For me, as a healthcare worker, the scariest part of the Covid 19

[SDANation]

outbreak will be the inundation of patients that will quickly overwhelm resources available. Medically fragile patients will be put at high risk of complications or death. I work in a major city hospital in CA, with 252 medical surgical beds and 72 ICU beds. Just last Tuesday we were in code ABC (all bed crisis). It means every unit is at capacity with the ICU’s and ED with no place to take patients, so critically ill patients are treated in the ED. And code ABC is a common occurrence.

This also means critical surgeries, cardiac, GI etc are delayed. So if Covid does reach critical community spread, the collateral death not caused directly by Covid infection will be very high.

What also is concerning, is that we don’t have enough nurses. I know cause I am one. We were told that if we were exposed to a covid patient at work we would be furloughed for 2 weeks. Which means 2 weeks I can’t care for patients. Multiply that by 20 nurses and it puts significant strain on patient care.

I keep cautiously optimistic that we will get through this and contain it before it can spread significantly, but this what worries me and my coworkers on the front lines.

[virgogal]

1. I wish all of you well,this is VERY frightening.

[The empressof all]

2. Yes, and it's not just in hospital its the EMT's and first responders

Kirkland currently has 27 fire fighters out on home quarantine. We are a small city and that's a hunk of our force. Luckily we have good neighboring towns to help in the event we need it.

The message here is to try not to overload the system. Call before you come to urgent care or the ER. My daughter had to go to the ER yesterday after nurse advice (not covid related) and she said it was really surreal to see all the workers suited up in hazmat like suits with goggles and masks. She's fine BTW...

In addition human service workers in shelters, and feeding centers are also at high risk and don't have the benefit of protective gear as in hospital

Thank you for your skills and training. Take care of yourself. Your community will probably need you.

[genxlib]

3. Thanks for your thoughts

And thanks for your work. I think nurses are one of the most important and under appreciated members of our society.

I don't envy you right now but I am really grateful that people like you exist.

[SDANation]

8. Thank you!

[genxlib]

70. Don't know if you have been coming back to this thread

But I thought you would want to know about the people responding to my post and concurring with my gratitude. See the other responses to my original reply.

[smirkymonkey]

12. +1000

I second this!

[dewsgirl]

35. 100 percent this.

[Stonepounder]

69. When I am in the hospital, I'm lucky to see my doctor once a day.

I see the nurses all the time, for meds, checking my tubes, giving me my meds. They are ALWAYS friendly and helpful. They are what makes getting better work.

To Nurses: Thank you for all you do, 24 hours a day!

[AncientGeezer]

4. What makes you fear an "outbreak"...of the proportions you describe?

In 1 yr H1N1 killed an estimated 12.5k..in the U.S.....Apr. '09-Apr'10

Tennessee had a tornado last night that killed more people than Covid-19 so far here.

I trust CDC...they won't roll over for the orange fuckwaffle...they will whistle blow like you've never seen if they see us in danger....

[SDANation]

7. The elderly

I don’t worry about myself or others like me cause I’m relatively healthy and young. But the elderly, which are most the patients I see, have multiple comorbidities. And based on the data so far those are at high risk for complications from this virus. Most might not have a bad complication but if they do, it adds burden to an already over stretched healthcare system.

[Kablooie]

39. Even if you're healthy, if you have some other emergency medical situation...

you might not be able to get all the care you need because of the massive amount of COVID patients flooding the hospitals.

[JudyM]

62. I was stunned when I looked at the CFR for seniors.

My mom is 95 in an assisted living facility and I’m filled with dread because the last flu they had, a few months ago, basically got everyone sick, including the staff. I called the dept of health to see if they’d issued any guidelines/protocols to senior living facilities and they’re not going to. These places aren’t run with the sensitivity of a health care facility, they’re in the “hospitality” business.
So in addition to serious convos about hand cleaning I’m trying to fortify her immune system with nutraceuticals. If you’ve heard anything else helpful, I’d love to know.

You’re doing the work of angels, every one of you.

[58Sunliner]

50. "In 1 yr H1N1 killed an estimated 12.5k..in the U.S.....Apr. '09-Apr'10"-false analogy.

What was the infection number?? How many needed hospitalization/life support? What was the death rate? I have one answer for you-not over 3%, less than 1%. This is not the flu. The CDC is already folding like a cheap suit.

[pnwmom]

61. Some of the epidemiologists are predicting 40-70% of people might get it.

If only 5% end up in a hospital, that will completely overload our system.

[LanternWaste]

68. Jesus! I didn't know the numbers were projected so high.

I've been pretty much ignoring or skimming over most of the chatter about it, but damn! Even 20% is crazy high-- more than that would... I dunno, put us in uncharted territory.

[lunatica]

5. The domino effect will also include

patients who don’t bother to go to the ER because the hospitals have to announce they have no beds and that they’re understaffed. That will also spread illness, not just COVID 19.

It’s not the illness that will be the worst. It’s every conceivable domino effect that is.

[redstatebluegirl]

6. Nurses are the angels of healthcare.

I had the best one after surgery, he was so caring and I was so darn scared. I am hoping you all get through this in one piece. It may be a tough go for a while.

[emmaverybo]

52. I love them. I just love them.

[rainin]

9. Couldn't we nip this in the bud by mandating masks?

Sounds crazy for anything to be "mandated" in the land of the FREE, but I'd feel so much safer if everyone were wearing masks. Obviously, we'd have to ramp up production. Maybe we could make them here in the US instead of going without because we rely on masks made in China.

[SDANation]

13. Masks could only help us far as airborne droplets go

Every year I am MANDATED to be fit tested for N95, because there are several sizes. If you don’t get fitted for the right size, it’s almost useless in wearing one because droplets can get through. That’s kinda the useless part about people buying up N95’s. They may be completely ineffective if not sized right. And even lets say we give every one masks, then all those people must adhere to strict hand washing and contact precautions

[rainin]

25. This is what I bought for my son. The rest of our family is SOL because I waited too long

What do you think about these?

Respokare Allergy Fighter Active Protection Comfort Fit
https://www.amazon.com/dp/B083YWC2L8/ref=dp_cerb_1

Pricey at $8 per mask, but I got what was available at the time. They're sold out now

Do you mind giving me your opinion on these masks? I don't know if he can use them where he is (serving his country), but I felt better doing something for him. I sent him a care package with things he could have on hand in case he riding out a fever. We're constantly amazed how the military treats its sick - they get sent back to the barracks. "104 degree temp? no problem, you get the day off"

[SDANation]

33. Hard to tell.

If it’s not N95. It won’t be effective. And if you are not fit tested, like I was saying, it can be not even worth it. Fit testing involves, sizing and testing with a sugary substance they spray while asking you to say the alphabet for example, then they ask you to breathe. If you taste the substance, it’s a failed test and they have to try a different mask. Sorry... 😢 I can’t be more help.

[58Sunliner]

58. Fit testing for what kind of N95? Fit testing is usually done for a bio hazard team.

And those masks aren't paper. Never been fit tested for an N95 paper mask. Whole different scenario if you are part of the bio response team. The goal is to lower your risk. Protocols are important as well, how you handle the mask, storage, disposal, etc.. And if you are part of the bio hazard team, you have a face/head shield incorporated into your protective equipment. Along with boots, suit, etc..

[SDANation]

64. I have mandatory fit testing for N95

Every year because of the possibility for TB patients. No biohazard team. They are disposable masks that covers your mouth and nose

[pacheen]

72. Me too.

Hospital nurse... assist with bronchoscopies. We get patients in respiratory isolation due to suspected TB.

[Boomer]

42. Masks don't stop you from becoming infected

At best, they're a reminder not to touch your face, which is THE BEST WAY to protect yourself. Wash yours hands thoroughly, don't touch your face.

And if you're sick, THEN wear a mask to keep from making other people sick. Or better yet, stay home.

[58Sunliner]

51. Think about eye goggles too.

[Jarqui]

10. They have projected a 40-70% infection rate

20% of those will be serious and 3.4% will die according to the latest numbers I've seen

For the 330,000,000 in the US, that means between 26.4 million and 46.2 million are going to get seriously ill and require a hospital bed. If I read these numbers correctly, there are only 1.8 million hospital beds for all illnesses - that are nearly full or beyond capacity now.

We're going to need auditoriums, sports stadiums or some facilities set up to deal with this.

In other words, the problem isn't just nurses and testing kits. Beds, additional folks to care for the sick, various supplies, etc are going to be needed and probably soon.

I've seen folks speculating that it might be to their advantage to get sick with it now while they can get medical help.

If they were going to batten down the hatches, it should have happened some time ago. I fear it is already too late.

The wrong guy is in the Oval office to manage this.

[dewsgirl]

36. This whole scenario is looking more and more likely.

[Jarqui]

40. US is roughly where Italy, Iran or South Korea was a couple of weeks ago

https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6

We're not locking things down like the Chinese did to curtail the spread.

People can be symptom free for days to weeks spreading it.

[Evolve Dammit]

46. Yes. And at least 25% of US workers have no sick time or health insurance which means, they will go

to work, infecting others. This is potentially a huge crisis.

[Jarqui]

49. And they won't sign up to pay the $3,400 some are being charged to test

to see if they have the virus.

It was free under Obamacare until Trump cut it.

So we're flying blind.

There's a major catastrophe underway and all Trump can do is try to keep it from the media.

What's next? Martial law that outlaws obituaries?

[Evolve Dammit]

53. Good questions on what comes next. Here's hoping.

[dewsgirl]

55. I think it's likely been here since mid January, while Trump

was acting like a virus wouldn't dare step on American soil.

[uponit7771]

56. +1,

[MerryBlooms]

74. Our local hospital is already overflowing.

I was in for surgery on 02/11/20, and ended up staying in recovery for 5 hrs waiting for a bed. My sister told me there were patients in beds lined up in the halls waiting for rooms. Granted, my doctor wanted me in isolation for the first 24 hrs after my procedure, but there just weren't any rooms available for anyone that evening. Speaking with nurses, I found out they are building on a 350 bed addition. The nurses said what was really needed was at least double that amount or an additional hospital to handle the patient load. I was finally released on 02/15 around 4pm, and on the way out, I could see the ER area was packed. It's still flu season here.

[Jarqui]

75. If everyone could just stay home for a month ...

that would save millions of lives.

[3catwoman3]

76. The wrong guy is in the Oval Office for anything...

...that comes across the desk.

[BigDemVoter]

11. It's the same with us. I live in San Francisco and work in a city hospital.

It won't take much for us to be completely overrun, as we are already completely inundated with seasonal flu cases.

[SDANation]

14. Exactly!

Add in standard patients, flu patients and now covid. Shit.

[TNNurse]

15. I will be thinking about you.

As an old retired RN ( who worked as House Supervisor after being in ICU for years), I understand your concerns. You were probably struggling with just the usual winter influx of problems and now this.

Please take care of yourself and keep us updated.

I am grateful every day for people like you.

I am also grateful to be retired after 37 years in a hospital.

[SDANation]

24. Thanks!!

[moniss]

16. Several times

in my life nurses were the ones who cared so much that they spent extra time with me as a scared boy a long way from home with nobody at the hospital with me as I awaited surgery and then recovery. Sometimes we see them as workers in health care. They are loving deeply caring human beings. On one occasion I was at a Catholic hospital many years ago awaiting a big orthopedic procedure. I was an adolescent all alone but a nurse brought a deck of cards to my room and sat on the edge of the bed with me and we played cards. I still remember that after awhile my attention was drawn to the games and away from what was coming. I also remember a couple of the other nurses in the hallway standing together and looking in to see why the scared little boy had stopped crying. I never forgot it. Never will.

[klook]

47. So beautiful.

The smallest act of kindness can reverberate throughout a lifetime and create ripples in the pond that end up touching many more lives (as your story has just done).

Thank you.

[Texasgal]

17. We have a volunteer network here

that nurses can sign up to volunteer in times of extreme health bombs. I remember when Katrina hit... I volunteered 12 shifts.

[appalachiablue]

18. Hospitals & resources, nurses, technicians, ventilators could be overrun:

'It Isn’t Just the Death Rate From Coronavirus That Should Have Us Concerned,' Daily Kos, Feb. 28, 2020.

There has been a lot of focus on the fact that, based on known cases, the Coronavirus mortality rate sits somewhere between two and three percent. Much less discussed is the fact that up to 25% of known cases have required intensive care hospitalization and a four to six week recovery window.

So lets play that out. Say 10% of Americans contract the virus. That is 32.7 million people. Should current trends on known cases hold, more than eight million of those could become so ill that they require hospitalization in order to survive. According to the American Hospital Association, as of 2020, America has a total of 924,107 staffed hospital beds across the country. Even at an infection rate of 10% of the population, spread across the country instead of (more likely) clusters, our hospitals would be massively overrun and unable to cope.

https://www.democraticunderground.com/114222653

[Bernardo de La Paz]

23. That assumes they all get sick on the same day. NO. Further, treatment WILL improve w experience.

[NickB79]

63. There's only so far you can spread 8 million hospitalizations

Even assuming we can magically keep it the same every day, that averages to 22,000 new hospitalizations per day for the next year.

We are not prepared.

[Bernardo de La Paz]

19. Any steps to slow the spread give time for medical facilities to cope. . . . nt

[PCIntern]

20. Exactly my thoughts

I agree 100%. These people do not begin to comprehend the concepts of morbidity and mortality.

[Jersey Devil]

21. Scary for patients too - I am not sitting in a waiting room with sick people for routine checkups

and not going to any hospital for elective procedures during a pandemic.

Sometimes avoiding medical care makes sense.

[lillypaddle]

22. Stay safe as you possibly can (as though you wouldn't?)

Thank you for your service to humanity.

[trof]

26. Thank you SO much for what you do.

[eilen]

27. I'm an RN and work in a mid-sized city hospital

And I know we will be overrun. It does not take much. We were critical last week with stretchers lining the halls in the ED, the One Day Unit and had no observation beds. Just the AMI's coming in were filling the beds faster than the cardiac unit could empty them. Worse, we don't have adequate testing. We "only have N confirmed infected patients" because that is all we have tested. As every Dr. and RN knows, once you get a positive test result... you have to do something about it.

[SDANation]

31. Exactly! That's why I'm hoping

It gets contained relatively quickly. We only have I think 4 negative pressure rooms with anterooms.

[eilen]

60. We have more than that but .. they fill up fast

And they are horrible to put elderly people in because they are alone in a huge corner room that staff cannot put their eye on from outside the room.

[Wounded Bear]

28. You're in the front lines on this. Best wishes to you...

[bronxiteforever]

29. You folks are heroes. I know that isn't comforting.

Yet the whole history of healthcare is about healthcare workers saving people in dire circumstances. I can’t say how much I admire you folks. I hope you stay healthy!

[SDANation]

32. Thank you! We all appreciate it!

[friendly_iconoclast]

30. EVERY health care worker I know is saying much the same thing- and I know many...

...as patient, friend, and relative.

So thank you for posting this, and best of luck

[warmfeet]

34. Safe passage everyone.

Thank you to every nurse and health care worker. I worked in a hospital for nine years.

[DesertRat]

37. Will they still keep the birthing units open for solely for labor/delivery?

It sounds like a far fetched question, but if the hospitals are inundated will it affect that area too? My niece is expecting her first baby in July and I'm concerned for her and others.
Thank you for all you do.

[SDANation]

44. Probably not since it's so specialized

[Kablooie]

38. Isn't this exactly what the CDC was supposed to prepare for?

To build up a large stock of emergency supplies, beds, equipment, etc. to help in a massive epidemic?

How much of this have they done and how much would they have done if Trump had not cut them down to the bone?

[SDANation]

43. It's more of an highly infectious disease hitting the population

En masse. We just don’t have enough hospitals, beds or healthcare workers to handle a potential large influx of patients.

[AllyCat]

41. I am also a nurse. Our hospital has no plan.

Except for what is said on the CDC website, there is NO PLAN. We are also short-staffed and the corporation that owns us will no longer give extra pay to come in on a day off to help out. Many of us will come in anyway but we are already overworked. I don’t know where we will put everybody

[58Sunliner]

45. The death rate is over 3% in Italy now, has been slowly climbing. Yesterday the hospitalization rate

was 40%. ICU was over 8 %. When I see the surgeon general of this administration telling me not to wear a mask, I think, I better wear a mask now. I have known this for years, having a degree in respiratory therapy and nursing. And my state relies upon the CDC for getting out their info, the data conflicts with itself and no one will tell me what the protocol is for PUI. They say they are tested, but in the charts you don't see the relevant numbers for testing. Start screaming to your state reps for answers.

[Evolve Dammit]

48. Agree. You wear a mask, protective disposable clothing and gloves as barriers. This is so basic.

It is amateur hour at our hour of need.

[lindysalsagal]

54. I'm hoping this virus weakens somehow and peters out.

I realize hope is useless,,,private, for-profit hospitals will fold..this is gonna totally melt down.

[OhioChick]

57. We are NOT Prepared, Not Even Close

I'm really worried as my two kids are ER doctors and hear a lot from them, since they're on the front line.

I'm afraid for their safety as well as for those that are immunocompromised or have comorbidities.

We don't have the beds, staff or equipment for something of this magnitude.

As the days pass and the numbers increase, the more afraid that I become.

[Horse with no Name]

59. I am an RN at a large hospital in Dallas

We have over 600 beds and 4 ICU’s....we are full almost every day.
If this becomes as bad as I think it might, we are going to be in a lot of trouble.

[rwsanders]

65. a for profit health system is not going to build in reserve capabilities. Disaster or disease, it

will easily be over run.
And its looking like it will not change in in our lifetimes.

Heck where I work, we come in sick and still treat patients.

[AllyCat]

66. Same here. We get "an occurence" if we call in...

...even if it is an illness that presents with symptoms that by the rules, we have to stay home. So, people come to work sick.

We've had RNs test POSITIVE for flu and they still get an attendance occurrence. Who has 3 weeks of sick leave or any leave to take 2-4 weeks off work for this new virus?

[rwsanders]

73. My wife is an NP and has had patients cough in her face. So to me her illnesses should be work comp

So if this virus is really that bad, its going to steamroll through the US like a runaway train.

[3catwoman3]

77. Boy, can I relate to that. I'm an NP, too.

Pediatrics. There is no way to try to get a good look at the throat of a screaming, bucking bronco, uncooperative toddler without getting a face full of whatever bug they have.

That is true even without something like Corona virus. I have been masking lately for the “up close and personal” part of the exam.

[rwsanders]

78. She gets mad because these were adults!!

[Chakaconcarne]

67. I have spoken with someone at a hospital who is on a Coronavirus response team

They have told me that, purposefully, numbers of those infected are not being reported out and that far more people have had it then we are being led to believe...The reason stated is to avoid a panic.... they wouldn't say if this is locally or nationally driven.

Most they show up to the ER are being told to go home and quarantine, the rest, that meet the threshold are being monitored.. they have set the threshold for testing high enough that it limits the number of tests and the potential of being reported.

[58Sunliner]

79. Holy shit. Which state is this?

[soldierant]

71. All the health care workers I know are saying exactly this.

And it came up on the Rachel Maddow Show - last night? the night before? - what about when there starts to be a need to quarantine health care workers themselves, who are already understaffed?

You have all the sympathy and best wishes I can possibly send.