Coronavirus/COVID-19 Post for 3/26/2020

I come from a family of physicians. I have 24 physicians in the family on both sides (uncles, cousins, my own father and brother). Not a single one thinks ending social isolation by Easter is a good idea. In fact, not a single MD I know thinks it is.

Has anyone encountered a physician that says we should end all restrictions and go back to life as it was by Easter? 

My wife is on a conference call as we speak that has ICU docs from NYC area and internationally describing what they are seeing to thousands of medical pros (this is OB/GYN and L&D focused).

ICU Doc form NYC Metro Area:

• Her 23 Hospital Network has all ICUs at 3x capacity.
• Severity of ICU patients was described as follows: the number of the worst ICU flu related patients she described as having 3-6 sever patients in a flu season. They have 70 at her hospital of that severity now.
• Less than 2 weeks ago, those hospitals were business as usual.

Wuhan physicians:

• Most dangerous person is the person with no symptoms. They carry it to so many without knowing they have it.
• PPE is crucial for health care workers
• what is the key to stop the spread of the virus: ISOLATION. Patients confirmed positive were isolated away from family at a hospital facility so they don't spread it to to family. 
• Limited Qtine does not have the effects one would want to see. Limiting travel from hot spots is how China contained it.

Italian physicians:

• NORTH Italy:
  • echos Wuhan experience. Italy was too late to enact social distancing at a serious level.
  • should husband allowed into delivery: Not if anyone is Covid19 positive. they are restricting non-confirmed, non-sympt fathers to waiting room.
  • 40 doctors died due to C19
  • Advice for a hosp in a city that's just starting: screen all patients for fever; all hosp. staff should have PPE and live by themselves to protect themselves 1st and their families and others 2nd.
• SOUTH Italy:
  • why it moved to the south: after an outbreak in the north of Italy, they shut down that town, but people had travelled south at that point spreading the virus to the southern regions of Italy
  • NO public activity is allowed (even in parks). Everyone seems to be wearing masks if they are out
  • Once a hot spot occurs, limiting travel is too late.
• Anti viral therapy is now being used in Italy in severe cases
• Advice for a hosp in a city that's just starting: screen all patients
• Imagine how many people have left NYC area to get away from the virus. They are spreading it to everywhere*

* Living in upstate NY (I call it vacationland USA), we've seen (anecdotally of course) that there are a lot of summer people up and around here right now compared to March normally (which has less than zero summer people since skiing is over and summer hasn't started yet).

 

For hospital staff, the biggest take-aways are to WEAR YOUR PPE all day and (this goes for everyone really) ISOLATE as much as possible NOW. In two weeks, you'll regret it f you don't

I guess a Southfield hospital maxed out its ventilator patients this morning.

I really worry for our nurses and doctors who will be facing a hellish month or more of long, long hours of treating the sick and making decisions no human being ever wants to have to make. 

The heartbreaking part is really how unprepared our health system was for this despite years of warnings and in this case a pretty obvious 6 week window to get our stuff together.  

 

I'm sad Michigan residents didn't seem to be taking this seriously initially, particularly our college students.  All indications are, its going to be bad in this state very soon.