We'll have more than 2000 dying a day by the end of next week.+18,294 cases, +398 deaths today. Another new record. That's 7 days straight that both stats have gone up.
Both stats are also up day over day for the world as a whole. The US growth curve is a factor in that, but there are also new hot spots emerging like Turkey.
We're really just getting started with this.
Trump is one stupid mfer... jfc.Just got this email from Today's Hospitalist: Biggest I saw was hydroxychloroquine is not effective.
CORONAVIRUS 1. U.S.A.: We're No. 1 The U.S. yesterday surpassed China as the nation with the highest number of confirmed cases. This morning's Johns Hopkins' stats: 85,996 cases in the U.S., 542,788 cases worldwide, 24,361 deaths worldwide. The House today may vote on the largest economic relief bill in U.S. history, one that would give hospitals $100 billion to offset the costs of treating covid patients. Early trials on the efficacy of lopinavir-ritonavir and hydroxychloroquine to treat hospitalized covid patients found neither to be effective. Research on patients hospitalized with coronavirus in Wuhan finds that 20% had cardiac injury, making those patients more likely to need noninvasive and invasive ventilation and have much higher mortality. The FDA is allowing clinicians to use alternative respiratory devices, and it has given the green-light to convalescent plasma from covid patients who have recovered as an investigational treatment for those with severe disease. Pediatric hospitals are resisting taking adult patients from other facilities, saying doing so wouldn't be safe. Instead, they urge hospitals that treat adults and are at capacity to send all pediatric patients to children's hospitals. An NEJM perspective outlines what the government can do to help alleviate PPE shortages. And hospitals are now debating whether to institute universal do-not-resuscitate orders for coronavirus patients, citing infection-control concerns and the shortage of PPE. Read more from the New York Times.
CRITICAL CARE 2. How to stretch ICU staffing ICUs should switch to a model of tiered staffing that integrates experienced critical care clinicians with others repurposed from other hospital departments. That's according to pandemic recommendations issued by the SCCM. The suggested model gives a physician who has critical care experience oversight over four teams, with each team managing 24 beds. Further, each team should consist of four staffing tiers. An experienced ICU APC or a reassigned non-ICU physician should be the first tier, while the second tier would consist of both experienced and reassigned physicians, APCs, respiratory therapists, CRNAs and CAAs; personnel in that second tier would concentrate on ventilation. Experienced ICU nurses would make up the third tier and reassigned non-ICU nurses would be in the fourth. To make such staffing possible, the SCCM issued the following recommendations: limit elective surgeries to free up beds, staff and ventilators; train reassigned staff; combine those who have ICU experience with those who don't; and practice public health measures to minimize transmission. The SCCM also points out that 48% of U.S. hospitals have no intensivists on staff. Read more from the Society of Critical Care Medicine.
PHYSICIAN WORKFORCE 3. Teaching hospitals face visa moratorium
With the State Department putting a temporary halt to issuing visas, the visas of more than 4,000 foreign physicians are now up in the air. Those doctors, most of whom are waiting for J-1 visas, are slated to begin their residencies in U.S. teaching hospitals in July. Earlier this month, the state department sent out guidance to sponsors including the ECFMG to either cancel their programs or postpone their start dates. Among the more than 7,000 IMGs placed in residency programs in last week's Match, more than 3,000 are already U.S. citizens Read more in FierceHealthcare.
HEALTH CARE DELIVERY 4. Moving care out from hospitals into the community In a new NEJM perspective, Italian doctors working in a hospital in Bergamo—the epicenter of the outbreak in Italy where, those physicians write, they are "far beyond the tipping point"—argue that a new model of care must be devised to effectively fight the outbreak. Instead of patient-centered care that revolves around hospitals, community-centered models need to move much more treatment and surveillance out into the community. Such a model would rely on a comprehensive network of home care, mobile clinics, telemedicine, and the delivery of early oxygen, pulse oximeters, and nutrition to the homes of patients with only mild illness or those who are recovering. Without robust outpatient resources, the authors argue, hospitals such as their own—which they call "highly contaminated"—as well as medical transport and health care personnel will remain vectors of infection. "The more medicalized and centralized the society, the more widespread the virus." Read more in NEJM.
INFECTION CONTROL 5. What worked in Asia? In a New Yorker article, Atul Gawande, MD, reports on how health care workers in some Asian countries treated covid patients while keeping themselves infection-free. All health care workers in Hong Kong and Singapore wore surgical masks and gloves, practiced hand hygiene, and disinfected all surfaces between consults. Patients with tell-tale symptoms, known contact or a travel history were treated in separate clinics and wards. Doctors stayed six feet away from patients (except during exams) and from each other. N95s were used only for procedures, like intubations, that involved aerosols. Each country also defined "close contact"; in Hong Kong, that meant spending 15 minutes at a distance of less than six feet without a surgical mask. (The definition was 30 minutes in Singapore.) When clinicians were exposed to suspected or positive patients within six feet for less than 15 minutes but more than two, they could stay on the job wearing a surgical mask and checking their temperature twice daily. Those with only brief contact monitored themselves for symptoms. "Extraordinary precautions," Dr. Gawande writes, "don’t seem to be required to stop it," adding that hospital workers in those Asian countries were able to stay infection-free without strict quarantine policies. Read more from The New Yorker.
OH FOR FUCKS SAKE!!!What was the tweet?
Its been removed.
I figured it must have been really shitty for him or person in charge to remove it, an hour or so later.