d better get out from under their desk and get their azz in those rooms with a tissue on their face and start wiping noses and buttholes themselves then. Stay the f-off the front lines, and I’ll stay away from your pencil sharpener and pie charts.

[StarTrekDoc]

Just watched 'don't look up' on Netflix. Such dark satire for our times. Today's Animal Farm for sure.

[burritos]

Old. Right now we are slowly climbing in the ICU; there is an explosion of outpatients (urgent cares out of test kits, fun!) which means next week will be the proof of how bad its going to get. Unvaccinated in ICU are all 20-55 obese, dying; the one vaccinated pt is 85 and already improving after a few days on high flow O2.

Once someone gets intubated, what percentage of people are extubated successfully in your experience?