The General Covid19 Thread

zackster

This is exactly the type of situation fuck face Cuomo is trying to prevent. To my US friends, please don’t ever vote for this man.

jonattonyeah

zackster

The questions around here is how the hell Ukiah got that many doses. It’s a tiny podunk town north of Sonoma.

benson

Yes, we have I think 19 beds for our ICU. There are currently 30 patients on it. I know of a big London hospital that intubated 20 patients in 36 hours. Plus people are doing their best to hold patients on the wards and only go to ICU if they need intubating. It’s bad.

C_J

benson so as far as you’re concerned, ICU capacity has been reached and breached already. Is that correct?

benson

https://www.bbc.co.uk/news/av/health-55540701

Plus everything has to be done in full PPE, which is extremely tiring.

C_J

zackster I guess everyone would guess that. But that’s my point - who actually knows?

what are the ICU occupancy rates for now compared to previous years?

I know what the morons will say: “oh I don’t have time for these antivax-flat earthers. This virus is killing people, guy, and those damn Covid nurses are angels ok?”

before anyone says that, I’m not disputing it. I just want to know how much closer to breaching ICU capacity we are now compared to prior years.

you can’t blame people for researching shit on Facebook if there is no actual data for them out there. Why doesn’t anyone know the answer to this basic question?

jonattonyeah

C_J

We usually hover around 50% occupancy. Currently at 35%. The Bay Area in totality is currently around 5% availability. It’s a tough metric to measure as many of these beds would have been taken by people following elective surgeries that are not happening right now. And then there’s the flu (which has not been an issue this year). The problem is with the flu and with post-surgery stays is that they’re usually quite short stays - COVID requires often weeks of care. Once that bed is taken, it’s taken for a good amount of time. There’s not much turnover. And these patients require a lot of monitoring. Respiratory is the most publicized concern but there’s also liver and kidney function, blood oxygen, et cetera. Staffing capacity has been been our bigger issue than bed availability. ICU nursing is high level and requires extensive training. “Bed availability” doesn’t quite get to the crux of the issue and I agree that the point hasn’t been argued the right way and has possibly caused more confusion.

Old-Dutch

Was sent this earlier.

Senior consultant urologist at Northwick Park wrote the below…
👇👇👇👇
From a frontline doctor
PAY ATTENTION.
I’m writing this from the middle of one of the most ridiculous night shifts. I’m really trying to not be hyperbolic when I say this, but the health service, specifically north London hospitals, is past breaking point. I cannot fully explain how much trouble we are in.
All of our intensive care units are full. Barnet, Royal Free, UCLH, North Middlesex. All of our hospital beds are full. We have patients on the verge of death in A&E department because there’s simply nowhere to put them if they need a ventilator. I’m not talking about the elderly and frail. I mean people in their 40s, 50s, 60s. We do not have the space in our hospitals nor the staff to look after any more patients. Not only covid patients, I mean anything.
Please don’t mix with other households. Not even your families. Not your friends. Not your mum or your dad. Not even if “I only see them” or “they don’t see anyone else”. You may think people are being careful but the reality is there’s no such thing. Any human contact will spread this virus, especially the new mutant strain.
People are complaining that cancer services and routine operations are being put on hold because of lockdown and covid. This is so patently ridiculous a complaint but I need to address it. Hospitals are so overwhelmed dealing with emergency care right now that it is impossible to deal with anything else. It’s not only covid emergency care, it’s everything. This is the direct result and the logical conclusion of allowing the virus to rampantly spread through out communities as we have done.
I’m sorry if this sounds preachy, but it needs to be said. We need to take more responsibility for our own health and that of the rest of our local communities. We need to do the right thing. That’s all this comes down to - doing the right thing. Not seeing other people. Not going into other people’s houses. Don’t invite people over. Not even to the garden. If you must see people, do it two metres away with masks. Forget whatever rules the government has made for us - it’s clear they have largely not been based on what needs to be done to drive down infections. Just act as if everyone you know has just tested positive and you need to avoid them like - quite literally - the plague.🙏

C_J

I mean, I have no reason to doubt you and I don’t believe you are lying about it - but this is massive if true, because it’s being completely covered up by the BBC and the rest of the media.

benson

As of today there are 2378 patients mechanically ventilated (that means properly asleep with a tube in their windpipe) with covid in England.

You can find that data here https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/

In February 2020 there were 4122 ICU beds. You can find that data here https://www.england.nhs.uk/statistics/wp-content/uploads/sites/2/2020/04/MSitRep-February-2020-alHTC.xls

So at the moment 58% of our entire ICU capacity immediately pre-pandemic is taken up by covid patients. Not all of those ICU beds are ‘general’ beds either. Some of them will be specialist cardiac / neuro intensive care beds. And covid hasn’t stopped other bad shit happening, like sub arachnoid bleeds (brain aneurysms) or heart attacks or strokes, or trauma, or cancer that needs operating but needs ICU care afterwards.

The NHS was running on pretty thin margins pre-pandemic, and now 58% of ints intensive care capacity has been turned over to covid. What we have done is increase capacity, but this means taking staff from other areas, such as planned surgery, and moving them to ICU.

Immediately pre-pandemic, so running at normal February levels, 3342 of those beds were occupied. I do not know how many were emergency vs elective admissions, although you could find that out. If you take off the elective admissions from there and then add on 2378, I suspect you will find we are probably over Feb 2020 cacpacity/

it took me 5 minutes to find that data

benson

jonattonyeah A single ICU bed in the UK requires 7 WTE nurses. 1 week is 168 hours. They work 37.5 hours a week, plus handover time plus accounting for leave. That easily gets you to 7.

A nurse costs at least £50k / year (costs, not earns) so nursing costs alone of an ICU bed are £1k / day. That does not include infrastructure, all the blood tests, drugs. Then you need doctors, 2 doctors per bed at least. Thats another £250k.

ICU costs about £3k / day. So we do not have a lot of spare capacity and units sitting empty because we want to make sure we keep it as lean as possible. That’s what the taxpayer would expect. It also means that you cannot magic out of thin air all the experienced nurses you need to run a 5000 bed hospital in a conference centre, and why it was never going to work, even if you had all the ventilators in the world. beds are not the problem. We have expanded into waht used to be an orthopaedic ward. It just means we are doing less orthopaedic work and we have lost a lot of our junior doctors from anaesthetics to intensive care

jonattonyeah

benson

Wow. Gotta say £50k / year is a good price for what we have here. SFDPH and UCSF nurses start at $150,000 per year and total compensation is well over $200,000 (£145,000) when pension and health coverage is taken into account. That’s also an RN not an NP (not sure if you all have that distinction over there - an NP can prescribe meds and get paid substantially more). We’re totally reliant upon residents/students to maintain our system of care. We’ve been pretty lucky COVID-wise. Not like Los Angeles. Partially because UCSF has such an extensive background in infection disease thanks to HIV hitting this area so hard in the ’80’s and ’90’s. Not sure of our costs per bed but I’ll see if I can get some data around that later today. I can promise you we’re not doing two docs per bed.

C_J

Interesting. Thanks.

FabiParas

@benson @jonattonyeah it must really frustrate you beyond belief the real lack of awareness on the media and the deniers in Social Media that think this is all a hoax and ’no worse than the flu.

My heart goes out to your colleagues who are dealing with this on the front line.

Mad_Cyril

FabiParas
Well said.

A lot of berks out there unfortunately. Hopefully a minority, just with a louder voice thanks to social media etc.

Thank @benson @jonattonyeah
appreciate it means fuck all in the grand scheme of things, but you have my utmost respect.

-si-

Millsy

Sounds like zack and Eddie’s night out last year, millsy!

zackster

-si- yes si, NYC is absolutely a desert! You are VICIOUS in 2021!

C_J

I bet if hospital beds cost the occupant £1,000 a night and the doctors got paid per patient all the beds would be empty and the doctors would all be like “ah go on - have a drink with your mates”

C_J

Chris Witty on the telly earlier saying that we’re all going to be legally forced to congregate in supermarkets controlled by oligarchs next winter as well!

thank god elite sport has been allowed to continue at least. That will flatten the curve and help to maintain the vital flow of income to multinational corporations too.

alistair

C_J I don’t see us ever going back to normal not with Whitty and Vallance running the show. I do wonder where the tax money will come from to grow future NHS expenditure when the economy is fucked. There will be mass youth unemployment for a long time

Mad_Cyril

C_J thank god elite sport has been allowed to continue at least.

You might need to mark that as ironing for Dave

FabiParas

alistair Why do you think Whitty and Vallance are doing a bad job?

Wasnt the NHS going to get £350m a week now we’re out of Europe? I’m pretty sure I read it on a bus somewhere?

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