Out of the frying pan…

and back to the COVID-19 unit. If it seems these COVID posts are coming closer together, you’re probably right.

We rotate therapy staff through there and the speed at which we rotate depends on how many of us are there at once. Last week there were three COVID Occupational Therapists all week, four on Monday. Once upon a time, there was one therapist for Β½ days.

Instead of starting my week there, I ended it there. Saturday I saw three COVID patients. Two were incidental findings in patients admitted for traumatic injuries. All patients are tested on admission and isolated until a negative result comes back. These two were positive but asymptomatic. The third was sick enough to be admitted but breathing on their own on the third day and may be going home this afternoon (Saturday).

Saturday, January 8

Recommendations are in flux once again. When the delta variant blew through, I saw young, previously healthy, unvaccinated, and very sick people. Those who survived were here for weeks or months. Now numbers are up but severity is down. We got new recommendations last night.

PPE from “strongest” to “weakest”:
–For COVID+ patients, I wear a PAPR (Powered Air-Purifying Respirator), gown, and gloves. The PAPR sucks in room air, runs it through a filter, then delivers it to my hood. The filter is self-monitoring to let me know when it needs to be changed.
–I have the option of wearing a fit-tested N-95 respirator with a face shield instead of a PAPR. “Fit-tested” means I wore that mask, a hood was placed over my head, and a bitter-tasting substance was injected into the hood multiple times under varying conditions (standing still, moving around, shaking my head, bending over, etc). If I never tasted the bitter substance, I was now “fit-tested”. Any detection of the taste would mean starting the test over with a different mask model.
–For COVID- (negative) patients, I now wear a “well-fitting” mask. That essentially means an N-95 mask that has not been fit-tested but fits tightly and has no apparent leakage. (Why this? Because we just got a new model of N-95 that is way more comfortable than the one I was fit-tested for. No one has yet been fit-tested for this model but it looks promising. The mask I was first fit-tested for 20 years ago was not an option this time, though is now back in stock and less uncomfortable than my current fit-tested model. We are supposed to be fit-tested annually. I was fitted at the beginning of the pandemic and fitting should be available again soon. [Two years is better than 20 anyway.]) It is also “strongly recommended” that I wear an eye shield, so I do. A mask and face shield makes it hard for patients to hear me. The eye shield doesn’t have that effect. The N-95 is fluid-resistant anyway, so the shield is overkill for non-COVID patients unless you try to wear the same mask for a long time (as we did earlier in the pandemic when supplies were short).
–A standard “barrier mask” (surgical mask) is no longer considered adequate for any patient contact and some are saying only appropriate in your own office. As of today, that’s what I wear to enter the building.We’ll see how that changes on Monday.
–A cloth mask has not been acceptable for many months. We used to wear them in all parts of the hospital except patient rooms.

I’ve seen a bunch of anti-vax memes. Today I saw a batch of pro-vax memes. I couldn’t resist.

From Reddit via The Daily Kos
From Reddit via The Daily Kos

Thursday, January 13

An interesting week so far. The hospital gods must be on my side. I have seen several trauma patients with incidental COVID+ findings, so I feel at home. I’ve also seen patients whose trauma may have been a result of their COVID confusion; there’s really no way to know for sure. Tuesday I saw a young and otherwise healthy person who was sedated due to extreme agitation due to COVID. Wednesday that person looked great, except for the need for CPAP. (Continuous Positive Airway Pressure, which feels sort of like a powerful fan being blown into your mouth and nose at all times. It makes it hard to exhale.) They were up and around the room. We stood and looked out the window together. Thursday they were intubated and moved to the ICU. I’ve seen multiple people with brain bleeds – from major trauma, minor trauma, no known trauma. I saw them after a decompressive craniectomy (in which a chunk of skull is removed to allow the brain to swell, the skin is closed over it, and the bone flap is stored to put back later).

We are too busy to keep up. I have 15 patients per day. I can’t see that many. On Tuesday I had 12 newly-diagnosed patients. Most of them I passed on to a Therapy Assistant to see Wednesday, so I could see a dozen more new folks. Today I had a few that I had to leave until tomorrow. The eight hour day is not really an option; nor is seeing everyone who should be seen. Each day is a compromise. “Triage” is my middle name.

Today a bunch of suits came through the unit, led by the Director of Nursing. They stood by the nursing station to hear tales from the front. As I walked by, I heard the word “burnout” and the phrase “we can’t keep up” more than once.

Friday, January 14

One in every five patients in the hospital are now COVID+. We have the incidental finding (here for some apparently unrelated reason, asymtomatic, but COVID+), the here because of severe COVID infection, and the grey area in between. The person who fainted “for no reason” but is COVID+ may have fainted due to weakness from the infection. Do we know for sure? The person who had the ischemic stroke could be coagulopathic from COVID infection, but possibly just happened to have a stroke while COVID+. The person with bleeding on the brain after falling – did the COVID infection lead to the fall? The people with what we call “failure to thrive” (general malaise, lack of appetite, unable to care for themselves) and COVID-19 probably are failing to thrive due to COVID, or it may just be what pushed a borderline functional person over the edge.

At any rate, my COVID caseload keeps growing. It shrunk by two during the course of today. One went home, one died.

I’m not on Facebook, so count on others to read it for me and tell me of the stupidity therein. I’ve seen a lot from people posting anti-vax and COVID-denying memes that stop the day they are admitted. Then their posts are about how miserable they are. And then comes the inevitable post from someone else about the GoFundMe campaign to support all the children this person left behind.

I saw the posts from a person who refused the vaccine because its development involved a fetal stem cell line, then demanded treatment with monoclonal antibodies which were developed using that same stem cell line.

Another series involved people claiming that hospitals are paid a bonus for killing people with COVID treatments, so you should refuse to go to the hospital…then those people show up at the hospital only when at death’s door and wonder why the hospital didn’t save them – probably because they failed to use the proper doses of dewormer and bleach. There are those who seek attorneys to help them sue the hospital for failing to provide them with unproven and unapproved treatments they read about on Facebook. Yet another involved people telling their friend to refuse remdesivir because it kills people (and is one of the ways hospitals claim their bonus). Yes, some people treated with remdesivir die; but at a lower rate than those who don’t get the treatment. So if you show up at the verge of death, the hospital tries everything and you still die, was it the disease or the treatment that killed you? Why is that even a question?

I could argue with equal accuracy that you should refuse to drink water, as 100% of people who drink water die. (Not right away – that’s what makes it so insidious.) I could argue that, if you get pregnant, you should demand an abortion rather than being forced to bring a child into the world. We know that 100% of those who are born die – many only after a lifetime of suffering. Is it more humane to sentence one to a life of suffering, or to save it from birth in the first place?

Saturday, January 15

My eight day COVID week has come to an end. I’ve got nothing to say, but it’s okay (how’s your boy been?). (20)

Author: halffastcyclingclub

We are a group of friends who ride bikes. Some of us are fast, some of us are slow, all of us are half-fast. In 2018, one of us rode coast to coast across the US. It was so much fun, he's doing it again in 2022! If we meet Sal Paradise, we'll let you know.

25 thoughts on “Out of the frying pan…”

  1. It has become a pseudo religion. A kind of cult really, where you you regurgitate whatever the person you have appointed to think for you tells you what to think. It is entirely possible to deny objective reality and believe fervently in absurdities when that sort of thing happens.

    Liked by 2 people

      1. Science isn’t a result. It is a process whereby we attempt to get closer to the truth. Everything is enveloped in a cloud of uncertainty and science is a methodology we use to shrink that cloud. The results are always couched in terms of probability. We are left to determine what is good and evil or neither. Maybe that’s where faith needs to stay rather than fighting against science.

        It is not easy for the average peson to live that way. It is easier to live in a religion that offers absolute certainty (thru faith) than a perspective that offers a 90% probability of X but Y could still happen and Z is still a remote possibility. It is laziness of thought that says both can’t be “true.”

        Thinking is also hard work. Most people farm that work out to “influencers.” The internet has made that fabulously easy. One can stay in one’s social bubble where never is heard a disagreeable word and the skies are not cloudy all day. We often choose our influencers basd on how little we have to change out world view to fit in.

        Carl sagan wrote the definitive book on the subject of science denial, “The Dragons of Eden.”

        When people’s beliefs are challenged they tend to circle the wagons and reject anything that doesn’t come from within their bubble. They double down on core beliefs and push them to the extreme.

        Anti-science has always been with us but it has become mixed up in the broader culture wars we are going thru. And science has been pushing back the boundaries of what we need religion to explain since the days of Archimedes. In mythology, Promethius was tormented by the Gods becaus he gave man science and that meant the Gods were less neccessary in life.

        There are plenty of anti-science people on the left too. It’s just that the right wing version version of it is far more dangerous right now. Pendulums always swing.

        Liked by 2 people

      2. Stevie Wonder was close with “if you believe in things you don’t understand…”, but understanding doesn’t require belief, nor does truth. What is true remains so regardless of our belief. And you’re right, science requires neither belief nor proof – science only can find very high probability; never absolute proof. There are anti-vaxxers who would probably consider themselves leftists. I know there are some who consider themselves natural healers and think they have the answers. I know someone who went to a conference of natural healers who thought they had developed their immune systems to reject COVID-19. Their conference became a Superspreader event.

        Liked by 1 person

      3. I read that several antivax leaders died after that event. I was reading a blof post by one of the deceased where he decried people getting taken in by “scientism” and thereby denying the healing power of herbs and diet and prayer.

        I have never met a medical professional yet who thought that a good diet and having faith didn’t help one stay healthy. But if you want to go into opposition against something like vaccinations, you have to create straw man arguments to fight against.

        All “science” says is that if a million people are vaccinated and a million people are not, 90% of the morbidity and mortality are in the unvaccinated. It doesn’t promise anything more than giving you your best chance according to what we see actually happening.

        That’s a difficult thing for some people to wrap heir heads around. They have an emotional need for certainty they can’t get past. Anti-vax offers an alternative narrative with specific witches to be burned.

        That happens all the time in very many complicated issues.

        Liked by 1 person

  2. Glad you survived the week. Hopefully psychologically as well. Just got a used (new to me) fat bike. Will see if it helps keep me sane this winter πŸ˜‰.

    >

    Liked by 2 people

  3. All I can say is that I hate this and don’t understand it and I’m tired of it and I don’t want to go to the doctor tomorrow but I have to and there are no N95 masks in the San Luis Valley at the moment so fuck it. Oh additionally, I don’t think the anti-tax “religion” is fair to people working hard to save the lives of others. It’s selfish and cruel and ignorant and fucking pisses me off. I know, I know, “How do you really feel, Martha?” Gonna try the bike to nowhere in a bit since there’s no way I can walk a dog at the present moment. It’s not nothing. Oh, and I think you’re heroic.

    Liked by 1 person

      1. Maybe auto-correct wasn’t that far off. I suspect the Venn diagram of the anti-vax and anti-tax movements would show a large overlap; along with those who call for the government to “keep your hand off my Medicare!”

        Liked by 1 person

  4. yowzers. You are brave and persistent and that you still have some sanity and compassion is remarkable. Retired family doc here, so I have a lot of empathy for those (still) on the front lines. Its exhausting, even at second tier. Skating is good.

    Liked by 1 person

  5. Thank you for sharing your story (stories) and for the devotion you continue to demonstrate day after day even when some people are so frickin’ stupid. Mind boggling to say the least, how (or if) some people actually use that gray matter between their ears. Not only is the disinformation, and their belief therein hurting them and their families, it’s effecting folks like you who just want to help; and it’s making it easier for the virus to try out new variants on us. Had we come together as a people, and rallied against a common cause early on, I think we’d be having a much different dialogue.

    Liked by 1 person

  6. I am not opposed to the vaccines. What rubs me the wrong way is the blatant disregard by the FDA and the media of people who report vaccine-induced health problems.

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    1. Those self-reports are problematic, in that the VAERS site is unregulated and anyone can report anything without evidence. Those with an axe to grind (and we know there are many) can falsify reports. Those reports are investigated and there has been media coverage just this week of warnings due to verified ill effects of the Johnson & Johnson vaccine. Reports are also easily accessible on the CDC website. There was extensive coverage of a celebrity’s claim of someone else’s claim of testicular swelling and erectile dysfunction – a claim that was subsequently debunked, but I suspect more people read the claim than the refutation of that claim. I would not call that extensive coverage “blatant disregard”. There has also been coverage recently of US Senator Ron Johnson’s agreement with another’s claim that the vaccines cause AIDS – the closest he came to denial was to say while “it may be true” but it is too soon to say so – “You’ve gotta do it one step at a time”. One might also complain of the lack of reporting of ongoing deaths from the virus. The US is approaching 1 million verified deaths.

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      1. I am not disputing the fact that Covid-19 has caused deaths for people. What I object to is the smear campaign by the media of families that report adverse effects from the vaccines.

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  7. I’m not sure how to reconcile your claim of “blatant disregard” with your claim of a “smear campaign”. Those appear to be mutually exclusive. I guess I’ve missed the smear campaign. I’ll admit I only read two daily newspapers and a few online aggregators. Maybe the campaign is on Facebook, to which I do not subscribe.

    Like

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