From SocoRuss
Do you think you could do a post about what you see as a medical person and covid. We hear from the govt and CDC we are all going to die and the latest variant will wipe out the world so we should hide and take the next 27 booster shots . We dont get to hear that much from someone like us who who skips the bullshit. But what are you seeing? Are you see large numbers of cases, how severe are the cases, what type of people are coming in? The healthy, the old and weak, the immune compromised? Is the large influx of illegals the cause of the number to rise? The big question would probably be who is getting covid more now, the vaxxed or unvaxxed. there seems to be more and more doctors studies saying the vaxxed are getting covid more now, whats the truth?. Whats you opinion and advice on this? I think a lots of your readers would like to hear this also.
OK. My ED sees between 200 and 300 patients per day. We are seeing about 50 to 60 people who have respiratory complaints each day. The majority of them wind up with cardiac, emphysema, COPD, and other infections like pneumonia and the flu. About 15-25 of those 50-60 wind up being diagnosed with COVID. How does that happen? The following is going to be a bit heavy in technical details, but I will simplify it as much as I can, so that it is more understandable.
We are a protocol driven hospital. Under the law, nurses can’t do anything that they aren’t ordered to do by a doctor. So hospitals using protocols have a set of SOPs that nurses enter into a patient’s chart, and a doctor (or other provider) signs off on it. These protocols can be entered by the nurse that is using their professional judgement, or they can be initiated by the nurse after being alerted by our computerized charting system generating a “best practice advisory.”
Hospitals have something called SIRS criteria, as pretty much every hospital in the nation does. When a patient arrives in the ED, they are initially triaged. The computer (and nurse) looks for the following:
- Body temperature over 38 or under 36 degrees Celsius.
- Heart rate greater than 90 beats/minute
- Respiratory rate greater than 20 breaths/minute
- partial pressure of CO2 (either end tidal or arterial blood gas) less than 32 mmHg
- Leukocyte >12000 or <4000 per microliter
- >10% immature forms or bands
If the patient has two or more of the above, the nurse will enter a standardized set of orders for tests. Those tests include tests for lactic acid, a CBC, CMP, and if appropriate, COVID/Flu tests, urinalysis, and other tests. If the nurse doesn’t enter those orders, the computer will alert them that it is best practice to do so. If the nurse STILL doesn’t do so, the computer requires them to enter a note in the patient’s chart explaining why they didn’t. The system is designed to do this so as to prevent human error from missing something important. Once those orders are entered, a e-note is sent to the provider (doctor, nurse practitioner, or physician assistant) who is in charge of that patient, and they will sign off on those orders. It’s a quick, efficient system that is designed to be safest for the patient.
If any of those tests or a physical exam shows that an infection is also present, the patient is said to be positive for Sepsis criteria. This activates an entire other process. Every attempt is made to identify the particular pathogen involved, but the important thing is to start aggressive treatment at that point, before the patient goes into septic shock. So they get IV fluids and probably antibiotics while we are waiting for the results of testing. Time is of the essence here.
If a patient tests positive for Flu A or B, or COVID, they follow a different path. They don’t get antibiotics. Flu patients get flu drugs like Tamiflu. We check COVID patients to see if their blood is clotting normally (INR, PTT, and other similar tests), they get a chest Xray, and we monitor their oxygen saturation. They get some IV fluids, and oxygen (if indicated) and that’s it.
Does this sound like familiar advice? For decades, we have known that viral respiratory illnesses need fluids and rest. Remember that water is nature’s expectorant. It thins out respiratory secretions so that they are thinned enough to be easy to cough out. If you are sick enough to meet SIRS criteria, you likely haven’t been drinking enough water, so we give you a liter or so of either Normal Saline (0.9% NaCl in water) or Lactated Ringers solution. The vast majority of them get sent home after being monitored for a couple of hours. Occasionally, one will get admitted, maybe one or two a day.
The demographics haven’t changed a whole lot. The ones who are the sickest have underlying conditions like cancer, advanced cases of diabetes, COPD, or other inflammatory or respiratory diseases. My hospital doesn’t see a whole lot of illegals, so I can’t comment there. COVID vaccine status doesn’t seem to matter one way or the other. I really don’t think that the vaccine does anything. That’s why I got the first series back in the spring of ’21, but haven’t gotten anything since. (I had COVID twice just a couple of months after I got vaccinated. I haven’t worn a mask since, yet I have been exposed to COVID at least once every working day, and haven’t gotten shit.)
I haven’t seen a COVID death in at least six months. We admit a few, but the VAST majority are treated and released. I will say that we are getting more cases lately, but I don’t see the cases we are getting now being as severe as the ones from 2020. I think that this is because of a few things:
- We know how to treat COVID now. That wasn’t true three years ago.
- COVID already killed off the weakest and sickest.
- The original strain of COVID was the most virulent, IMO. These new variants are not as deadly as the first one.
We have had a lot of staff testing positive for COVID. We had 15 call ins just in the ED staff on the last day that I worked. It seems to be going around and is more contagious than before, but it seems to be no worse than the flu. I have been beefing up my immune system in the meantime by taking vitamins (especially C, D, and E), calcium, and zinc, trying to be a bit proactive.
Understand that this is the experience of one nurse in one hospital, and we all know that anecdotes are not data.
14 Comments
The Scarlet Letter · August 31, 2023 at 1:37 pm
But, but, but, muh Tik Tok video? (s/)
Unelected comrade commissar Gill Bates has said that those who do not get the depop clot shot experimental gene therapy will be “excluded” fro society, time for a new society.
Any actual photo or slide of the most dastardly heinous virus in human history?
What is the mathematical probability of pandemic after pandemic, wasn’t it 600 years between the Black Death and the after WWI outbreak, then 1968 for the next major one?
How long have these bioweapons labs been around since WWII?
Wasn’t there an “intelligence agency” created around 1947.
Hmm so hmm.
Birdog357 · August 31, 2023 at 5:38 pm
Pandemics will increase in frequency for no other reason than the human race is more mobile now than in the past.
Craig · August 31, 2023 at 6:26 pm
IIRC when viruses mutate they become less severe but more contagious. I wish the truth was spread instead of the propaganda. I know I know: wish in one hand poop in the other.
W Wilson · August 31, 2023 at 3:41 pm
Two years ago I was hospitalized for covid , but I had pneumonia. I requested that I not be restuated or given resdeathisnear. I didn’t want to be killed , I knew what I needed. The Doctors were not happy.
J · August 31, 2023 at 4:43 pm
I’m wondering how you’re diagnosing patients for/with COVID? It’s been confirmed the PCR tests are ineffective or unreliable. I’d also thought the CDC removed these from use for this purpose. Is there another method being employed? Thanks!
Divemedic · September 6, 2023 at 9:31 am
We take a sample from the patient’s oropharynx and send it to the lab. What exact test they are using, I am not sure. We get an answer back within an hour or so.
I think the problems with PCR testing specifically involve the at home tests for a number of reasons that have to do with how the test is being done at home. I do know that the biggest problem with the at home PCE test is false negatives.
Joe Blow · August 31, 2023 at 6:25 pm
Very helpful, thanks.
During the initial go-around, I was very skeptical of hospital numbers posted on the tv news. I called. Buddy i used to work with who delivered oroduce to some of the local hospitals – if they’re ordering a ton of food, their beds must be full. Said some were, some weren’t, but his info told me I couldn’t trust the news on tv, they said every one was over flowing.
Noway2 · August 31, 2023 at 8:39 pm
“Understand that this is the experience of one nurse in one hospital, and we all know that anecdotes are not data.”
True, but when mypuktiple data points start to align, a picture begins to form
“I have been beefing up my immune system in the meantime by taking vitamins (especially C, D, and E), calcium, and zinc, trying to be a bit proactive.
At the onset of COVID, I discovered Chris Martensen of Peak Prosperity who did daily hour long videos on the subject. His posts were honestly not just a source of information, but a grounding in the real world information and a sourcec or comfort in an uncomfortable world. One of his daily items was to “prepare your terrain” to best weather an infection. Do things to minimize the innocuous load and boost your immune system: sunshine, vitamin D, zinc, vitamin C quercetin, zinc and elderberry syrup.
As Chris, you are a voice of sanity in an insane world. Thank, you,
C · August 31, 2023 at 9:59 pm
I wish we logged bodies in the morgue with a COVID and negative listing. The former got a COVID labeled bag. Log book didn’t get any extra notation. 2020 there was a spike in admissions to the morgue. Old, sick, and fat were COVID positive when wheeled in. The young and fit were either car accident, drug overdose, or suicide. We did get way more suicides than usual. So much data we could have catalogued.
Aesop · September 1, 2023 at 12:41 am
FWIW from the opposite end of the country:
Amongst our usual patient population, we’re seeing a spike (from 0 cases) of between three and half a dozen confirmed COVID cases/day.
Unlike in 2020, where people came in satting 90% on room air, desatted to 60-70% within hours despite maxxing out on oxygen, and got intubated, the current cases are less severe than any case of flu you’re ever seen.
The youngest one was a 4-week-old.
The oldest was 102.
To date this year, we have hospitalized exactly zero COVID cases, for COVID alone.
A non-zero number of them who tested positive when checked prior to admission were entirely asymptomatic, and their COVID infection was only discovered because we were testing all admitted patients for it.
In short, the virus has mutated to far less lethal/virulent strains.
Despite no masks on anyone, patients or staff (unless a patient tests positive for COVID), unvaccinated moi (and multiple other Purebloods) remain COVID-free since ever, AFAIK.
Multiple staff members with 2-3 doses of The Jab have all caught COVID again in this latest outbreak.
All the staff vaxxholes who gave the 1/3 of staff who remain unvaxxed endless rations of shit from 2021-2022, have now elected to STFU.
They don’t want to talk about Not-A-Vaxx anymore, for some reason.
Three years later, COVID is now “just the flu”.
Han Shot First, He Was No Fool · September 1, 2023 at 4:01 am
“… so we give you a liter or so of either Normal Saline (0.9% NaCl in water) or Lactated Ringers solution …”
Ringer’s lactate has the tendency of complicating detection of certain types of Gram negative bacteria involved in sepsis, so it’s often a good idea to do the diagnostic blood draws early and BEFORE putting the patient on IV fluids.
Also, other everyday stuff messes up the YSK analyser, but patients often think that paracetamol, ascorbic acid, and other OTCs are no big deal, plus they may be in pain and not think of mentioning it.
And so A&Es screw this up routinely by not asking patients, “What about OTCs, vitamins, and supplements?”
Someone shows up with a puncture wound and a clear case of sepsis, but without accurate diagnostics, they’ll get put on antibiotics as per protocol, often the wrong ones.
A&E doctors often don’t ask other intelligent questions such as, “Were you in a hot tub or soaking in your bathtub?”
Because these kinds of questions often lead to diagnosing the right kinds of bacteria for sepsis early.
So perhaps if you see patients presenting with sepsis symptoms it’d be helpful to ask these questions yourself.
But at least some of the treatment regimens are getting sorted.
You know how in “House” it’s often Lupus?
Well, with sepsis it’s often Pseudomonas.
If it looks grim and the patient’s been on an unsuccessful course of antibiotics, why not try clindamycin?
It often has enough Gram negative activity that works as a diagnostic tool for botched diagnostics.
Yes, I know this isn’t about COVID, but sepsis will also kill people deader than Dickens.
See enough of this and you’ll refuse to soak in your bathtub without spraying it down with Barbicide and leaving it to sit for thirty minutes.
joe · September 1, 2023 at 5:35 am
there were treatments for covid, hospitals weren’t allowed to administer them… we all know those in power aren’t going to make a bug that they can’t take medicine for… they just won’t give that medicine to us… they want to kill as many of us as possible… one way or another
SoCoRuss · September 1, 2023 at 1:24 pm
Thanks DM and Aesop for the info. It’s good to get it unfiltered.
Aesop, so you are seeing the vaxxed get it vs purebloods not, eh? That confirms some other sites info thanks again. Get conformation from multiple sources helps.
D · September 1, 2023 at 1:27 pm
> We have had a lot of staff testing positive for COVID.
I interact with a lot of medical personnel in my job. I see a *lot* of this.
Granted, I don’t want to have surgery or get my teeth cleaned by someone who has the flu…but I think a *lot* of people have figured out that you can test positive for COVID but be completely fine…and they’re using it as an excuse to get out of work for 2 weeks.
Meanwhile, I work from a cabin in the woods, so I can do my job even when I’m sick as a dog with a 101 fever….unfortunately. 😉
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