astonishing how many people in the world have been thinking of this as a hoax and an annoyance simply because they're not in the advertised 'high risk over 60 with other medical problems' group.
it doesn't matter whether you're in that group or not, you can still get the virus and get very sick from it. will it kill you? i don't know, probably not. but that doesn't mean that your survival didn't occur without the expenditure of extensive human and medical resources to make sure you're alive.
i can guarantee you all of the people downplaying the virus have never had to deal with the physical and mental stress of trying to stabilize a patient in respiratory compromise with their body literally shutting down in front of you. it's not fun, it's hard, it's stressful, it sucks
people who are hospitalized with the virus, survive, and make it out don't become one of the death statistics. fine. but it doesn't recount the severity of their condition if they were hospitalized in the ICU and required stabilization with high flow nasal cannula, bipap, or venting, or how bad their ABG or respiratory status looked like for a time even despite the use of high level supportive equipment, which is in finite quantity
all of this has a substantial effect on the healthcare delivery system. there are people other than coronavirus patients needing hospitalization requiring providers, meds, and some of this supportive equipment. if the outbreak becomes bad enough to the point that these hospitals cannot provide care due to the sheer number of cases they have to deal with, it's not just the coronavirus patients that suffer, it's all patients that suffer. i cannot stress this enough. i cannot comment on the economic ramifications of the shutdown on the financial security of many people across the country as it is not my arena, and i can only imagine that many people are going to lose their businesses, savings etc and how hard that's going to be. but my immediate thought is that at least they'll be alive to see it through, whether good or bad. with the coronavirus, too many people have the potential to die NOW, and not just those with the coronavirus.
even having to use something like high flow or bipap to stabilize a patient has insane consequences. these machines freaking aerosolize every freaking thing that patient has and any coronavirus patient that needs these things to survive has the chance to infect anybody in the room present with them at that time
like DCM already mentioned, some hospitals are switching to systems during rapids and codes where only 1-2 people enter the room to try and mitigate the spread of infecting an entire room of 15-20 providers helping a crashing patient. having been in these rooms many times i can tell you that often that amount of manpower is needed to try and help stabilize the patient. if the patient does not have access to that help because of this virus, that patient is dying
vents are technically closed circuits so the risk of aerosolizing is not as much of an issue, but vents are in limited quantity. already some hospitals in NY are running out of vents, hospitals in america are finding ways to macguyver this excrement and use one vent to ventilate and share between multiple infected patients which seems freaking unreal, other places are talking about intubating a patient and protecting their airway, without a hooked up 'vent', and having med students take shifts ventilating and oxygenating the patient manually with bag-valve masks as a contingency once the vents run out.
anesthesiologists who are exposed to these patients during the intubation process are exposed to every freaking thing in that patients mouth and are dropping left and right from being infected during this process. quarantining healthcare workers becomes an issue when you need man power to help care for some of these critically ill patients. calling in orthopedists, radiologists, dermatologists to try to manage a critically ill patient on a freaking vent which is something they are literally not trained to do is obviously not an ideal situation, but it's happened in some places, and it's what we're trying to prevent.
i have friends at NY programs who have been hit pretty hard and it sounds horrible. even if tested positive, some of these programs are telling their employees to come in if they feel 'well' enough to work because the situation there has literally gotten 'all hands on deck'. my hospital has not reached that level yet but it's going to within the next couple of weeks. i was already working 60-80 hour weeks on the regular on a fixed salary, and have actually been scheduled to come in for MORE, not less shifts, during this time because of how bad this thing is going to get. hospitals during this time of year and the colder months are already near close to full capacity without a global pandemic in the backdrop. i'm going to get the virus, and i fully expect to be told to come in if i feel well enough to work. when it gets really bad, i don't think hospital networks will make a big deal about testing their employees to confirm whether they have it or not, if manpower is needed. what's the point? and on top of this, we still don't have enough available tests or tests that come back
the hospital environment during this time is tense. people are scared, people are worried, people are being extra cautious. i've seen work stations being completely wiped down by one person after another person has finished using them, in another time this may seem completely freaking over the top but no offense is obviously being taken. i know of a few people that have had a hard time dealing with the stress/anxiety of all this stuff, but it's whatever. we need to come in
