Finland, northern parts. The capital (Helsinki, which is way south of here) is the epicenter of Covid nastiness.
I am concerned that the lack of travel restrictions will cause major issues here. Additionally, alot of people from the southern parts spend their ski-holidays in the north, which of course coincided with the Covid. Fortunately we have had a week or two to prepare (and continue to do so)
RRT here from NYC working at a major hospital, the shortage of ppe can be dangerous and an alarming situation. Fellow RRTs in other hospitals have adapted a full face bibap mask with a filter in order to make the best use of equipment available. This solution covers the eyes, prevents face touching and the HEPA filter will filter out bacteria/viruses.
Is this part of the WHO study?
Today was the first day I feel like we really got hit. From the moment I got into work a majority of our calls were potential or confirmed Covid patients. Last week we had similarly dispatched calls, but most were just worrisome individuals. Today we started to see what it really looks like first hand. I’d be lying if I said I wasn’t starting to be scared.
I yelled at a guy walking down the street with an N95. Said - you know people in the hospital need these. Another guy was wearing it the wrong way in the supermarket earlier I said if you're gonna take one of these from a healthcare worker at least wear it correctly. Very angering.
Thanks for the support pouring in from people. It means a lot.
Last night we had a call for a community doctor who had an exacerbation of a painful chronic condition that required her to be brought to the hospital. She is older than 70 at this point and until her medical practice was put on hold she was working every day. I felt horrible bringing her to the hospital, knowing that they won't be able to prevent infection. The same doctors are treating COVID-19 patients and non-COVID-19 patients (assuming that the ones who don't have symptoms don't have it - which is very far from a certainty). She's and her spouse have been doing such a good job self-isolating and social-distancing only to be forced into a situation which almost certainly will expose her to COVID-19.
I called her this morning to check in on her and she said that she was in debilitating pain for 3 hours hours before even being seen by a doctor and given pain medication and only after 9 hours on the ER main floor was she transferred to a different area which likely has less COVID-19 patients and is more specialized to treat the chronic condition.
Maybe that will put into perspective another one of our crew's calls from the past two days. A patient who is 90+ fell out of bed and clearly fractured bones and was in pain. In any normal scenario, we would have transported the patient to the hospital and the extent of injuries would have prevented us from allowing them to "refuse transport" as doing so would be considered a dereliction of duty on our part as medical providers (any pre-hospital care really can't rule out internal bleeding secondary to fractured bones). The family healthcare proxy fought so hard with our medical control team to keep the patient from being brought to the ER knowing that going right now could very well be a death-sentence to a 90-year-old as patient would very likely contract COVID-19 there. Medical control agreed that it was within their rights to refuse. So the family was scrambling to see if they could find a doctor who could provide some kind of outpatient services the next day to help the patient... There is no right answer anymore for these patients.
As a board certified pediatrician but retired since 2007, due to chronic lung disease (i.e. fibrosis mediastinitis with total left pulmonary vein obstruction resulting in pulmonary hypertension, hypoxia, and hemoptysis), I have always had a small handful supply of N95 masks on hand to protect me.
You may not be aware of all of the circumstances behind someone wearing a mask in public, and I'd hope that you would not rush to be so judgmental of me when I had to wear one to drop off my broken MacBook at a repair center recently (called ahead to do a no-contact drop but you never know when someone else will screw that up). I've been holed up in my house for several weeks, terrified to catch this. If I get sick and medical services are overwhelmed, I have to hope my cpap at 14cm and 5L of O2 piped in from my concentrator will keep me from needing hospitalization, but with one functional lung and 90% sats on a good day I'm one of those most at risk. I've been on a ventilator in the ICU a few times, and is NOT fun, especially when your ET tube gets plugged and you pass out while they try to clear the blockage.
I made my wife wear one of my masks on an airplane when she traveled without me 4 weeks ago, so she would not bring something home to me. She wiped down her seat and everything nearby with Clorox. She recently quit seeing private pediatric occupational therapy patients at their home, and is doing telemedicine on the half of her patients that are willing to do so. As director of clinical services for a not for profit pediatric PT/OT and Speech therapy company, she has been instrumental in setting up telecommuting to work from home, and implementing their telemedicine program and getting approval for her people to be paid, so that she can keep her 200 employees working instead of looking for food stamps.
A question: orthopedic physical therapist in private practice, getting multiple calls from patients who are in significant pain and want to be seen.
I'm deferring to the dentists, who, like me, practice for many hours in close proximity to their patients. Most of them are closed until at least April 7th, and will re-assess after that.
So, what would you all recommend as a good screening thermometer when I decide to again see patients? Forehead swipe; sub-lingual with disposable sleeve? I hear the "gun" style is often inaccurate. Many thanks.
