Italy no longer intubating those over 60 years old (seniors, place, parents)
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* This is the end of life as we know it and I suspect that life is going to get very difficult for all of us from now on. Maybe we need to start looking beyond the economy for answers.
The trade-off is whether life is going to get very difficult for all of us, so that nearly all of us could survive; or that many of us will die, so that life continues more or less unimpeded, for the rest. I am not convinced that there's a "right" answer to this.
I've never been entirely enthused about living, and must confess, that the prospect of potentially dying soon, actually gladdens me. Hopefully it will be painless and easy, but one never knows; nasty surprises abound. There is a kind of satisfaction, maybe a catharsis, in sorting one's papers and writings and so forth, and notifying trusted people, where copies are stored. Catastrophizing? Perhaps. But many of us are guilty of the same, in this thread and in others.
The overarching summary is this: life's not all that great, and it never has been. Why are so many - nay, almost all! - are so tirelessly adamant about clinging to it?
Wealthy individuals buying ventilators and keeping them and medical staff on standby at a time when hospitals are facing a severe shortage?
What a completely nuts idea :-). In this situation, a ventilator might buy you a few additional miserable days, but it will not cure you. I suspect the underlying reason why 80 out of 100 infected people have no symptoms to speak of, 17-18 have a severe flu, and 2-3 die, is molecular - the genes of those fewer people who have a bad course must be making some protein that the virus uses to their disadvantage, or are not making some protein that protects against the virus. It does not seem that too many people with bad course of this infection come off ventilators alive.
The focus should be on speeding up vaccine development, and maybe purifying something (like an immune globulin) off of plasma of those who have died to possibly manufacture an anti-serum, or at least analyzing the DNA of people with bad course of the disease vs. DNA of asymptomatic people to see who is truly at risk and why, so they could be selectively isolated rather than shutting the whole world down. The focus should not be on pathetic stuff like masks and ventilators, which protect nobody and help nobody.
I think the plasma thing from survivors is in testing now.
Yes, but the research and clinical tests are moving too slowly. Relevant molecular studies could have been completed in the first week after the initial US patients were detected - or even earlier, using the specimens from patients in China. Considering the urgency, FDA should have allowed the usual clinical trials to be bypassed, and an antiserum preparation, no matter how crude, to be given to all patients with severe symptoms that were willing to try it. Edward Jenner in the 1700s England inocculated people with pus scraped from cows with cowpox, and saved those people from smallpox - you can't do any more crude immunoprotection than that, and yet it was far more effective than what we can apparently do with our FDA rules. I do not understand FDA's concerns about possible side effects of the new antiserum in this situation. Just which possible side effect is worse than death? The usual biomedical administrative ****, and mindbogglingly wrong priorities. I said already why I wanted to retire and not have anything to do with "healthcare" any more.
[quote=elnrgby;57690226]
and maybe purifying something (like an immune globulin) off of plasma of those who have died to possibly manufacture an anti-serum ./quote]
And sorry for the typo in my previous post, it should not be "off of plasma of those who have died", but "off of plasma of those who have NOT died". Those who have not died are those who were able to mount a successful immune response, ie, their serum/plasma reliably contains the right antibodies.
The trade-off is whether life is going to get very difficult for all of us, so that nearly all of us could survive; or that many of us will die, so that life continues more or less unimpeded, for the rest. I am not convinced that there's a "right" answer to this.
I've never been entirely enthused about living, and must confess, that the prospect of potentially dying soon, actually gladdens me. Hopefully it will be painless and easy, but one never knows; nasty surprises abound. There is a kind of satisfaction, maybe a catharsis, in sorting one's papers and writings and so forth, and notifying trusted people, where copies are stored. Catastrophizing? Perhaps. But many of us are guilty of the same, in this thread and in others.
The overarching summary is this: life's not all that great, and it never has been. Why are so many - nay, almost all! - are so tirelessly adamant about clinging to it?
I asked this exact question to a friend, 80, with end stage COPD. He is hoarding everything in sight, and proudly proclaimed he doesn’t need to leave the house for six months. He had no answer to the question.
Personally, I don’t understand the will, even desire, to live at any cost.
The trade-off is whether life is going to get very difficult for all of us, so that nearly all of us could survive; or that many of us will die, so that life continues more or less unimpeded, for the rest. I am not convinced that there's a "right" answer to this.
...
The overarching summary is this: life's not all that great, and it never has been. Why are so many - nay, almost all! - are so tirelessly adamant about clinging to it?
May I gently point out that death by suffocation by breathing failure is not exactly a sudden or painless event. I have a friend (in his 50s) with severe COPD and he described the feeling he had before being put on a vent when his lung collapsed and it is not an acceptable thing to embrace.
I have certainly heard from (mostly) older people who are tired of the stay-home orders and life and make comments about "getting it over with," given that so many people will get COVID anyway. I do doubt that they'd quietly suffocate/drown at home in peace. Likely would reasonably panic and call 911 and expose their first responders. I just got an email from my local first responder (a neighbor!) and she listed all the things they have to do to preserve PPE and attend to home calls these days.
I am not a joyful "love life" person either. I lost a friend of 28 years ago to alcohol/drugs/diabetes, and now and then I think, "Michael, you're not missing much."
May I add the notice I got from our local EMS (small mountain town in SW Colorado, all of some 5000 people in the whole county if that)
We just wanted to fill you in on the precautions Ouray County EMS (OCEMS) is taking and the actions you can expect from us on any EMS calls during this pandemic. These actions will apply on ALL EMS calls regardless of the reason for the call until social distancing rules have been relaxed.
* 911 dispatchers may ask questions regarding known contact with sick people and any recent travel. This is to help our responders choose the appropriate level of Personal Protective Equipment (PPE) prior to entering your home. Your answers to these questions will NOT change how you are cared for.
* When EMS arrives, only 1 EMT, wearing gloves, goggles, and a surgical mask, will enter your home. They will bring the minimum necessary equipment based on the reason for the call.
* The EMT may elect to also wear a gown and/or N95 mask based on symptoms and/or their own comfort level.
* Additionally we are going to give YOU a surgical mask to wear while we are there. With both of us masked up we greatly reduce the chances of passing on germs in either direction!
* Additional responders will only enter your home if requested by the initial EMT to provide assistance with on-scene care or to bring in other needed equipment.
* Treatment options may include recommending that you stay home and rest, see you personal doctor, or transport to the ER at Montrose Memorial Hospital (or rarely, via helicopter to the ER at St. Mary’s in Grand Junction). Once an initial assessment is done the EMT will discuss the options that are appropriate for your treatment and will consult with an ER physician as needed to determine the best course of action.
* If you have mild symptoms suggestive of COVID 19, or other respiratory illness, and we determine that staying home and resting is your best course of action, you may receive a follow up call from Ouray County Public Health to check and make sure you are doing ok.
* If it is determined that transport to the ER is the care you need we will ask you to walk to the doorway of your house or to the ambulance if it is appropriate based on your illness or injury. The reason for this is to avoid bringing 1-3 extra people and extra equipment such as our gurney into your home.
* Once placed in the ambulance you will be attended by a single EMT unless your care specifically requires additional personnel. If you have symptoms suggestive of COVID 19 or other respiratory disease we may use exhaust fans and heating systems to encourage good airflow in and out of the patient compartment.
* After any EMS call ALL diagnostic equipment, the ambulance, and the gurney will be throughly cleaned and disinfected. These are standard practices for EMS, and all of our disinfectant products meet federal guidelines for ‘emerging viruses’ such as the SARS-CoV2 virus that is responsible for COVID 19 disease.
In the mean time we appreciate your help in slowing the spread of COVID 19 disease by following stay-at-home rules and washing your hands like you just chopped jalapeños.
...Considering the urgency, FDA should have allowed the usual clinical trials to be bypassed, and an antiserum preparation, no matter how crude, to be given to all patients with severe symptoms that were willing to try it. ...
... The usual biomedical administrative ****, and mindbogglingly wrong priorities. ...
This is precisely why large-scale response is going to be bungled. It's not lack of willpower, or corruption, or political calculation superseding the reality on the ground. It is entrenched mentality, developed over a century (or longer?) of how society ought to be governed.
Quote:
Originally Posted by brightdoglover
May I gently point out that death by suffocation by breathing failure is not exactly a sudden or painless event. ...
I have certainly heard from (mostly) older people who are tired of the stay-home orders and life and make comments about "getting it over with," given that so many people will get COVID anyway. I do doubt that they'd quietly suffocate/drown at home in peace. Likely would reasonably panic and call 911 and expose their first responders. ...
That's an excellent point! What many of us fear most, isn't death itself, but the nasty process of death, the pain and dread of our body shutting down. What prevents a good solution is another cultural taboo. elnrgby noted that we can't coax the regulatory establishment to make exceptions in desperate, no-alternative situations. In a similar way, we can't coax the whatever-it's-called establishment to release euthanasia pills, for desperate and no-alternative situations. It's "immoral", or "killing grandma".
We're stuck in collective mental constructs that so much complicate the situation, whether for those already on death's door, or potential survivors.
Yes, but the research and clinical tests are moving too slowly.
I read a story in the "Bezos Post" about the complete unknowns regarding childbirth in this time period (hospitals aren't allowing anyone to accompany the mother in labor and suggesting that the newborn be removed from the mother immediately on birth) and the lack of evidence or studies. So a group at UC San Francisco Medical school is CROWDFUNDING a study, enrolling pregnant women and tracking them.
They are crowdfunding it because the red tape for new studies and grants through federal avenues is so bad that they know they couldn't get the study done any other way.
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