Texas governor to residents: "The safest place for you is at your home" due Covid-19 spike

A Hit With The Ladies, BSN, RN · Jun 25, 2020

2 minutes ago, Wuzzie said:
What is your basis for saying this is happening at all. It certainly isn't happening at any hospital that my nurse friends work at.

This entire thread is about hospitals in Texas filling up with Coronapositive people...

But anyway, I think the governor made a big mistake by halting elective surgeries in my county and the other big metro areas here. Hospitals need revenue to keep functioning. This is why firm boundaries are so so important. The hospitals really ought to keep those beds held for the elective surgeries. And they need to block off certain beds, such as in surgical ICUs, for emergent conditions that may arise from post-operative patients. Under no circumstance should that bed be filled, nor should it be staffed, for a COVID-positive person. This is exactly like the airplanes telling you to put the bag mask on yourself first before you try to help someone else out. The hospitals cannot spend on caring for Coronapositive people if they are hemorrhaging cash elsewhere. The world doesn't revolve around Corona and it should not. Be firm!

allnurses Guide · Jun 25, 2020

1 hour ago, A Hit With The Ladies said:
https://www.wsj.com/articles/texas-orders-some-hospitals-to-halt-surgeries-amid-coronavirus-outbreak-11593099383?mod=hp_lead_pos3
It would be a lot better to ensure that anyone and everyone with a COVID-diagnosis doesn't get to clog up a hospital bed for weeks on end. Hopefully the hospital administrators will be much more effective in discharging COVID people who aren't crashing home, while only putting those who are genuinely in poor shape in the ICU. Be fair but assertive here. Say, "I'm sorry, there's no cure for Coronavirus. We can give you some steroids to take every day but you need to stay home. Unless you are having trouble breathing there's really not much we can do for you. Here are your discharge papers."

We aren’t keeping anyone who doesn’t need hospital level support and we discharge as soon as it’s safe! If they have other issues and covid settles down, as soon as it’s safe they are transferred to a different unit. Where are you getting your information??

toomuchbaloney · Jun 25, 2020

https://www.nejm.org/doi/full/10.1056/NEJMsr2019953

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As economic and political pressure has built to relax “shelter in place” public health orders for control of coronavirus disease 2019 (Covid-19), industry, professional service firms, retail and service establishments, and educational institutions seek to establish norms that protect workers, customers, clients, students, and visitors. A public health order represents a minimum disease-prevention standard, adherence to which is not elective, but may not satisfy all legal requirements with respect to the personal safety of workers and others.1 The “general duty” clause of the Occupational Safety and Health Act requires all employers to take reasonable steps to reduce risk to employees,2 and establishments have common-law obligations to ensure that their premises that are open to the public are maintained in a safe condition without concealed, reasonably avoidable hazards.3 Responsible conduct of a business or facility in a pandemic represents opportunities for private entities to contribute to public health by implementing traditional and innovative disease-control measures, such as contact tracing with the use of mobile applications (“apps”) on personal devices.

Would you visit a bar or restaurant that asked you to use a disease tracking app?

pixierose, BSN, RN · Jun 25, 2020

This is CT now:

http://c-hit.org/2020/06/24/coronavirus-faqs-resources/

This was CT in April:

https://www.CDC.gov/mmwr/volumes/69/wr/mm6915e4.htm

Being part of the tri-state area, CT was hit hard.

It boggles my ever loving mind that people here in the US won’t wear a mask. “Infringing on my rights” my sweet Aunt Fanny ... wearing a mask, and others wearing one, helps ensure that a mandatory quarantine isn’t altogether necessary, and allows an economy to start, function, and grow. I finally am back at my home base, as my COVID unit closed - we are now on to ONE main COVID unit in our hospital.

We need to adjust to the pandemic that is still occurring, not ignore it so completely that 100,000’s more die.

AHWTL - you sure don’t seem to understand the physiology and thus the complicated treatment associated with COVID patients. I can’t even answer your posts, they seem so out of touch.

toomuchbaloney · Jun 25, 2020

It's probably best to simply ignore the persistently hyperbolic, inaccurate and agitated posts. Lack of attention generally results in escalation of behavior and then the moderators step in.

lifelearningrn, BSN, RN · Jun 25, 2020

This is from THE TEXAS MEDICAL CENTER

Do you still want to pretend nothing is happening?

A Hit With The Ladies, BSN, RN · Jun 25, 2020

On 6/25/2020 at 3:12 PM, lifelearningrn said:
This is from THE TEXAS MEDICAL CENTER
Do you still want to pretend nothing is happening?

Nothing I haven't mentioned before. Look at the chart itself. Two whole weeks before ICU capacity exceeded. Most ICU patients aren't Corona patients even. Don't give in to fear!!

lifelearningrn, BSN, RN · Jun 25, 2020

32 minutes ago, A Hit With The Ladies said:
Nothing I haven't mentioned before. Look at the chart itself. Two whole weeks before ICU capacity exceeded. Most ICU patients aren't Corona patients even. Don't give in to fear!!

I've watched this metric for weeks. Two weeks ago the ICU was only about 17% Covid. Now it's nearly 30%.

I am not afraid.

A Hit With The Ladies, BSN, RN · Jun 25, 2020

30 minutes ago, lifelearningrn said:
I've watched this metric for weeks. Two weeks ago the ICU was only about 17% Covid. Now it's nearly 30%.

So it's gone up 11%. Wooo. Hardly some apocalypse where the gunshot victim is left bleeding to death in the ER because everyone else in the hospital's got Corona.

macawake, MSN · Jun 25, 2020

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Don’t give in to fear!!

Hmm.. I’m starting to wonder if you are actually scared and this denial thing is some kind of coping mechanism?

Yesterday afternoon you were claiming that there were ”heaps and heaps” of available hospital beds, including ICU beds. Heaps and heaps isn’t a very exact measurement, but there really wasn’t (assuming heaps and heaps was meant to imply ”nothing to worry about here, folks”).

As of the latest available update 28% of ICU beds were Covid-19+ and 72% are non-Covid. Expect that ratio to change over the coming days and weeks.

The average daily growth for the past seven days for Covid-19 patients has been 5.8% med surg and 6.4% for ICU. I assume you’re not seeing a similar increase in appendectomies and car accidents?

Your 2-week projection using bed occupancy growth estimates that you will exceed sustainable surge capacity and reach UNsustainable surge capacity on July 6. (The calculation assumes that the appies and car crashes stay at a stable level, so the increased demand on hospital beds is due to Covid-19 in this projection).

What we see unfolding here is exactly the reason why we all need to work together to ”flatten the curve”.

I hope that you will be able to provide care for all patients in need for the coming weeks and months.

I don’t think you or anyone else should live in fear, but I think it wise to feel concern in light of the current rapid growth of number of patients requiring hospital care.

Stay safe you all!

allnurses Guide · Jun 26, 2020

Low-cost dexamethasone reduces death by up to one third in hospitalised patients with severe respiratory complications of COVID-19

Statement from the Chief Investigators of the Randomised Evaluation of COVid-19 thERapY (RECOVERY) Trial on dexamethasone, 16 June 2020

A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone. Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio and by one fifth in other patients receiving oxygen only. There was no benefit among those patients who did not require respiratory support.

Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone...

… Peter Horby, Professor of Emerging Infectious Diseases in the Nuffield Department of Medicine, University of Oxford, and one of the Chief Investigators for the trial, said: ‘Dexamethasone is the first drug to be shown to improve survival in COVID-19. This is an extremely welcome result. The survival benefit is clear and large in those patients who are sick enough to require oxygen treatment, so dexamethasone should now become standard of care in these patients. Dexamethasone is inexpensive, on the shelf, and can be used immediately to save lives worldwide.’…

… The RECOVERY trial involves many thousands of doctors, nurses, pharmacists, and research administrators at over 175 hospitals across the whole of the UK, supported by staff at the NIHR Clinical Research Network, NHS DigiTrials, Public Health England, Public Health Scotland, Department of Health & Social Care, and the NHS in England, Scotland, Wales and Northern Ireland…

https://www.recoverytrial.net/news/low-cost-dexamethasone-reduces-death-by-up-to-one-third-in-hospitalised-patients-with-severe-respiratory-complications-of-covid-19

happygal56 · Jun 26, 2020

On 6/24/2020 at 7:47 AM, A Hit With The Ladies said:
I voted straight ticket Democrat in 2018 so I didn't vote for Governor Abbott. But I'll vote for him in 2022. He has proven himself to be our last line of defense against tyranny. I am beyond grateful he keeps superseding local Democrats' orders to mask up or pay fines, or to stay home or face legal issues. Thanks to him we Texans don't live in some dystopian nightmare where the leftist politicians have used Coronavirus as an excuse for totalitarian social control.

Why in the world did you vote straight Democrat in 2018? Couldn't you already see then what they were? Or did it take Covid to clue you in?