Thank frontline workers by staying home today
November 26, 2020 9:09 AM Subscribe
Midwest Nurses Say Their Hospitals Are On The Verge Of Collapsing — And Leaders Aren’t Listening. For Tammy Tate, a nurse at a Missouri hospital, this wave is like watching a train about to crash, knowing that it could be stopped in time — if people would listen.
C.D.C. Pleads With Americans to Stay Home on Thanksgiving. Even as the White House downplays the coronavirus threat, health officials warned against traditional gatherings with those from outside the immediate household.
‘Many of us have PTSD’: Pennsylvania nurses strike amid Covid fears. Strike is the latest in a wave of healthcare worker protests over low pay, understaffing and PPE shortages.
‘Catastrophic death’ coming with staff, PPE, and hospital capacity shortages in US, warns top nurses union
Frontline nurse shares story of working with COVID-19 patients. Medical professionals on the frontlines of the pandemic are once again urging people to take the virus seriously “What started as a sprint is now a marathon and we are mentally and emotionally exhausted,” said Christina Hanson, registered nurse.
'You got me emotional': Joe Biden started tearing up after talking to a nurse about treating COVID-19 patients in ICU.
Some hospitals are running out of health care workers. Here's what could happen next. Imagine going to a hospital so overwhelmed, doctors and nurses with Covid-19 are allowed to keep working. Or having a heart attack and getting rushed to a hospital, only to learn there's not enough emergency care for you.
Hospitals Can’t Go On Like This. Twenty-two percent of American hospitals don’t have enough workers right now.
South Dakota Nurse's Tweets About COVID Positive Patients Who Don't Believe in the Virus Go Viral. Those who don't believe the coronavirus is real can still wind up catching it. That's something hospital workers have seen regularly throughout the pandemic and it's made an impact on them.
Reframing Clinician Distress: Moral Injury Not Burnout
Healthcare worker check-in in Metatalk
C.D.C. Pleads With Americans to Stay Home on Thanksgiving. Even as the White House downplays the coronavirus threat, health officials warned against traditional gatherings with those from outside the immediate household.
‘Many of us have PTSD’: Pennsylvania nurses strike amid Covid fears. Strike is the latest in a wave of healthcare worker protests over low pay, understaffing and PPE shortages.
‘Catastrophic death’ coming with staff, PPE, and hospital capacity shortages in US, warns top nurses union
Frontline nurse shares story of working with COVID-19 patients. Medical professionals on the frontlines of the pandemic are once again urging people to take the virus seriously “What started as a sprint is now a marathon and we are mentally and emotionally exhausted,” said Christina Hanson, registered nurse.
'You got me emotional': Joe Biden started tearing up after talking to a nurse about treating COVID-19 patients in ICU.
Some hospitals are running out of health care workers. Here's what could happen next. Imagine going to a hospital so overwhelmed, doctors and nurses with Covid-19 are allowed to keep working. Or having a heart attack and getting rushed to a hospital, only to learn there's not enough emergency care for you.
Hospitals Can’t Go On Like This. Twenty-two percent of American hospitals don’t have enough workers right now.
South Dakota Nurse's Tweets About COVID Positive Patients Who Don't Believe in the Virus Go Viral. Those who don't believe the coronavirus is real can still wind up catching it. That's something hospital workers have seen regularly throughout the pandemic and it's made an impact on them.
Reframing Clinician Distress: Moral Injury Not Burnout
Healthcare worker check-in in Metatalk
...residents, especially in smaller communities, are refusing to wear masks and reacting with fierce anger at anyone — from their doctor to their governor — who suggests that they should.
I wish I could say I was surprised at this. After the violence I’ve experienced from politely asking people not to smoke in clearly marked nonsmoking areas, I knew it was going to be the same with mask-wearing.
I read the other day about two people who started punching an elderly man who asked them to pull their masks up while waiting in line at the Magic Kingdom. They got away before the police could get there.
posted by The Underpants Monster at 9:21 AM on November 26, 2020 [4 favorites]
I wish I could say I was surprised at this. After the violence I’ve experienced from politely asking people not to smoke in clearly marked nonsmoking areas, I knew it was going to be the same with mask-wearing.
I read the other day about two people who started punching an elderly man who asked them to pull their masks up while waiting in line at the Magic Kingdom. They got away before the police could get there.
posted by The Underpants Monster at 9:21 AM on November 26, 2020 [4 favorites]
“Hospitals in Kansas are calling as far away as Omaha, Denver, [and] Oklahoma City to transfer them and finding they are full, too,” Slabach of the National Rural Health Association said. “It's a scramble.”Because the pandemic is worsening almost everywhere we will very soon reach capacity everywhere at once. The number of cases per day is still going up, and now we have the holidays. Over a million people went through US airports yesterday, and AAA has estimated only a 9% decrease in the number of people traveling by car. 40% of Americans will spend Thanksgiving with a group of 10 or more, and 20% of fucking epidemiologists say they plan to celebrate Thanksgiving with people outside their household.
The IHME model currently predicts about 470k deaths by March 1st, which means another 210,000 dead before vaccinations hopefully start to put a dent in things.
posted by jedicus at 9:25 AM on November 26, 2020 [4 favorites]
Diary of a Sad Woman - why I hate COVID.
I'm so over people not taking this seriously. "Oh I only have a 0.1% case fatality rate for my age". Well, asshole, what about if things go badly? What about the people who don't have such a low CFR. What about that low levels of CFR will only hold when we have a functioning fucking healthcare system.
You ever had to choose who gets ECMO? It's basically trying to decide who lives, and who will, most likely, die. And it's not choosing between three old people. It's choosing between three young people.
All we have to do is stay home if we are able to. That's it. Be economical with our social activities. That's all these people have asked us to do and we privileged can't even do that. The truly sad thing is that the bulk of the suffering inflicted on society for our pandemic transgressions will fall on those who are forced to be out there who neither deserve it or can ill afford it.
Fuck this country.
posted by Your Childhood Pet Rock at 9:29 AM on November 26, 2020 [36 favorites]
I'm so over people not taking this seriously. "Oh I only have a 0.1% case fatality rate for my age". Well, asshole, what about if things go badly? What about the people who don't have such a low CFR. What about that low levels of CFR will only hold when we have a functioning fucking healthcare system.
You ever had to choose who gets ECMO? It's basically trying to decide who lives, and who will, most likely, die. And it's not choosing between three old people. It's choosing between three young people.
All we have to do is stay home if we are able to. That's it. Be economical with our social activities. That's all these people have asked us to do and we privileged can't even do that. The truly sad thing is that the bulk of the suffering inflicted on society for our pandemic transgressions will fall on those who are forced to be out there who neither deserve it or can ill afford it.
Fuck this country.
posted by Your Childhood Pet Rock at 9:29 AM on November 26, 2020 [36 favorites]
I did my final drugstore and grocery stock-up in the early hours mon/tue when the stores were almost empty and, outside of an outdoor farmers market trip (walking distance) in the next few weeks, I'm in for the season. (I considered getting a turkey but ended up just getting a rotisserie chicken instead lol)
I listened. I listened back in March. I can't even believe this is all happening. What is wrong with people?
The IHME model currently predicts about 470k deaths by March 1st, which means another 210,000 dead before vaccinations hopefully start to put a dent in things.
Does that model include catastrophic hospital failure and 20+% fatality rates (like happened in Italy and NYC)? Because if that happens, the deaths won't be anywhere near that low.
posted by sexyrobot at 9:40 AM on November 26, 2020 [11 favorites]
I listened. I listened back in March. I can't even believe this is all happening. What is wrong with people?
The IHME model currently predicts about 470k deaths by March 1st, which means another 210,000 dead before vaccinations hopefully start to put a dent in things.
Does that model include catastrophic hospital failure and 20+% fatality rates (like happened in Italy and NYC)? Because if that happens, the deaths won't be anywhere near that low.
posted by sexyrobot at 9:40 AM on November 26, 2020 [11 favorites]
I said this in a different context in a different thread a while back, but I believe that many people feel so powerless on a macro level during this stage of late capitalism and everything it entails that they overcompensate by doing stuff calling 911 when Burger King messes up their order, sending death threats to people who work on pieces of popular entertainment who don't conform to their expectations...or, say, not wearing a mask during a pandemic because "freedom." I doubt this is any kind of new phenomenon but the whole thing has been turbo-charged by the internet, where you can reach out and find fellow travelers for any ideological journey and/or fall down any number of misinformation rabbit holes, which is why virtually any even remotely controversial issue in society quickly gets intertwined with all kinds of conspiracy theories. And speaking of which...
> Fuck this country.
...it's not just the U.S., of course. This is happening in Toronto, where I live, as I type. Fuck these people.
posted by The Card Cheat at 9:47 AM on November 26, 2020 [19 favorites]
> Fuck this country.
...it's not just the U.S., of course. This is happening in Toronto, where I live, as I type. Fuck these people.
posted by The Card Cheat at 9:47 AM on November 26, 2020 [19 favorites]
Right now, as I write this, people are sharing the virus with their families as they break lockdown and bubble protocols to gather together to selfishly celebrate a holiday meant to give thanks to others.
I can't laugh, I can't weep, I can only just sigh at the inevitability of thousands of refrigerated transport trailers full of bodies quietly humming away come Christmas.
posted by seanmpuckett at 9:53 AM on November 26, 2020 [8 favorites]
I can't laugh, I can't weep, I can only just sigh at the inevitability of thousands of refrigerated transport trailers full of bodies quietly humming away come Christmas.
posted by seanmpuckett at 9:53 AM on November 26, 2020 [8 favorites]
And when that happens you know who or what they're gonna blame? Not the correct targets of their grief and ire, that's for sure.
posted by The Card Cheat at 9:55 AM on November 26, 2020 [9 favorites]
posted by The Card Cheat at 9:55 AM on November 26, 2020 [9 favorites]
Oh I only have a 0.1% case fatality rate for my age
There's a 10% to 30% chance of having post-covid symptoms that can last weeks or more. Some seem indefinite. I haven't seen a great deal of evidence that this is linked to age; indeed I've seen reports that it can happen even for people who were asymptomatic.
These symptoms can be very un-fun, and affect one's ability to work an 8 hour day, do household chores, walk up and down a flight of stairs, breathe without care. In my case, they only lasted a few weeks, but those were anxious ones, not knowing how long it would all last.
Even practically, taking away the human factors, I don't know that having 10% or more of the health care staff benched, physically unable to work is a fantastic idea right now.
posted by bonehead at 9:55 AM on November 26, 2020 [11 favorites]
There's a 10% to 30% chance of having post-covid symptoms that can last weeks or more. Some seem indefinite. I haven't seen a great deal of evidence that this is linked to age; indeed I've seen reports that it can happen even for people who were asymptomatic.
These symptoms can be very un-fun, and affect one's ability to work an 8 hour day, do household chores, walk up and down a flight of stairs, breathe without care. In my case, they only lasted a few weeks, but those were anxious ones, not knowing how long it would all last.
Even practically, taking away the human factors, I don't know that having 10% or more of the health care staff benched, physically unable to work is a fantastic idea right now.
posted by bonehead at 9:55 AM on November 26, 2020 [11 favorites]
Our rural Wisconsin hospital, which has 38 COVID beds to be shared by 30,000 people, is full and shipping people very far away who can't be accommodated. Last week, when our positivity rate hit 49 percent and after hearing emotional pleas from the hospital CEO, our elected officials finally requested the public to wear masks and practice social distancing. This represents an improvement over their attitude in July, when I wrote this letter, but the GOP continues fighting every restriction in the courts when they're not kissing Trump butt by pretending the election was stolen.
Yesterday I got into a confrontation with an obnoxious woman, about 75, without a mask who screamed at me about how it was all fake news. I remained calm, trying different approaches (statistics, respect for the aforementioned edict, appeal to emotion via stating an assumption that she's a caring person who doesn't want to inspire fear in others, etc.). Other people in the check-out line joined in with facts, figures and personal stories. Finally she said, "What if I can't wear a mask?" which crucially is not the same as "I can't wear a mask." I replied, "The fact that you've been yelling at me for several minutes now with barely a pause demonstrates that this hypothetical doesn't apply to you." Applause from the bystanders. Swearing from the allegedly sweet little old lady.
I've gotten reasonably skilled at these "discussions" because I'm the Commodore of the local yacht club, which is basically about running a restaurant and a bar. So many of our members just refuse to wear masks because "It's our club!" They protest every safety measure we've added to the SOP. I deal with them to protect the staff from their wrath and its effects on their tips. Sure, some people think I'm doing a great job, but it's these entitled assholes who make every day a nightmare. My term is up 12/31 and I can't wait.
posted by carmicha at 9:59 AM on November 26, 2020 [50 favorites]
Yesterday I got into a confrontation with an obnoxious woman, about 75, without a mask who screamed at me about how it was all fake news. I remained calm, trying different approaches (statistics, respect for the aforementioned edict, appeal to emotion via stating an assumption that she's a caring person who doesn't want to inspire fear in others, etc.). Other people in the check-out line joined in with facts, figures and personal stories. Finally she said, "What if I can't wear a mask?" which crucially is not the same as "I can't wear a mask." I replied, "The fact that you've been yelling at me for several minutes now with barely a pause demonstrates that this hypothetical doesn't apply to you." Applause from the bystanders. Swearing from the allegedly sweet little old lady.
I've gotten reasonably skilled at these "discussions" because I'm the Commodore of the local yacht club, which is basically about running a restaurant and a bar. So many of our members just refuse to wear masks because "It's our club!" They protest every safety measure we've added to the SOP. I deal with them to protect the staff from their wrath and its effects on their tips. Sure, some people think I'm doing a great job, but it's these entitled assholes who make every day a nightmare. My term is up 12/31 and I can't wait.
posted by carmicha at 9:59 AM on November 26, 2020 [50 favorites]
it's not just the U.S., of course
Of course. Human nature being what it is, people all around the world are effectively expressing their unhappiness by blaming the restrictions for their problems instead of the virus. The worrisome part for me is the extent to which this anti-establishment and anti-authority sentiment might bleed into greater support for far-right organizations such as the AfD in Germany.
The U.S. is a bit unusual in this regard in that there's no coordinated national response and that the Republican party manages to be both the establishment and the "anti-establishment".
posted by Slothrup at 10:00 AM on November 26, 2020 [5 favorites]
Of course. Human nature being what it is, people all around the world are effectively expressing their unhappiness by blaming the restrictions for their problems instead of the virus. The worrisome part for me is the extent to which this anti-establishment and anti-authority sentiment might bleed into greater support for far-right organizations such as the AfD in Germany.
The U.S. is a bit unusual in this regard in that there's no coordinated national response and that the Republican party manages to be both the establishment and the "anti-establishment".
posted by Slothrup at 10:00 AM on November 26, 2020 [5 favorites]
There's a 10% to 30% chance of having post-covid symptoms that can last weeks or more. Some seem indefinite. I haven't seen a great deal of evidence that this is linked to age; indeed I've seen reports that it can happen even for people who were asymptomatic.
Yeah exactly. Lungs can also get fibrotic and when that happens it's a lifetime of wheezing and being out of breath doing basic things until one gets a lung transplant, which I'm sure are going to be in extremely short supply for the next couple of decades.
posted by Your Childhood Pet Rock at 10:02 AM on November 26, 2020 [7 favorites]
Yeah exactly. Lungs can also get fibrotic and when that happens it's a lifetime of wheezing and being out of breath doing basic things until one gets a lung transplant, which I'm sure are going to be in extremely short supply for the next couple of decades.
posted by Your Childhood Pet Rock at 10:02 AM on November 26, 2020 [7 favorites]
If the activity on my block this week is anything to go by, things are going to get quite dire here in Miami about two weeks from now. In addition to the usual not giving a shit that my neighbors have been practicing, several have had all night parties in the past few days. They weren't particularly responsible before, but it's pretty clear they're done with the whole social distancing thing. Last week on my way to the drug store I passed several restaurants that where the only care given seemed to be that only every other table was occupied. The ones that were had large groups of people all shouting to be heard over the din.
The sad thing is that we had appeared to be approaching a peak of infections without completely overloading the hospitals. At least most people are complying with the indoor mask requirements at the store. It's not much, but it provides at least a glimmer of hope that Christmas won't involve people dying outside the ER waiting to get in.
posted by wierdo at 10:12 AM on November 26, 2020 [5 favorites]
The sad thing is that we had appeared to be approaching a peak of infections without completely overloading the hospitals. At least most people are complying with the indoor mask requirements at the store. It's not much, but it provides at least a glimmer of hope that Christmas won't involve people dying outside the ER waiting to get in.
posted by wierdo at 10:12 AM on November 26, 2020 [5 favorites]
Even if one doesn't think covid is a big deal, full hospitals are a big deal. I had an extremely painful, potentially life-threatening, but easily treatable (with surgery) acute medical crisis a few years ago and spent the night in the ER. It makes me panicky to think about going through that without a bed, nurses, pain meds, a surgeon, etc. I guess for some people, if you've never experienced something like that, the idea of having an untreated medical emergency is abstract? And American exceptionalism means some people don't really believe they might go to an ER and be left there to die. Our hospitals can't collapse. We're America, the greatest country in the world.
posted by Mavri at 10:13 AM on November 26, 2020 [25 favorites]
posted by Mavri at 10:13 AM on November 26, 2020 [25 favorites]
That's the real nightmare for hospitals: it's not just that they're filling up rapidly, or even that things are going to get much worse in the coming weeks and months, but that the sort of patients coming in will be the same exact people who have refused to take precautions previously and promise to be about the worst possible patients (from a behavioral perspective) that the hospital has ever had. That lady in carmicha's comment above? Imagine her in an ICU, still in denial and trying to argue with the doctors and nurses trying to save her life. That's already happening in places. Winter is here.
posted by Halloween Jack at 10:21 AM on November 26, 2020 [9 favorites]
posted by Halloween Jack at 10:21 AM on November 26, 2020 [9 favorites]
El Paso County Medical Examiner’s Office is seeking to hire morgue attendants immediately; the county had been paying inmates $2/hour to move the bodies of deceased COVID patients, and earlier this week the Texas National Guard was deployed to help with the morgue overflow.
posted by Iris Gambol at 10:36 AM on November 26, 2020 [6 favorites]
posted by Iris Gambol at 10:36 AM on November 26, 2020 [6 favorites]
Our rural Wisconsin hospital...after hearing emotional pleas from the hospital CEO, our elected officials finally requested the public to wear masks and practice social distancing ...but the GOP continues fighting every restriction in the courts when they're not kissing Trump butt by pretending the election was stolen.At least once a week I head over to Robin Vos' & other WI GOP Twitters and and call them what they are: Murderers.
--posted by carmicha at 11:59 AM on November 26
I am so furious and angry at these chicken shit cowards, for failing to do their job, for being so afraid of actually having to face opposition due to their gerrymandering. Absofuckinglute cowards, and we Wisconsinites pay the price, and they try to make it Evers "fault" when they're the assholes who along with the WILL constantly do everything they can to stop responsible government and social functioning.
I'm so sorry you're dealing with that carmicha. Sympathies from a comrade in this state. Glad you recovered. This shit is so unnecessary.
I've had multiple years where I haven't been able to see my family, and this would have been the first year that I really had a lot of time off in ages to see them, but I am choosing not to be selfish. Maybe it's easier for me, because I've already had years where I wasn't able to, so am "used to it" but it still doesn't make it easy. But I do it because it's the right thing to do. Dad died last year, and who knows when mom might go. But I'm not gonna risk getting it or infecting anyone else (family or outsiders).
posted by symbioid at 10:47 AM on November 26, 2020 [17 favorites]
This may hit home in a few weeks when some luminary or relative thereof can't get their emergency gallbladder surgery for lack of beds. Americans are proving to be more paranoid, selfish, and stupid than could ever have been predicted.
posted by docpops at 1:06 PM on November 26, 2020 [6 favorites]
posted by docpops at 1:06 PM on November 26, 2020 [6 favorites]
In a normal, non-pandemic year, hospitals are at or above capacity most of the winter. This is intentional, because the bean counters believe that an empty bed represents lost revenue.
So come December, the ICU patients are boarding in stepdown, stepdown patients board on the floor, floor patients board in the ED, and ED patients get the "hallway beds." If you've ever been to an ED during flu season, you'll know what I mean. When we run out of hallway beds, the hospital goes on divert, which makes the bean counters mad because again, lost revenue.
And that's a normal year.
Please, for the love of all that is holy, stay home.
posted by basalganglia at 1:24 PM on November 26, 2020 [31 favorites]
So come December, the ICU patients are boarding in stepdown, stepdown patients board on the floor, floor patients board in the ED, and ED patients get the "hallway beds." If you've ever been to an ED during flu season, you'll know what I mean. When we run out of hallway beds, the hospital goes on divert, which makes the bean counters mad because again, lost revenue.
And that's a normal year.
Please, for the love of all that is holy, stay home.
posted by basalganglia at 1:24 PM on November 26, 2020 [31 favorites]
docpops, the luminaries and their relatives will ALWAYS be able to get their gall bladders taken out and their faces lifted. Having $$$ and/or clout trumps any other principle of triage, including actual medical need, because this is Murca.
posted by basalganglia at 1:27 PM on November 26, 2020 [7 favorites]
posted by basalganglia at 1:27 PM on November 26, 2020 [7 favorites]
The Supreme Court ruled again New York's restrictions on the size of religious gatherings: CNN Link
Over a million people went through US airports yesterday, and AAA has estimated only a 9% decrease in the number of people traveling by car. 40% of Americans will spend Thanksgiving with a group of 10 or more, and 20% of fucking epidemiologists say they plan to celebrate Thanksgiving with people outside their household.
I get the sense people are creating their own interpretation of what constitutes responsible behavior to protect themselves and their families, as well as prevent COVID spread. That interpretation may not be congruent with behaviours necessary to actually prevent COVID spread at the population level.
posted by eagles123 at 1:37 PM on November 26, 2020 [5 favorites]
Over a million people went through US airports yesterday, and AAA has estimated only a 9% decrease in the number of people traveling by car. 40% of Americans will spend Thanksgiving with a group of 10 or more, and 20% of fucking epidemiologists say they plan to celebrate Thanksgiving with people outside their household.
I get the sense people are creating their own interpretation of what constitutes responsible behavior to protect themselves and their families, as well as prevent COVID spread. That interpretation may not be congruent with behaviours necessary to actually prevent COVID spread at the population level.
posted by eagles123 at 1:37 PM on November 26, 2020 [5 favorites]
I had a telehealth appt with my nurse practitioner yesterday, and at the end of the call wished her a happy holiday. She sighed and said that her husband and MIL were insisting on having the family, so she was expecting 13 people over today. She is a former ER nurse! The mind boggles.
posted by Lawn Beaver at 2:09 PM on November 26, 2020 [6 favorites]
posted by Lawn Beaver at 2:09 PM on November 26, 2020 [6 favorites]
Between now and, say, the end of January, if you're in a part of the world that's beating all previous records for infection and is about to celebrate one or two holidays typically involving travel and gatherings, assume that you're on your own if you have an emergency.
This isn't the zombie apocalypse, you don't need a bug-out bag and a hidden stash of Krugerrand, but you do need to consider that emergency help will be slower than normal.
posted by krisjohn at 2:13 PM on November 26, 2020 [22 favorites]
- Check the state of any first-aid kits you have. Renew or buy as necessary.
- Test your smoke alarms. Fix as necessary.
- Check the state of any fire extinguishers you have. Charge, replace or buy as necessary. (Do you have a fire blanket in the kitchen?)
- Get your car serviced. Make sure the spare is in good order.
- Pull out a little extra cash if you can, but only as much as you'd feel comfortable carrying around.
- Maybe get one pack ahead on any prescriptions you have, keeping in mind the shelf-life.
This isn't the zombie apocalypse, you don't need a bug-out bag and a hidden stash of Krugerrand, but you do need to consider that emergency help will be slower than normal.
posted by krisjohn at 2:13 PM on November 26, 2020 [22 favorites]
We just had our family Thanksgiving Zoom call, and of 12 households on the call, 2 had people who were newly sick with Covid and a third had been exposed but didn't have the test results back yet. And these are people who are being relatively cautious and believe in science. It's going to be _ugly_ in this country the next few weeks. Fortunately, it's all younger people who are sick so far so hopefully no serious illnesses in the family.
posted by tavella at 2:52 PM on November 26, 2020 [4 favorites]
posted by tavella at 2:52 PM on November 26, 2020 [4 favorites]
The number of cars on my street indicates that my neighbors, who have not kept distance from people nor masked at all - at all!, have people over for Thanksgiving, and a good number at that.
Last week I commented in a work meeting, “Well, no one’s going anywhere next week...” and one person said they were traveling across multiple states to be with family. We’ll be in the garage, they said.
I get it. It all sucks. But these people are being irresponsible AF. I wish no ill will on any of them, but it is exceptionally hard to be cooped up for 8 1/2 months and look out one’s own window to see people being unsafe.
posted by hijinx at 3:02 PM on November 26, 2020 [19 favorites]
Last week I commented in a work meeting, “Well, no one’s going anywhere next week...” and one person said they were traveling across multiple states to be with family. We’ll be in the garage, they said.
I get it. It all sucks. But these people are being irresponsible AF. I wish no ill will on any of them, but it is exceptionally hard to be cooped up for 8 1/2 months and look out one’s own window to see people being unsafe.
posted by hijinx at 3:02 PM on November 26, 2020 [19 favorites]
I left my house to celebrate thanksgiving with my girlfriend and her family because 4 people around s as table is much better than C 12 neighbors all spread around a living room.
This is the same family who are Q anon anti vaxxers. I can’t get out from under my medical debt and move out with my girlfriend soon enough.
posted by thebotanyofsouls at 6:15 PM on November 26, 2020 [2 favorites]
This is the same family who are Q anon anti vaxxers. I can’t get out from under my medical debt and move out with my girlfriend soon enough.
posted by thebotanyofsouls at 6:15 PM on November 26, 2020 [2 favorites]
My sister decided that this was the year she and her boyfriend should drive over multiple states to visit both of my parents. Mom managed a Thanksgiving in the garage, but going by my whatsapp call, we are now pretending that my Dad's kitchen table is 6 ft and they can just have dinner in his enclosed kitchen. I believe they're going on to said boyfriend's sister's place in NYC next, and I just...cannot. I spent last night and this morning incandescent with rage, because I'm doing everything right, and I'm isolating and I'm not even seeing the person I just started dating because you're not supposed to be inside with a person you don't live with. Now I'm just exhausted -- there's just...no awareness that this is the year we don't travel. That this is the year the CDC and nurses and doctors and epidemiologists have begged us to stay home. None whatsoever with my mother chirpily asking me if cases are going up in WA. YES. YES THEY ARE, WOMAN. THEY ARE GOING UP EVERYWHERE.
I meditated a little on my rage, and I think part of what's so agonizing is that my reward is a negative. My reward for doing what I am supposed to and conducting myself the way one ought when one lives in a society is...I don't get COVID, and I don't spread COVID to someone else. It's not like I feel better -- I had a little cry this morning before Zoomsgiving because I missed my Quaker community, and the Thanksgiving we had last year. I don't get bonus health, or a prize or anything. I get not-dying of COVID, and I get not-having-extended-problems (I mean, probably, I still go out for a grocery shop, but let's say that my chances are quite low), but because these are absences of things, it feels like I'm just sacrificing for nothing; not even the status quo. And I watch my sister bop all over the fucking Eastern Seaboard and the disconnect is just...astonishing.
I've been working through a lot of anger because I know it's going to happen all over again at Christmas, is what I'm saying.
(I know that it matters. I know that not spreading this awful thing is the most loving thing I can do right now. But I am working on internalizing that, I think.)
posted by kalimac at 7:06 PM on November 26, 2020 [46 favorites]
I meditated a little on my rage, and I think part of what's so agonizing is that my reward is a negative. My reward for doing what I am supposed to and conducting myself the way one ought when one lives in a society is...I don't get COVID, and I don't spread COVID to someone else. It's not like I feel better -- I had a little cry this morning before Zoomsgiving because I missed my Quaker community, and the Thanksgiving we had last year. I don't get bonus health, or a prize or anything. I get not-dying of COVID, and I get not-having-extended-problems (I mean, probably, I still go out for a grocery shop, but let's say that my chances are quite low), but because these are absences of things, it feels like I'm just sacrificing for nothing; not even the status quo. And I watch my sister bop all over the fucking Eastern Seaboard and the disconnect is just...astonishing.
I've been working through a lot of anger because I know it's going to happen all over again at Christmas, is what I'm saying.
(I know that it matters. I know that not spreading this awful thing is the most loving thing I can do right now. But I am working on internalizing that, I think.)
posted by kalimac at 7:06 PM on November 26, 2020 [46 favorites]
I have pleaded with parts of my family to stay home, shared lots of articles and resources, but still they are flocking to the homes of friends and family. I have been trying since this whole thing started to reinforce how serious this is, but they still won't wear masks, and they gather with friends and family from all over, all the time. I care about these people a lot, but for the sake of my own sanity, I have finally washed my hands (ha!) of it all. They are adults, they have made their choices. I sincerely do not wish them harm, but it is wearing me down trying to convince them to be safe. I quit.
posted by xedrik at 7:06 PM on November 26, 2020 [2 favorites]
posted by xedrik at 7:06 PM on November 26, 2020 [2 favorites]
One thing the junkie lifestyle taught me is that you cannot save those who do not want to be saved; those who won’t admit what they’re doing. There are always more excuses, always more explanations, always more justifications. It becomes circular very very quickly.
Put on your own mask first, put on your own seat belt first, then try to help and if they say no just assume the brace position. There’s always a limited time before impact.
posted by aramaic at 7:53 PM on November 26, 2020 [21 favorites]
Put on your own mask first, put on your own seat belt first, then try to help and if they say no just assume the brace position. There’s always a limited time before impact.
posted by aramaic at 7:53 PM on November 26, 2020 [21 favorites]
That "South Dakota Nurse's Tweets" story repeated without question by Newsweek was better investigated by Wired in an article linked in this previous post comment.
posted by superna at 8:44 PM on November 26, 2020 [4 favorites]
posted by superna at 8:44 PM on November 26, 2020 [4 favorites]
Here in South Texas, we had our first (sigh) surge after Memorial Day and spent the summer recovering from it. Now, we are bringing patients in from El Paso, while all holding our collective breaths in preparation for a second surge of cases.
I get called to help with the hematologic issues - blood clots and coagulopathies, low platelets, and the like - in the hospital. I have had multiple patients with cancer who became infected, one from a funeral and others from going to the gym, shopping, spending time with family unmasked. A colleague got infected by her infant daughter who got it from the daycare teacher. By some miracle, I have only lost one cancer patient, but I counsel aggressively - every patient, every visit.
We are all exhausted. Even the folks like me, who don’t spend that much time on a COVID ward. Lots of my nursing friends faced pay cuts at best, layoffs at worst. Lots of local practices talking about selling, shutting down, retiring. I have worked 80-100 hours a week without a break this year. Can’t go anywhere, and staycations don’t really provide any distance or relief. I am fearful for the toll this is going to have on HCPs - the burnout and moral trauma is just unreal.
posted by honeybee413 at 9:12 PM on November 26, 2020 [21 favorites]
I get called to help with the hematologic issues - blood clots and coagulopathies, low platelets, and the like - in the hospital. I have had multiple patients with cancer who became infected, one from a funeral and others from going to the gym, shopping, spending time with family unmasked. A colleague got infected by her infant daughter who got it from the daycare teacher. By some miracle, I have only lost one cancer patient, but I counsel aggressively - every patient, every visit.
We are all exhausted. Even the folks like me, who don’t spend that much time on a COVID ward. Lots of my nursing friends faced pay cuts at best, layoffs at worst. Lots of local practices talking about selling, shutting down, retiring. I have worked 80-100 hours a week without a break this year. Can’t go anywhere, and staycations don’t really provide any distance or relief. I am fearful for the toll this is going to have on HCPs - the burnout and moral trauma is just unreal.
posted by honeybee413 at 9:12 PM on November 26, 2020 [21 favorites]
That "South Dakota Nurse's Tweets" story repeated without question by Newsweek was better investigated by Wired in an article linked in this previous post comment.
Dammit did I fall for BS?
posted by eagles123 at 9:23 PM on November 26, 2020 [1 favorite]
Dammit did I fall for BS?
posted by eagles123 at 9:23 PM on November 26, 2020 [1 favorite]
In a normal, non-pandemic year, hospitals are at or above capacity most of the winter. This is intentional, because the bean counters believe that an empty bed represents lost revenue.
Even in nationalised systems this is the case and in a narrow sense it is true. Fundamentally what this is about is mis (under-) pricing optionality. An empty bed at peak "normal" is an option to deal with a surge gracefully that you pay for through "wasted" resources in a typical year.
For years, it has been a commonplace in German medical circles that Germany has way too many hospital beds, way too many ICU beds. Wide consensus on this. Everyone knows that outcomes are better when you concentrate procedures rather than having lots of small town hospitals.
However the decision to close one has to be taken locally, and no Germany mayor is going to close *their* local hospital even if they agree that in the aggregate there are too many.
As a result, Germany has not come close and will not come close to running out of ICU capacity and is able to provide care to patients from neighbouring countries.
See also a comparison between European rail systems: The Swiss have the least "optimised" system in terms of using available capacity and the UK the most. As a result the Swiss have a well earned reputation for on-time performance and the UK some of the worst. That's because small disruptions in the Swiss system are absorbed by speeding up or re-routing trains, the UK systems runs very close to maximum and therefore reducing max speeds in an area due to leaf-fall, frost, or other factors ends up rippling through the system and causing disruptions a hundred miles away and six hours after the original event.
Investing in scientific research, in the most vulgar utilitarian sense, is the ultimate optionality play. You're spending resources to do completely open-ended things that might make technologies possible which might in turn be useful. Not just that, but payment for this optionality, unlike paying for extra hospital beds and extra rail capacity is upfront and one-time, once you have it you have it forever.
posted by atrazine at 3:35 AM on November 27, 2020 [23 favorites]
Even in nationalised systems this is the case and in a narrow sense it is true. Fundamentally what this is about is mis (under-) pricing optionality. An empty bed at peak "normal" is an option to deal with a surge gracefully that you pay for through "wasted" resources in a typical year.
For years, it has been a commonplace in German medical circles that Germany has way too many hospital beds, way too many ICU beds. Wide consensus on this. Everyone knows that outcomes are better when you concentrate procedures rather than having lots of small town hospitals.
However the decision to close one has to be taken locally, and no Germany mayor is going to close *their* local hospital even if they agree that in the aggregate there are too many.
As a result, Germany has not come close and will not come close to running out of ICU capacity and is able to provide care to patients from neighbouring countries.
See also a comparison between European rail systems: The Swiss have the least "optimised" system in terms of using available capacity and the UK the most. As a result the Swiss have a well earned reputation for on-time performance and the UK some of the worst. That's because small disruptions in the Swiss system are absorbed by speeding up or re-routing trains, the UK systems runs very close to maximum and therefore reducing max speeds in an area due to leaf-fall, frost, or other factors ends up rippling through the system and causing disruptions a hundred miles away and six hours after the original event.
Investing in scientific research, in the most vulgar utilitarian sense, is the ultimate optionality play. You're spending resources to do completely open-ended things that might make technologies possible which might in turn be useful. Not just that, but payment for this optionality, unlike paying for extra hospital beds and extra rail capacity is upfront and one-time, once you have it you have it forever.
posted by atrazine at 3:35 AM on November 27, 2020 [23 favorites]
Other examples: Keeping lots of cash on-hand as a company is wasteful, better to use leveraged and not retain cash in a bank account... until a liquidity crisis hits.
Just in time supply chains are efficient, until you hit a demand surge or a supply shock or both. Our system has very few mechanisms for allocating resources against this kind of rare contingency. In theory public sector bodies are better positioned to do it because they can use their taxing power to charge everyone for something that is collectively useful but rarely needed but in practice governments also under-value optionality in most cases.
Given future uncertainties, you rarely want to optimise for a particular future but should instead regret-minimise over a wider set of likely futures. It's a concept that I use day-to-day in working on energy policy but it has much wider applicability and despite all the fancy words is pretty close to what people do instinctively in many circumstances.
posted by atrazine at 5:10 AM on November 27, 2020 [11 favorites]
Just in time supply chains are efficient, until you hit a demand surge or a supply shock or both. Our system has very few mechanisms for allocating resources against this kind of rare contingency. In theory public sector bodies are better positioned to do it because they can use their taxing power to charge everyone for something that is collectively useful but rarely needed but in practice governments also under-value optionality in most cases.
Given future uncertainties, you rarely want to optimise for a particular future but should instead regret-minimise over a wider set of likely futures. It's a concept that I use day-to-day in working on energy policy but it has much wider applicability and despite all the fancy words is pretty close to what people do instinctively in many circumstances.
posted by atrazine at 5:10 AM on November 27, 2020 [11 favorites]
...it's not just the U.S., of course. This is happening in Toronto, where I live, as I type. Fuck these people.
If the U.S. had Canada's covid-19 response almost 100,000 fewer Americans would be dead. Sure you have idiots. Maybe even lots of them. But you will lose in a stupidity contest because of the U.S.'s official policy of decisively winning any contest of Mutually Assured Dumbassery
posted by srboisvert at 5:24 AM on November 27, 2020 [1 favorite]
If the U.S. had Canada's covid-19 response almost 100,000 fewer Americans would be dead. Sure you have idiots. Maybe even lots of them. But you will lose in a stupidity contest because of the U.S.'s official policy of decisively winning any contest of Mutually Assured Dumbassery
posted by srboisvert at 5:24 AM on November 27, 2020 [1 favorite]
Just in time supply chains are efficient, until you hit a demand surge or a supply shock or both. Our system has very few mechanisms for allocating resources against this kind of rare contingency. In theory public sector bodies are better positioned to do it because they can use their taxing power to charge everyone for something that is collectively useful but rarely needed but in practice governments also under-value optionality in most cases.
The private sector (and the public sector) can put in buffers for supply shocks or demand surges IF the people in charge have objective, reliable estimates of the risk and the consequences. I work for a company that does precisely that for the power sector. We're just insanely over-specialized actuaries. Waffle House is legendary for being able to withstand those events, and that is because they have reasonable estimates of the risk, they are the entity incurring the risk, and they are the ones who benefit when they withstand it successfully.
The hospital sector is failing here because they did not have good information (novel virus, political interference), and the entities expected to incur the risk are not the ones that benefit from it being handled well.
posted by ocschwar at 8:20 AM on November 27, 2020 [5 favorites]
The private sector (and the public sector) can put in buffers for supply shocks or demand surges IF the people in charge have objective, reliable estimates of the risk and the consequences. I work for a company that does precisely that for the power sector. We're just insanely over-specialized actuaries. Waffle House is legendary for being able to withstand those events, and that is because they have reasonable estimates of the risk, they are the entity incurring the risk, and they are the ones who benefit when they withstand it successfully.
The hospital sector is failing here because they did not have good information (novel virus, political interference), and the entities expected to incur the risk are not the ones that benefit from it being handled well.
posted by ocschwar at 8:20 AM on November 27, 2020 [5 favorites]
While it's undoubtedly true that just-in-time supply chains have trouble withstanding sudden shocks, the fact is that, in the US, the capacity issue is literally every year. The actual coronavirus is novel, but the strain of inequity and understaffing is the system working as designed. (If you can say "designed" for a system that's basically a hodgepodge stew.)
That's why the "clap for carers" thing from the spring really stuck in my craw. You want to show gratitude to health care workers? Don't put yourself and your loved ones at needless risk. Vote for candidates who support safe staffing levels and maintaining preventative services. Wash your damn hands.
And that's true every year, not just in a once-a-century pandemic.
posted by basalganglia at 9:48 AM on November 27, 2020 [16 favorites]
That's why the "clap for carers" thing from the spring really stuck in my craw. You want to show gratitude to health care workers? Don't put yourself and your loved ones at needless risk. Vote for candidates who support safe staffing levels and maintaining preventative services. Wash your damn hands.
And that's true every year, not just in a once-a-century pandemic.
posted by basalganglia at 9:48 AM on November 27, 2020 [16 favorites]
Chiming in from New Zealand to agree with atrazine and say it's not just the profit motive that's important here. Sounds like our system is more like the UK than the German or Swiss, public-funded, but set up to have very little slack in order to keep costs down. (We've had nine years of right-wing government, but even our left-wing party isn't exactly splashing the cash). Medical friends tell me we routinely hit capacity in the winter flu season. Back in February/March we were scrambling around to source new ventilators etc, and cross-train staff to use them.
Ironically, our relative lack of resources helped us: the government had to impose a strict and reasonably early lockdown, because it knew we would have been overwhelmed.
posted by Pink Frost at 12:31 PM on November 27, 2020 [4 favorites]
Ironically, our relative lack of resources helped us: the government had to impose a strict and reasonably early lockdown, because it knew we would have been overwhelmed.
posted by Pink Frost at 12:31 PM on November 27, 2020 [4 favorites]
Norton, Kansas - When the governor issued an executive order in early July requiring masks in public places, the county opted out of a mandate. A day before the order went into effect, Norton's police chief announced on Facebook officers would not be enforcing it.
Jeff Johnston grew up in Norton and now lives in Sacramento County, California, where "you wouldn't dream of being out in public without a mask on. He says he is still in touch with Norton residents, including childhood friends who live there.
"If you were to admit that you thought wearing a mask was a good thing, you would be a suspected Democrat," he says of his hometown."
posted by shoesietart at 7:23 AM on November 29, 2020
Jeff Johnston grew up in Norton and now lives in Sacramento County, California, where "you wouldn't dream of being out in public without a mask on. He says he is still in touch with Norton residents, including childhood friends who live there.
"If you were to admit that you thought wearing a mask was a good thing, you would be a suspected Democrat," he says of his hometown."
posted by shoesietart at 7:23 AM on November 29, 2020
This is one of my big complaints of modern workplaces: No Slack. Practically every where I've worked it's been normal to be assigned 45+ hours of tasks for a 40 hour week. And that's for a normal week. Stuff gets left undone or is done half assed or both. And then when crisis hits there is no possibility of reacting without totally dropping the ball on day to day activities.
We likened it to bridge painters. You know those guys who do nothing but paint the Golden Gate Bridge. Modern "management" would have the crew paired down until they can in theory just barely paint the bridge in a year. And then every earth quake, freak storm, or presidential visit puts them days behind schedule. Eventually the bridge collapses because it got rusty from not being painted to the schedule but hey, all the management made money for 40 years before that happend so it's all "good". Infuriating.
Note as a fudge for the discourse I've got the painters painting the bridge end to end every year. It doesn't work like that. Painters paint the bridge in specific areas as needed.
posted by Mitheral at 12:21 PM on November 29, 2020 [6 favorites]
We likened it to bridge painters. You know those guys who do nothing but paint the Golden Gate Bridge. Modern "management" would have the crew paired down until they can in theory just barely paint the bridge in a year. And then every earth quake, freak storm, or presidential visit puts them days behind schedule. Eventually the bridge collapses because it got rusty from not being painted to the schedule but hey, all the management made money for 40 years before that happend so it's all "good". Infuriating.
Note as a fudge for the discourse I've got the painters painting the bridge end to end every year. It doesn't work like that. Painters paint the bridge in specific areas as needed.
posted by Mitheral at 12:21 PM on November 29, 2020 [6 favorites]
superna: That "South Dakota Nurse's Tweets" story repeated without question by Newsweek was better investigated by Wired in an article linked in this previous post comment.
Other HCW in places across the US have mentioned similar experiences. Mostly not as extreme, but covid patients' denials of covid and antagonism for their HCWs are certainly there. This MedPage Today article mentions, besides the South Dakota nurse, HCW reports from TX, DC, AZ. Here's a reporter's twitter thread about denialism in Appalachia.
In my opinion, that WIRED piece makes a mistake by bracketing together "deathbed denialism" and some covid patients' resistance to acknowledging this virus's existence. The former is highly specific and rare, whereas the latter is a broader category and so, somewhat more common.
posted by cybercoitus interruptus at 5:36 PM on November 29, 2020 [2 favorites]
Other HCW in places across the US have mentioned similar experiences. Mostly not as extreme, but covid patients' denials of covid and antagonism for their HCWs are certainly there. This MedPage Today article mentions, besides the South Dakota nurse, HCW reports from TX, DC, AZ. Here's a reporter's twitter thread about denialism in Appalachia.
In my opinion, that WIRED piece makes a mistake by bracketing together "deathbed denialism" and some covid patients' resistance to acknowledging this virus's existence. The former is highly specific and rare, whereas the latter is a broader category and so, somewhat more common.
posted by cybercoitus interruptus at 5:36 PM on November 29, 2020 [2 favorites]
Jessica Gold, Forbes, "‘Here I Am, As A Human, Doing The Best I Can’: Bridging The Gap Of Covid-19 Denial With Vulnerability."
posted by cybercoitus interruptus at 2:38 PM on November 30, 2020 [2 favorites]
posted by cybercoitus interruptus at 2:38 PM on November 30, 2020 [2 favorites]
In California (where several hospitals are already reaching 85% ICU capacity), some projections estimate tripling hospitalizations by Christmas: https://www.usnews.com/news/best-states/california/articles/2020-11-30/california-hospitalizations-soar-may-spur-more-restrictions
Masking guidance/communication was a disaster at the beginning of the pandemic, and the misconceptions still abound.
--Wearing a mask protects others AND yourself (https://www.npr.org/sections/health-shots/2020/11/11/933903848/wear-masks-to-protect-yourself-from-the-coronavirus-not-only-others-cdc-stresses)
--Wear a mask in indoor AND outdoor public spaces.
--Not all masks are created equal.
"Hold up the fabric to a bright light or to the sun....if you can see the light outlining the individual fibers in the fabric, it's probably not a good filter. And if you can't, it's probably going to filter better."
posted by beastelyse at 1:35 PM on December 6, 2020
Masking guidance/communication was a disaster at the beginning of the pandemic, and the misconceptions still abound.
--Wearing a mask protects others AND yourself (https://www.npr.org/sections/health-shots/2020/11/11/933903848/wear-masks-to-protect-yourself-from-the-coronavirus-not-only-others-cdc-stresses)
--Wear a mask in indoor AND outdoor public spaces.
--Not all masks are created equal.
"Hold up the fabric to a bright light or to the sun....if you can see the light outlining the individual fibers in the fabric, it's probably not a good filter. And if you can't, it's probably going to filter better."
posted by beastelyse at 1:35 PM on December 6, 2020
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posted by supercrayon at 9:11 AM on November 26, 2020 [49 favorites]