Divemedic

The medical personnel are working six 12 hour days per week. Yesterday was his day off. He told me that he walked around lower Manhattan and took the ferry past the Statue of Liberty. He got pictures of the Bull in front of the Stock Exchange, and walked by Ground Zero and the Trinity Church. Of course, they are all closed and fenced off, but at least he got to see them.

This morning he sent me a video of what the hospital does every time a COVID patient is taken off the ventilator and has their breathing tube removed. The view is blurry because the staff has to carry their phones inside of sealed specimen bags so that the phone doesn’t become contaminated.

Even though they are dealing with untold tragedy dozens of times each day, they take joy and comfort where they can find it. It will not surprise me to find out that we have a large number of medical professionals experiencing PTSD over the coming months. Even though they are used to death and tragedy, there are hospitals that are dealing with a career’s worth of death in just a few weeks. I once had a stretch of death that saw me lose 26 patients in less than six months, a

The Florida governor issued a 2 page executive order (pdf warning) that reads (in pertinent part):

Section 2. I hereby suspend and toll any statute providing for an eviction cause of action under Florida law solely as it relates to non-payment of rent by residential tenants due to the COVID-19 emergency for 45 days from the date of this Executive Order, including any extensions.

Section 3. Nothing in this Executive Order shall be construed as relieving an individual from their obligation to make mortgage payments or rent payments. 

The counties are interpreting this order to mean that NO evictions are permitted and are refusing to even serve process on any eviction cases whatsoever.

Orange County Mayor Jerry Demings explained that the county is following that order.
“Evictions can’t be processed further by the clerk or served by the sheriff. What I’m saying to you is, there is no mechanism to evict people in the state of Florida. That won’t last forever, those property owners will be able to get their money,” Demings said.

So if I have a tenant that is destroying my property, I can’t even have them evicted, even though the governor’s order only prohibits evictions for nonpayment. So let’s say that this order gets extended for another 30 days, which is likely. Now landlords are going to potentially miss out on months of income. Once they evict their tenant, the landlord will likely never see the money that they are owed.

While it seems like a kind gesture, remember that landlords have expenses, too. As soon as the government requires that one person provide something to someone else without recompense, you have established slavery. This is, IMO, a violation of the 5th Amendment’s takings clause. You have deprived that land owner of the use of his own property for public use (controlling the pandemic) without reimbursement.

Demings, a Democrat, is married to US Representative Val Demings. She is most famous around these parts for losing her duty firearm in 2009 by leaving it in her unlocked patrol vehicle while serving as the Sheriff of Orange County. As the Sheriff, she punished herself by sending herself a strongly worded letter.

Democrats love three things:
1 Socialism
2 Gun Control
3 Exempting themselves from 1 and 2

What disappoints me is that the Governor is issuing these orders. I am fully upset with those who downplay  the threat posed by the Wuhan virus, but the threat of tyranny is far greater.

During the first week of March, my son told me that his hospital was requiring workers to show up to work, even though there was no PPE available. They were each issued one disposable N95 mask and told to make it last. My son was then sent to NYC, where he has all the PPE he needs. Some of it, the staff bought themselves, but at least they have it.

Without proper PPE, this is what happens to nurses in Florida:

“She always puts people first before her,” he said. “She showed up for work one day and they didn’t have a mask for her.” He explained that her symptoms slowly got worse, including coughing and fevers, but she put off going to the hospital. She began self-isolating in her family’s living room, where her husband found her lifeless body Thursday morning.

We have all heard the stories about nurses claiming that their hospital is not filled to capacity, or how their particular area is not so hard hit, and so they want to play like the Wuhan virus doesn’t exist. I just spoke with a good friend of mine who is an ICU nurse, and passed on the conditions at her hospital:

The ICU filled up about two weeks ago, so they began converting other areas of the hospital to be overflow ICU. Nurses typically work a 12 hour shift, three days a week. The ICU nurses are now working six of those 12 hour shifts per week. Becoming an ICU nurse requires years of training and experience, especially with the current challenging conditions. They can’t simply take a nurse from a random section of the hospital and stick them in the ICU.

The ED isn’t as busy as normal because most people are sitting at home doing nothing, and the remainder are not going to the ED for minor, stupid shit because people perceive the ED as a place filled with COVID patients and they don’t want to be exposed. For the first time in my memory, the ED is being used for actual emergencies.

What this means is that the nurses who worked in the (now shut down) areas of the hospital that have been converted to ICUs are being sent home, the ED seems slow (unless you are in a high COVID region), and the ICU and respiratory units are all working overtime.

This morning’s report from Harlem has a few more interesting facts. It seems that it is still taking 5-7 days for COVID test results to come back. My son reports that test results don’t matter at this point, because they have gotten quite good at spotting COVID patients by looking that the patient’s lab results, chest xray, and vital signs. He reports that nearly every patient who comes in has COVID.

Last night saw 5 patients die in the ED of COVID.

One patient who came in had been stabbed in the arm, but had an O2 sat of 76% and a fever of over 100F. He refused a COVID test and left after being stitched up. He likely has it, but we will likely never know for sure.

A couple of other factoids:
People with COVID are having coagualtion issues- they either have too many clots in the blood (called DIC) or they have to few, and whenever the hospital staff tries to secure an IV, the patient turns into a bloody mess. This is one of the reasons why the presence of elevated D Dimer is predictive of patient mortality.

The other thing that COVID is doing is triggering high blood sugar (HHS and DKA) in diabetics. For some reason, this disease really targets people with blood sugar issues.

With all of that, my son reports that they can see a definite reduction in patient volume and death. The worst of it appears to be over, and it looks like NYC is over the hump. Hopefully we will see a drastic reduction within a couple of weeks.

As you all know, my son is in NYC working in the ED at Harlem hospital as part of a medical surge team that is trying to get the situation under control. I had a conversation with him last night, and I wanted to share a few things from that conversation.

They have organized the ED into teams that are based upon the severity of the patient. In ascending order, the teams are: Blue, Green, Yellow, Orange, Red. My son is on the red team. (AKA Team 1)

He said that every single patient that comes into the ED is positive for COVID. At this point, it appears like most of the population of NYC has the virus. He believes that they have turned the corner, and we should begin seeing a drop in patients in NYC, simply because there is no one left to infect.

They are not placing COVID patients on ventilators or intubating them, because placing patients on a ventilator is an almost certain death sentence. They are only intubating patients as an absolute last resort, and even then are advising their families that their loved one is about to die and then speaking with them about end of life decisions. Instead, they are finding that the most effective treatment is having the patient lie prone while giving them supplemental oxygen at 6 liters per minute.

They are almost out of all antibiotics, so unless the patient’s pneumonia is confirmed to be bacterial by culture, no one is getting antibiotics.

I have recently seen people complaining that the US is padding stats by classifying anyone who dies while positive for COVID as being a COVID related death. This is actually valid, and I will explain using a couple of anecdotes from my son’s patients:

His very first patient was complaining about shortness of breath, but was sitting up in a chair, texting.  The doctor he is working with took one look at the patient from across the room and said “COVID.” My son said he laughed, thinking the doctor was joking. His oxygen saturation was measured at 68 percent.

Another patient came in with diabetic related symptoms. His blood glucose was 1,000. His blood chemistry was completely abnormal. He also tested positive for COVID.

Many people with aggravating conditions like diabetes, kidney or liver problems, or heart disease are walking around all the time with their body maintaining itself through compensation. What COVID is doing is pushing these patients over the edge.

One takeaway from my conversation with him:
The staff at the hospital wears a head to toe Tyvek suit with mask, goggles, shoe covers, gloves, and faceshield for their entire 12 hour shift. When they enter a patient’s room, the put more gloves and a disposable gown over the top of that. He said that eating, drinking, and going to the bathroom is a 20 minute ordeal of decontaminating, dressing down, and then redressing. My son said he dressed down twice during his 12 hour shift- he went to the bathroom, chugged a bottle of water, and grabbed a bite to eat. (First time was a giant cookie delivered by a local bakery, and the second was two slices of pizza)

They had to begin doing this because too many of the hospital staff were getting infected.

What this tells me is that the Wuhan virus is far more contagious than we are being led to believe.