OtherGround Forums OG doc. AMA on COVID-19

4/1/20 4:51 PM
1/1/01
Posts: 26862
Rahjai MD -

We are running so low on ppe, they giving us just two for the whole shift.  We are now required to all wear masks the whole shift.

All this started after a patient who was admitted for a uti and was in non isolation room and then two days later tested positive and also his neighbour as well.     Who the hell knows how many ppl went onto that room and might be infected.    Logistically we cant swab everyone but my god this is how the hospitals are going to get hit by this virus.    With lack of ppe we are all fucked.   This is canada too.    The hell is going on.

Is this similar situation in quebec mateo?

Complete shit show, i feel like its only a matter of time when i get covid,  not even a if anymore.

Governments need to step the fuck up.  This is getting ridiculous.   Frustrating

what does the government need to do?

4/1/20 6:36 PM
10/16/10
Posts: 29964
yusul - 
Rahjai MD -

We are running so low on ppe, they giving us just two for the whole shift.  We are now required to all wear masks the whole shift.

All this started after a patient who was admitted for a uti and was in non isolation room and then two days later tested positive and also his neighbour as well.     Who the hell knows how many ppl went onto that room and might be infected.    Logistically we cant swab everyone but my god this is how the hospitals are going to get hit by this virus.    With lack of ppe we are all fucked.   This is canada too.    The hell is going on.

Is this similar situation in quebec mateo?

Complete shit show, i feel like its only a matter of time when i get covid,  not even a if anymore.

Governments need to step the fuck up.  This is getting ridiculous.   Frustrating

what does the government need to do?


Earlier today the Ontario govt asked private sector manufacturers to retool their plants so they can make medical equipment in province to help with the shortages. Hopefully it's feasible.
4/1/20 6:46 PM
9/14/12
Posts: 1879

I may have been exposed today. We put a guy in a holding cell, and as soon as he hit it he started coughing and hacking up mucus. He started sweating profusely. He denied having been sick before he came in to the office, but on further questioning he admitted to him and his girlfriend having had fevers a week or two ago that he treated with advil. The medics said his symptoms and timelines are consistent with covid, IF he's telling the truth. I'm isolating myself from the family. Should I hit one of the drive through testing centers here, or would that be a waste of a test? If I was exposed how long would I need to show a positive result? Should I wait until i show symptoms?

4/1/20 6:56 PM
3/17/14
Posts: 2731
red7 -

I may have been exposed today. We put a guy in a holding cell, and as soon as he hit it he started coughing and hacking up mucus. He started sweating profusely. He denied having been sick before he came in to the office, but on further questioning he admitted to him and his girlfriend having had fevers a week or two ago that he treated with advil. The medics said his symptoms and timelines are consistent with covid, IF he's telling the truth. I'm isolating myself from the family. Should I hit one of the drive through testing centers here, or would that be a waste of a test? If I was exposed how long would I need to show a positive result? Should I wait until i show symptoms?

im answering this based on the fact my gf was exposed at work with a positive coworker. I called my doctor and I cannot get tested for the fact I am not showing symptoms so it is considered a wasted test. Was told to quarantine. I had to email HR to use the new FFCRA leave which just started today that allows you to get paid sick time for up to 80 hours related to Covid-19

4/1/20 7:02 PM
3/17/14
Posts: 2732

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 

4/1/20 7:47 PM
8/2/19
Posts: 1306
knappster -

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 

What you're asking is the equivalent of asking if we should wear seatbelts. For 99.999% of situations the answer is yes - you should wear seatbelts and you want a strong immune system.

Unfortunately, once in a while a situation comes along where that same thing that is suppose to protect you is what kills you. That's the trade-off.

4/1/20 8:47 PM
4/15/16
Posts: 7498

4/1/20 8:49 PM
4/15/16
Posts: 7499
knappster -

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 

What also strikes me is so far, the most effective medication is an immunosuppressive paired with an antibiotic. Send counterintuitive to suppress you're immune system, but maybe this helps explain it. 

Most patients given the drug combination claim their conditions improved quickly.

4/1/20 11:51 PM
6/30/07
Posts: 60503
CPickering -

ER PA here and our hospital is so strict on testing criteria, it’s beyond frustrating. When we are able to test, results are taking 2-10 days. Hoping things change soon with more private labs creating tests etc. We’re really low on PPE too and haven’t seen a surge of critical patients yet.  Crazy times, be safe everyone 

We are absolutely hurting for PPE (air medical). We are already using our share of the state cache. This is unsustainable unless production and distribution ramp up and get to rural America. Pretty soon we'll be wearing trash bags for gowns. Issued (literally signed out and accounted for) 1 n95 that we need to reuse under cloth masks that can be washed. We all know that it's about impossible to not contaminate ppe when doffing. 

We're in very close contact for hours with these people in a space the size of a Volkswagen, I need my equipment to work. We're spending hours on decon after every flight and are running out of those supplies as well. We're moving to 36hr shifts and then mandatory call. We'll keep rolling until we run of something critical, then we're going to have to start making hard decisions.

Edited: 4/2/20 12:18 AM
4/27/14
Posts: 23677

Needed.

 

https://youtu.be/HhNo_IOPOtU

 

4/2/20 1:46 AM
4/26/13
Posts: 8312
Mountain Medic -
CPickering -

ER PA here and our hospital is so strict on testing criteria, it’s beyond frustrating. When we are able to test, results are taking 2-10 days. Hoping things change soon with more private labs creating tests etc. We’re really low on PPE too and haven’t seen a surge of critical patients yet.  Crazy times, be safe everyone 

We are absolutely hurting for PPE (air medical). We are already using our share of the state cache. This is unsustainable unless production and distribution ramp up and get to rural America. Pretty soon we'll be wearing trash bags for gowns. Issued (literally signed out and accounted for) 1 n95 that we need to reuse under cloth masks that can be washed. We all know that it's about impossible to not contaminate ppe when doffing. 

We're in very close contact for hours with these people in a space the size of a Volkswagen, I need my equipment to work. We're spending hours on decon after every flight and are running out of those supplies as well. We're moving to 36hr shifts and then mandatory call. We'll keep rolling until we run of something critical, then we're going to have to start making hard decisions.

That’s wild.

 

the next few days/couple weeks could get absolutely nuts

Edited: 4/2/20 1:55 AM
1/7/09
Posts: 15973
Hashtag -
knappster -

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 

What also strikes me is so far, the most effective medication is an immunosuppressive paired with an antibiotic. Send counterintuitive to suppress you're immune system, but maybe this helps explain it. 

Most patients given the drug combination claim their conditions improved quickly.

Hydroxychloroquine only becomes immunosuppresive after longer term use...it takes months of use to get there. This is not a factor when it's used for covid19.

 

It's not just you, but this is how bad information spreads.  

4/2/20 7:55 AM
10/23/05
Posts: 3185
knappster - 

my GF was potentially exposed from a positive coworker last week, so we are both on quarantine. Of course I have several concerns but one of them is I am on antibiotics currently. how alarming is it to be on antibiotics which suppress the immune system while battling Covid-19? Can taking Zinc with Vitamin C help?

sorry if this has been talked about before.

 Im more concerned with my gf, who has a blood disorder ( beta thalassemia) and a weak immune system in general.

what a crazy time to be alive

Thanks


You are not considered very immunocompromised by taking antibiotics per se.

As boring as this might seem, good sleep, healthy eating, exercise, cut tobacco are the best things you can do right now. I'm sure you'll find data on vitamin C + Zinc, but there is no evidence supporting that it reduced your risk of transmission.

You don't risk getting infected if you both stay in quarantine.

4/2/20 7:57 AM
10/23/05
Posts: 3186
Winston Wolf - 

im sorry if this was asked before theres a lot of pages here.Im in Huntington Station NY one of the worst spots for it.When should i wear the mask and gloves ? thanks Hope everyone is safe


Masks if you can spare some, yes. Be mindful of those who might need them more, including medical personnel.

4/2/20 7:57 AM
10/23/05
Posts: 3187
Jump Kick - 

I’d like to see antibody testing available to everyone at home, is this possible?


Considering that we cannot even test those who need it right now, this is just wishful thinking!

4/2/20 7:58 AM
10/23/05
Posts: 3188
Morpheus1976 - 
gregbrady -
CPickering -

ER PA here and our hospital is so strict on testing criteria, it’s beyond frustrating. When we are able to test, results are taking 2-10 days. Hoping things change soon with more private labs creating tests etc. We’re really low on PPE too and haven’t seen a surge of critical patients yet.  Crazy times, be safe everyone 

were seeing 2-5 day turnaround time at the local hospital for tests and Im seeing pateints discharged with cough pending covid test with no ppe for myself or my team. we're completely out of stock. theyve defined me as "medium"risk so its not deemed appropriate.

 

this is a cluster

 

like everyone else has been saying. this is my duty, not my job. i would tell them to shove this job up their ass.

i know we(Netherlands) are cleaning maks for re-use


We're doing the same in Montreal right now. They're expecting we'll be out of masks in 5 days.

4/2/20 8:00 AM
10/23/05
Posts: 3189
SpeedKing9 - 

Why is the W.H.O. saying that masks do not prevent you from getting the virus when even the head of infectious disease in S Korea says everyone in Asia knows that is not true. Is this something being said so people do not buy up masks so healthcare professionals can start receiving more? If so, why lie about it as it starts hurting credibility of no transparency?


Good question.

Authorities should have said it a while ago. Masks are not full proof but they certainly reduce transmission a lot, as much as we know now.

4/2/20 8:02 AM
10/23/05
Posts: 3190
Rahjai MD - 

We are running so low on ppe, they giving us just two for the whole shift.  We are now required to all wear masks the whole shift.

All this started after a patient who was admitted for a uti and was in non isolation room and then two days later tested positive and also his neighbour as well.     Who the hell knows how many ppl went onto that room and might be infected.    Logistically we cant swab everyone but my god this is how the hospitals are going to get hit by this virus.    With lack of ppe we are all fucked.   This is canada too.    The hell is going on.

Is this similar situation in quebec mateo?

Complete shit show, i feel like its only a matter of time when i get covid,  not even a if anymore.

Governments need to step the fuck up.  This is getting ridiculous.   Frustrating


We're in the same boat brother. NY and Montreal: same shit is going on.

We're running out of PPE, especially masks.

What also pisses me off is that we're now treating morons who decided to have a fucking wedding with 80 people. 15 of them have COVID.... And we're supposed to jeopardize our health for these fuckers.

4/2/20 8:04 AM
10/23/05
Posts: 3191
red7 - 

I may have been exposed today. We put a guy in a holding cell, and as soon as he hit it he started coughing and hacking up mucus. He started sweating profusely. He denied having been sick before he came in to the office, but on further questioning he admitted to him and his girlfriend having had fevers a week or two ago that he treated with advil. The medics said his symptoms and timelines are consistent with covid, IF he's telling the truth. I'm isolating myself from the family. Should I hit one of the drive through testing centers here, or would that be a waste of a test? If I was exposed how long would I need to show a positive result? Should I wait until i show symptoms?


Isolate yourself for at least a week, but 2 is ideal because incubation period can take a while. Get tested if you develop symptoms.

4/2/20 8:07 AM
10/23/05
Posts: 3192
knappster - 

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 


It isn't really simple to "build your immunity". Rather, take steps not to reduce it: stop smoking, eat well, plenty of sleep, hydrate.

I understand your point but those dying right now are the ones with low immunity (older age + comorbidities). Young patients can get very sick and may require intubation but death remains unlikely.

Don't forget that those who died in 1918 didn't have ventilators, oxygen, and non-invasive ventilation (among other things)

4/2/20 8:08 AM
10/23/05
Posts: 3193
Hashtag - 
knappster -

my biggest question right now is with Cytokine Storm. in the 1918 spanish flu it killed a lot of young healthy people. The immune system overwhelmes itself and causes massive inflammation and causes sepsis, organ failure, lungs to drown etc. It is happening with COVID-19.

 

so im confused on if we try to build our immune system stronger or will that be more dangerous because of what happens with cytokine storm. 

What also strikes me is so far, the most effective medication is an immunosuppressive paired with an antibiotic. Send counterintuitive to suppress you're immune system, but maybe this helps explain it. 

Most patients given the drug combination claim their conditions improved quickly.


HCQ (and azithromycin usually used as an antibiotic) have known antiviral properties.

4/2/20 8:11 AM
10/23/05
Posts: 3194

Several docs and nurses in Montreal are currently hospitalized. Same in NY.

LaPresse (French newspaper here) has a piece on a young ER physician who was close to being put on a vent.

Guess how many docs I know who needed hospitalization for the common flu? None in 20 years of practice.

I'm trying to be fair here, but i'm going to fight back if I hear this is a conspiracy or just another flu virus... :)

4/2/20 8:17 AM
9/26/10
Posts: 21863
SpeedKing9 -

Why is the W.H.O. saying that masks do not prevent you from getting the virus when even the head of infectious disease in S Korea says everyone in Asia knows that is not true. Is this something being said so people do not buy up masks so healthcare professionals can start receiving more? If so, why lie about it as it starts hurting credibility of no transparency?

this is something that all good teachers and parents have known for years (lying takes away your credibility) but polticians and political organizations don't get. they lie for a living and get away with it a lot. and they will continue to lie when they feel it can benefit them. 

4/2/20 10:30 AM
11/1/03
Posts: 21638
ufc98newb -
SpeedKing9 -

Why is the W.H.O. saying that masks do not prevent you from getting the virus when even the head of infectious disease in S Korea says everyone in Asia knows that is not true. Is this something being said so people do not buy up masks so healthcare professionals can start receiving more? If so, why lie about it as it starts hurting credibility of no transparency?

this is something that all good teachers and parents have known for years (lying takes away your credibility) but polticians and political organizations don't get. they lie for a living and get away with it a lot. and they will continue to lie when they feel it can benefit them. 

The face mask lies arent for their benefit, its so people dont hoard masks that are essintial to first responders. The sentiment may be honorable but lying should never be acceptable.

Edited: 4/2/20 11:13 AM
6/14/19
Posts: 1051

So got contacted by manager. I have been in contact with a patient who has since been confirmed positive. I am being placed on a 14 day quarantine leave.

 

This is very frustrating to process as I've been fighting with my workplace to get PPE. Been told by management I can't use my own N95 at work and now here I am.

 

I can't describe how seething mad I am, not that I might be sick. My family is all at risk now because this stupid policy of not using your own PPE at work. I have access to n95s. I could have been using them.

 

Now I have to sweat for the next 14 days if I'm sick, as well as deal with my family possibly being exposed.