I thought this was an interesting article. I think I found it most interesting because of the face masks they are wearing
Red eyes can be a symptom to many health issues including lack of sleep. But, in Kirkland, Washington a nurse believes this is an important symptom.
Amazon has these face masks in their online catalog. They should provide them to their workers. They can reuse them.
March 27, 2020
By Jak Connor
One nurse in Kirkland (click here) has noticed a common symptom throughout every patient she has treated with COVID-19. This symptom has surprisingly not been reported as a common symptom. Chelsey Earnest, who works at the Life Care Center in Kirkland, Washington, recently spoke to CNN and stated that she has noticed that every patient who has tested for positive for COVID-19 has had red eyes.
Many of the commonly reported symptoms, according to the World Health Organization, are; dry cough, fever, tiredness, shortness of breath, aches/pains, sore throat, diarrhea, nausea, or a runny nose. Earnest said, " It's something that I witnessed in all of them. They have, like ... allergy eyes. The white part of the eye is not red. It's more like they have red eye shadow on the outside of their eyes. We've had patients that just had the red eyes as the only symptom that we saw and go to the hospital and pass away."
She continued, " I've even had the disaster medical control physician say, 'Do they have the red eyes?' And I will say yes. And he'll say, 'I'll find you a bed.' It's just something about this, the way that it affects these patients"....
Trump said, "If they don't treat you right, don't call them." The president of Ukraine should be so lucky. He never knew what "treat him right" meant either.
Trump wants to find something that sticks to the wall for his campaign.
I find it interesting that the president and the Democrats have been effectively communicating during this national emergency. The executive order he signed today to initiate the Defense Production Act (DPA) began with a letter from Democrats. The Democrats have been correct about this national emergency from Day 1. It is UNFORTUNATE that Donald Trump DOESN'T SHOW RESPECT AND GRATITUDE FOR THEIR INSIGHT AND ATTENTIVENESS TO DETAIL. The door swings both ways. That goes for the Republicans, too.
On March 18, President Trump (click here) issued an executive order invoking the Defense Production Act (DPA) to prioritize the production of much-needed medical equipment and supplies to combat the novel coronavirus. This follows a March 13 letter signed by 57 House Democrats requesting the president to invoke the 1950 act to “begin mass production of supplies needed to address the ongoing Coronavirus Disease 2019 (COVID-19) pandemic.”
As the Centers for Disease Control and Prevention (CDC) notes, with the decrease in exports from countries affected by the virus and an increase in demand from medical professionals, certain manufacturers of personal protective equipment (PPE)—such as masks, eye protection and isolation gowns—have found satisfying the increased volume of orders challenging. In light of the public health challenges, the DPA has taken on a renewed significance. Recently, the Congressional Research Service published a report detailing policy considerations in employing the act in the face of the current pandemic....
Good night. I deeply appreciate the attentiveness of the American press as well.
"Workers First" is signed!
63,000 pounds of freight is equivalent to one 64 foot tracker trailer load.
It is a good idea to keep the weight limits at 20,000 pounds per twin axles because of the Bridge Law. The bridges in the USA are all built with the design that allows that much weight intensity over every dual axle. It is safe to maintain truck weight limits.
More trucks with legal weight when large amounts of supplies are being moved through the country.
New York may have to pursue its own path when it comes to ventilators. A lawsuit may be necessary.
The Army Corp of Engineers like to do work that is appreciated including playgrounds at request of some federal legislators. Governor Cuomo thanked the Army Corp. to accolades today. Trump is out of line in his harsh criticism of great Americans.
Trump is not a team player.
Each producer of ventilators need to have a model available to allow governors know the design for the hospital managers to be confident they will fit in the units and that they work well.
GM needs to get their tool and dye workers to build the case from the design of their engineers. GM needs to work with a 3D manufacturer to produce the small pieces. There is no time to take bid from GM’s usual suppliers. Please.
I would think the manufacturers that are producing ventilators can use a standard design as well. It simplifies the job of repair persons.
ASAP, please. They are smart people and understand the need and mass production. Americans are counting on you.
The FDA is capable of fast tracking a drug. The agency has fast tracked AZT. Enough. If the drugs are working the FDA is very sensitive to the need in the country.
Louisiana is not as economically agile a state as New York is and will be more dependent on federal dollars. Every state needs to begin to find companies that can manufacture their much needed supplies. New York tasked their own companies in a public “On Air” request by Governor Cuomo. I would urge every governor to do the same thing. The response by GM, Ford and others will be coming but the gap until that point is going to have to be filled by local companies.
None of this is easy. It requires the best of all Americans.
I do not want to be disrespectful or cruel but Mr. Trump is unhelpful in most of his comments.
All Americans need to hunker down and stay at home or the place they call home. The only way Americans are going to be okay is to stay at home. Know more than anyone else that says otherwise. STAY HOME and be patriotic in doing so.
Apply for unemployment and wait for word from an employer to return to work. Help is coming.
Congratulations to the US House is passing the "Workers First" bill.
Knowing Elon Musk as a public figure, this is probably the beginning of his medical branch. He really is a remarkable engineer himself. I am sure he has a design already.
March 26, 2020
By Kristen Korosec
Tesla CEO Elong Musk (click here) said Wednesday that the company’s factory in Buffalo, New York will open “as soon as humanly possible” to produce ventilators that are in short supply due to the spread of the COVID-19 pandemic.
His comments, which were made Wednesday via Twitter, follows previous statements by the CEO outlining plans to either donate ventilators or work to increase production of the critical piece of medical equipment needed for patients who are hospitalized with COVID-19, a respiratory disease caused by coronavirus. COVID-19 attacks the lungs and can cause acute respiratory distress syndrome and pneumonia. And since there is no clinically proven treatment yet, ventilators are relied upon to help people breathe and fight the disease. There are about 160,000 ventilators in the United States and another 12,700 in the National Strategic Supply, the NYT reported....
Ohio is postponing in person voting for the primary.
There is some evidence that a nurse may have caused some infections in other people because she was positive. It is not her fault. She did not know she was positive until she had symptoms. These health care professionals are very valuable people. They are important beyond their own understanding. She blamed herself. That was wrong of her. She could have come back to work as soon as she was well taking care of people she may have infected without knowing of her status. These things happen.
NO SHAME - NO BLAME
Self-esteem issues among professionals are to seek SUPPORT among colleagues and other nursing and doctor professionals best to understand and offer perspective.
March 25, 2020
By Kelsey Landis
The Catholic Diocese of Belleville(click here) will continue a suspension on Mass through Holy Week during the coronavirus pandemic, Bishop Edward K. Braxton said in a letter Tuesday.
The Chrism Mass on April 7 and Holy Week liturgies will not be celebrated publicly in parishes but streamed online only.
The diocese suspended all Mass earlier this month to prevent the spread of COVID-19.
There is no reason to back away from producing ventilators. MIT has a what seems to me to be a "quick vent," in design.
It looks very workable to me, but the BLUE BAG is the place where air enters and then is forced into the patient. It MUST be more durable than is in use now as temporary resuscitation devise. THAT SAID, this looks like a very viable design. It is a matter of using the current supply available for resuscitators and improving on the manufacturer's GRADE OF RUBBER/PLASTIC used.
Clinical and design considerations (click here) will be published online; goal is to support rapid scale-up of device production to alleviate hospital shortages.
The current resuscitators CURRENTLY IN THE HOSPITAL are not designed for extended use. That will have to be considered in that design.
...The team, called MIT E-Vent (for emergency ventilator), was formed on March 12 in response to the rapid spread of the Covid-19 pandemic. Its members were brought together by the exhortations of doctors, friends, and a sudden flood of mail referencing a project done a decade ago in the MIT class 2.75 (Medical Device Design). Students working in consultation with local physicians designed a simple ventilator device that could be built with about $100 worth of parts. They published a paper detailing their design and testing, but the work ended at that point. Now, with a significant global need looming, a new team, linked to that course, has resumed the project at a highly accelerated pace....
The states are not only competing for equipment, it is actually a global competition.
...We are one of several teams (click here) who recognized the challenges faced by Italian physicians, and are working to find a solution to the anticipated global lack of ventilators. In the US alone, the COVID-19 pandemic may cause ventilator shortages on the order of 300,000-700,000 units (CDC Pandemic Response Plans). These could present on a national scale within weeks, and are already being felt in certain areas. An increase in conventional ventilator production is very likely to fall short and with significant associated cost (paywall warning).
Almost every bed in a hospital has a manual resuscitator (Ambu-Bag) nearby, available in the event of a rapid response or code where healthcare workers maintain oxygenation by squeezing the bag. Automating this appears to be the simplest strategy that satisfies the need for low-cost mechanical ventilation, with the ability to be rapidly manufactured in large quantities. However, doing this safely is not trivial....
They appear to be made of items already in the hospitals in the USA. The cities need to put their city engineers to work on the design and teach hospital maintenance personnel how to assemble them. Basically, there needs to be a teacher to facilitate the distribution of that information to many hospitals.
My only real concern in this design is the DURABILITY of the soft parts and having either items nearby to bring about a quick replacement and/or asking the manufacturer of these SOFT items to make them now more durable for longer term use.
Just a word about the markets. This fluctuation is nothing. They appeared to have stabilized. I have an article I want to discuss about the ethics of the current financial sector, BUT, FIRST, let's discuss the ethics of ventilators.
To being there is such a thing as A HEALTH CARE PROXY AND HEALTH CARE POWER OF ATTORNEY.
Those must be honored at this time and hospital staff that meets the admission to the hospital have ways of assessing the wishes of the patient when being triaged. Many hospitals have a record (copy) in a patient's chart already. These are frequently found in patients hospitalized with end-stage cancer. In the case of these patients, the health care proxy may prohibit ventilation AND may demand Hospice Care at Home or in Hospice units. The demand for PPE by home care staff is necessary as well.
IT IS NOT MY CALL to encourage discharge to the home of seriously ill patients with COVID-19 with Health Care Proxies that demand no invasive methods. Those best to make policy regarding these patients are LOCAL Public Health personnel. When a policy is in effect, the doctors will defer them to Hospice and home. Docs and Nurse Practitioners write the discharge and/or home orders.
To vent or not to vent and termination of a ventilator. It appears there is already some discussion of this. BUT, I would like to see more ventilators. There need to be more ventilators NOT fewer patients when they are very ill.
March 25, 20202
By Dr. Mark Abdelmalek, Kaitlyn Folmer and Josh Margolin
Faced with more critically ill COVID-19 patients (click here) than equipment to treat them, hundreds of hospitals are mapping out how they can ration care and equipment in order to save the greatest number of patients possible.
In the last two days, guidelines were provided to scores of hospitals around the country, including every hospital in Pennsylvania, that include a point system that could – in extreme cases – end up determining what patients live or die.
"Priority is assigned to those most likely to be saved, and most likely to live longer," said Dr. Scott Halpern, professor of medical ethics and health policy at the University of Pennsylvania.
On Monday, Halpern and Dr. Douglas White, chairman of ethics in critical care medicine at the University of Pittsburgh, released guidance to hospitals that is now being adopted throughout the nation.
White said "the existing approach to allocate ventilators was unfair because it excluded large groups of patients."...
Local and State Authorities have the right to review hospital policy under their authority. NO government policy should override the doctor's assessments and ethics. They believe in life and it is their call to order a vent or just oxygen. Even if a COVID-19 patient is end-stage anything, it is still the decision of the physician to make the order with respect to a patient's wishes. That relationship CANNOT change. Physicians and Nurse Practitioners have to be able to look themselves in the mirror and know they acted ethically with each such decision.
AGAIN, euthanasia is illegal in the USA, except where legislation has allowed terminally ill patients their dignity, including I think it is Oregon which allows self-termination.
An example of an end-stage disease that has patients living for a decade or more is kidney failure and dialysis. So, just because a patient has an end-stage diagnosis does not mean they are terminal. Physicians and Nurse Practitioners can determine these decisions.
There are also people in home care with ventilation already. An example of that is ALS. Lou Gehrig's Disease is a terminal illness whereby a patient often dies at home on Hospice with a ventilator. Yes, the ventilator is on until death when the patient no longer is capable of sustaining consciousness.
So, it is the decision of physicians to discern the care of a patient going forward. This is not simply a government policy. The government legislates PERMISSION to the individual American to determine their path forward with advanced methods of sustaining their life. That MUST NOT CHANGE. American physicians have perfected these delineations.
ONE MORE TIME. MORE VENTILATORS AND NOT LESS PATIENTS.
That should do it for now. Public Health authorities can be helpful at this time to help with difficult decisions by government officials.
SPEAKER NANCY PELOSI NEEDS TO STAY IN HER OFFICE WITH A FILTER MASK WHILE THE DEBATE AND VOTE OCCURS.
That should hold true for any elderly and/or high-risk wellness lawmakers if the US House reconvenes and then one House member at a time casting a vote in the chamber. I am sure Speaker Pelosi can order the Capital Guard to carry out the single voters in the chamber at a time.
I am very serious about that. It will delay the final vote, but, it will be worth it.
Perhaps the US Air Force can shuttle members of Congress to and from home. They can control the environment in which the legislators travel.
Florida's lethargic governor has a quickly escalating caseload. The Florida governor needs to LEARN QUICKLY from his peers.
Ohio is now predicting a 40 to 70 percent exposure of all Ohioans. Ohio is expecting 6000 to 8000 new cases per day in the coming weeks.
THE ONLY WAY to handle that infection rate is to restrict the assessment of patients to small clinics throughout the state. The faster testing tool is definitely needed and now.
How is New York's trial of medication coming along? It is slightly early to know for sure, but, is there any indication that the new medications are effective, either in the USA or other countries?
Hospitals cannot continue to be the clearinghouse for a caseload that big. Hospitals should begin closing their doors to isolate the ill from the well. The ER will only receive cases that need hospitalization from the assessment clinics. SERIOUSLY. I am saying this knowing I might be the one standing in line at a clinic, okay? I rule nothing out because the most successful ISOLATION of the public happened in Wuhan and I am not convinced we understand this atypical virus completely, so much as how to treat it and end the plague.
I do have an air purifier that I love. The air in the apartment is wonderful. There is a big difference in my wellness since obtaining the air purifier. Yes, it has a sophisticated filter and UV system. It is all contained in one unit and it is completely safe even if a child knocks it over.
Hospital staff is too vital to the best outcomes of patients. The staff is going to need every employee working to protect the medical milieu of the hospital. Floors cleaned frequently, sterilization units operating 24-7 and clerks stocking the floors on a continuous basis.
Nurse Managers are responsible for establishing stocking levels for a unit. That means there is a "daily standard" for supply clerks to bring IV bags of Normal Saline, Dextrose 5% bags, etc.... That daily refill for the units are more than likely hourly restocks at the height of the pandemic in the USA. So, the hospital staff can't be interfered with by visitors.
The hospital can be a source of infection as well for visitors that allow themselves the freedom of wandering the hospital floors to "find word" about their loved ones. That visitor traffic needs to stop as far as I am concerned.
Most outpatient surgery clinics (same day units) should remain operational for normal emergencies. Those clinics can handle uncomplicated surgeries such as appendectomies, etc. They are mini-hospitals, EXCEPT, they don't entertain high-risk patients normally. Surgeons can determine if a patient is high risk and move them to the hospital where a more dense number of professionals can respond to CODES. These surgical units have suspended ELECTIVE surgery. My guess is for this reason so they can assume the emergency surgery normally received in the ER.
Ancillary staff needed: (click here)
Americans need to be ready to find a health care system that is different than they are used to for the next few months.
As a side note: The workforce in these states are going to be ill and recovering so the unemployment support makes complete sense.
March 26, 2020
Doctors test hospital staff with flu-like symptoms for the CCP virus in tents set up to triage possible COVID-19 patients outside before they enter the main emergency department area at St. Barnabas hospital in the Bronx borough of New York City on March 24, 2020.
In Thursday’s midday report, (click here) a total of 378 new cases have been identified, pushing the total positive tests in the state to 2,355 (2,235 Florida residents, 120 non-residents). In the last two-plus days, state health officials have confirmed 1,128 new cases - 240 on Tuesday, a single-day record 540 on Wednesday and the 378 in Thursday’s first report. Polk County up to 17 cases.
This is interesting. Americans love potatoes.
March 25, 2020
By Jessie Higgins
Evansville -- Potato growers and shippers (click here) are working overtime to keep American grocery stores stocked with enough spuds to meet skyrocketing consumer demand during the coronavirus pandemic
With restaurants closing and governors forcing people to stay home, grocery stores are struggling to keep potatoes in stock, and many suppliers have exhausted supplies earmarked for retail consumption, said Blair Richardson, CEO of Denver-based Potatoes USA, a marketing organization for the industry...
There is absolutely no reason for Donald John Trump to take political advantage of Democratic governors. MIT is providing a tool to look at this virus and it's effect on the American population to governors and mayors. THERE ARE NO QUESTIONS TO THE EXPERTISE OF MIT.
March 26, 2020
By Ruth Reader
The interactive map represents a relative risk profile of counties within each state. The red areas on the map represent regions with higher relative risk compared to the white ones. To categorize counties e produced a score that ranges from 0 to 6, 6 being the highest risk. For each of the risk factors a county can be given 2, 1, or 0 points if it belongs to the top 25%, top 50%, or bottom 50% of counties in the state, respectively. The risk profile was created on the basis of three categories – hypertension, diabetes, and obesity.
We have overlaid the number of known COVID-19 cases in the form of blue circles on top of the corresponding county.
That woman at Trump's briefing, what's her name....Betty White looking woman will have no problem to understand THE COUNTRY'S COUNTIES BURDEN TO DATE IN THIS CRISIS THANKS TO THE INSTANT TOOL BY MIT.
The coronavirus is moving at a blurring rate. (click here) But researchers, doctors, and health officials still have a lot to learn from even the most recent events. That’s why a group at the Massachusetts Institute of Technology has released a set of tools aimed at helping officials find the people most likely to suffer negative effects from the coronavirus. Included in those resources are a couple of maps that identify the most risk-prone counties all around the U.S.
“I think there’s some very dark days ahead, and in those dark days state and local officials will want to know where are those vulnerable people,” says Simon Johnson, a professor of entrepreneurship at MIT and the former chief economist at the International Monetary Fund, who is co-leading the effort.
Two weeks ago, Johnson and Retsef Levi, a professor of operations management at MIT, formed the COVID-19 Policy Alliance. The two have gathered a team of MIT experts to develop tools to help public officials understand and manage COVID-19 outbreaks across the U.S.
The group is also making recommendations on policy. On Monday, the alliance sent a proposal to the White House suggesting that the government purchase medical equipment such as respirators, scrubs, masks, swabs, and other needed equipment from China and use currently grounded passenger and freight airplanes to retrieve it. Johnson says the group is working with state officials on coordinating similar plans.
MIT’s COVID-19 Policy Alliance is among several institutions trying to use data to help identify vulnerable populations, which may need additional resources as states trying to forestall the virus’s spread enact restrictions on leaving the home....
The US House needs to pass the "Worker First" bill as soon as possible to RETURN CONSUMER CONFIDENCE.This accounting occurred as the Senate was deciding on a vote.
March 25, 2020
By Carmen Reinke
US consumers (click here) are backing away from the housing market as the coronavirus pandemic shuts down large swaths of the economy in an attempt to curb the spread of disease.
Mortgage application volume fell 29% in the week ending March 20, the largest drop since 2009, according to a Wednesday report from the Mortgage Bankers Association. The home-purchase index fell 15% to its lowest level since August 2019 and decreased 11% on the year, the first year-over-year decline in more than three months.
Refinance applications also decreased 34% from the previous week, but are up 195% from a year ago....
March 27, 2020
