Just the Facts, the Crown virus.

[doc henderson]

It is hard to wade through the bull.  media says that Fauci and trump are not on the same page, but they are.  It is the difference between how a trained objective Dr. talks and a New York business man.  NY gov.  says he needs 30,000 ventilators and only got 4,000.  More than the  machine, you need people who know how to run them.  Are people being allowed to die in the hospital without them?  No! the gov.  anticipates and in his wildest dreams wants 30,000 vents.  they would be in the way and not be useful with no RTs to run them.  Fema had people from around the country that can be sent along with a temporary hospitals to care for the overflow.  We are OK.  

[Jeff]

What was this I heard of modifying or refitting ventilators to serve two patients at once,  effectively doubling the amount we have now?

[samandothers]

Just a thank you to Doc and others that are sharing in an informed and calm manner the detail here.  I have gained a great deal from this thread.

Thanks

[doc henderson]

Yes that is interesting but not practical, most likely.  First we have all kinds of ventilators.  We upgrade all the time, and some older models are sent/sold to 3rd world countries, but some are in the "basement".  Also all anesthesia machines are essentially ventilators. In a pinch the person can be manually bagged by a person.  once intubated it is not complicated although tedious and ventilators do it effortlessly for days with precise settings for flow and pressure.  Our ems has transport vents and there are IPPB machined that can be used.  You will not run out of vents, but hospital beds, nurses and RTs to mange them.  (respiratory therapists).  Sedge had sent me a PM with an article on a vent adapted for 9 people and the pic looked like a modified vent circuit (tubing and valves) with one way valves.  It would indeed ventilate 9 sets of lungs, but the machine would have only one set of controls to manage.  So the details are that each person has different needs bases on their size and lung condition.  underlying COPD and if they have ARDS the needs can change by the minute.  one of the goals is to minimize the pressure and rate, as some of the damage during treatment is from the Barotrauma from the mechanical ventilation.  If you have 2 patients on the same circuit, the setting would be for pressure or volume.  the air is pushed for a breath by pressure pushed by the machine.  the volume to each lung, is based by the compliance of that lung.  so someone with a small chest and or skinny or with healthier lungs would get more, poss. too much volume, and the other not enough.  too much volume does damage to the lung worsening ARDA and or collapse of the lung.  (pneumothorax),  not so good.  I use to sail, and broke my cable to the centerboard on my boat.  I took corrugated tubing and a series of valves from a vent circuit so I could breath under water under the boat.  It was basically a modified snorkel with fresh and exhaled air circuits 8 feet long.  I was able to work under the boat indefinitely.  In Ks the water is green and murky so I could only see 8 inches in front of my face, but the snorkel worked.  I tried in our pool a few years back, and at 3 feet I could not overcome the water pressure to breath.  I began as a respiratory therapist in 1981.  So everyone is trying to plan for a worse case scenario, but wanting 30,000 vents is the same as hoarding toilet paper, IMHO.  So not to get political, but no good is coming from governors and mayors acting like people are dying in the streets.  Some people will die from this virus.  Most will be asymptomatic.  We may all turn out to have gotten this virus.  Most will be asymptomatic, or fine otherwise.

[doc henderson]

For medical professionals, this is a challenge that we can handle.  It is a real science project.  we are short on masks because everything is disposable.  places are starting to sterilize and reuse masks.  We will run out of ventilator circuits before vents, but we used to clean/sterilize and reuse these, and that can be done again.  We are expected to surge mid April, and I plan to form up sidewalk today so we can pour it tomorrow.  NY is getting hit hard now.  It is hard to social distance if you live in a building with a thousand other people.  Cuomo needs to be a governor, and not a Drama Momma.  He is talking about a "bullet train"  instead of a fright train.  how is that helpful, except to imply he is not getting help and people should vote Dem.  this virus was unknown before the first of the year.  We are doing the impossible, and doing it well.  again not to be political and IMHO.

[Ljohnsaw]

I tried in our pool a few years back, and at 3 feet I could not overcome the water pressure to breath.

Fond memories!  When I was about 14, my buddy and I would go swim in the river around some rocks to retrieve Shad lures after the shad run.  We would snorkel in the somewhat murky water - had to our masks close to the rocks to find them.  I had the bright idea to add length to my snorkel - about 2 feet.  We would hold a big rock to pull us down.  I found out that a couple feet down I could exhale quite well but not inhale!

[petefrom bearswamp]

Thanks for the objective input to both dochenderson and doctorb.
I wonder how manufacturers such as GM, Ford,  etc can change over to manufacturing ventilators, masks, personal protective gear etc in a timely fashion.
I agree with our NY Governor on some of his points but most of his demands are IMO not feasible.
We have been sheltering in place except for docs appts.
I have one this PM in Syracuse for pre op consult for a high end pacemaker.
I guess this is not considered elective stuff.

[Gary_C]

I wonder how manufacturers such as GM, Ford,  etc can change over to manufacturing ventilators, masks, personal protective gear etc in a timely fashion.

From what I've heard, GM and others are repurposing some car ventilation parts for use in ventilators. Plus all auto manufacturers make a vast array of injection molded parts and those large injection molding machines can easily be set up with quickly made dies to make tens of thousands of parts in a short amount of time. 
Plus there is a local story about doctors at the U of MN that have assembled a ventilator with off the shelf parts. It's simply a slow turning motor with an adjustable length plunger arm that pumps a ventilator bag. 
Never underestimate the innovative ability of the people to make do with simple solutions.

[Brian_Rhoad]

Here is a link to an article about Ford and respirators.

https://www.roadandtrack.com/car-culture/a31917145/ford-respirators-coronavirus-covid-19/?utm_source=facebook&utm_campaign=socialflowR%26T&utm_medium=social-media&fbclid=IwAR1zWdqvYT3Wd_UJIVSKTyUBQvh5eWWbZbfFXdLTeMuHvgE_JmhjLwBFeJg

[SwampDonkey]

I think these motor companies and others have offered up assistance and producing medical supplies close to 2 weeks ago. I know the prime minster mentioned it, so your government knew then to. But it is interesting to follow and see what they are getting done. Unlike the naysayers out there this doesn't take forever to do. Heck they had a job to do during WWII and it didn't take 6 years to get started. Same with building the Alaskan highway during wartime, today that would take 20 years. Good grief. But it sure don't have to. If you want to get stuff done, get on with it. ;)

[kantuckid]

I'd like to see some reporting about how the virus spread locally.  They must collect some info from people who test positive about who they were in contact with and how they may have contracted it.  I'm sure this becomes nearly impossible in places like New York and WA state, but here in VA we have just a bit over 300 cases as this afternoon.  Surely this can be more or less traced back to our patient-zero.  In the way distant past, enterprising journalists would have dug into this and reported on it.  There doesn't seem to be much journalistic interest in something like this.  I dug around and can find very little that actually sheds some light on how some of this spread is taking place.  I'm pretty sure that as much information as possible is being collected from patients who test positive.

Has anybody seen anything useful about this for your area or any area?

Our county health depts have people assigned to play detective and investigate who made contact with who. once those numbers multiply it becomes impossible to continue. Given that the county which had 37 cases had stopped what they call "tracing", that provides incite into just how many contacts (overall) happen in these folks who test positive.
My county has two cases who are unknown persons as we see in the news as well, privacy laws?
If I had it I'd want the area near me to know to stay away from me for their benefit.
Reporting will be anectdotal from those who share it on their own I guess.

[SwampDonkey]

Eight new cases in NB, Premier sets check points at borders. Travel into NB that is not necessary is now prohibited and people can be turned back others will have to self isolate 14 days.
Anyone who doesn't comply could face a fine of up to $10,000.
Commercial traffic and essential services will be exempt, said Premier Higgs.

Officers will collect the identity of those individuals, as well as their intended destination and contact information, the premier said.
The officers will also follow up to ensure compliance, even if the individuals are only travelling through New Brunswick to another province, the premier said.

https://www.cbc.ca/news/canada/new-brunswick/covid-19-new-brunswick-provincial-border-checkpoints-higgs-1.5509870

[SwampDonkey]

People, do not ingest chloroquine phosphate, an additive from fish tank cleaner. A couple in Arizona tried that and it did not go well. The husband died and the wife is very ill. (it's on several news sites) This is not the same chloroquine formulation in human medicine for malaria.


Despite a certain political assertion as a possible curative, the U.S. Centers for Disease Control and Prevention (CDC) has said there is no available data from randomized clinical trials to inform the use of hydroxychloroquine against the novel coronavirus.

[Ianab]

Despite a certain political assertion as a possible curative, the U.S. Centers for Disease Control and Prevention (CDC) has said there is no available data from randomized clinical trials to inform the use of hydroxychloroquine against the novel coronaviru

Those tests are currently underway in Australia and New Zealand (probably elsewhere as well). But they don't have any results yet. 

Day one of a minimum 4 week lockdown here in NZ. Only essential services are open, everyone else stays at home. (well you can go out for a walk, or to get groceries, but avoid people). 2 of my part time jobs are on the "essential" list, Mail and IT Support for other essential operations, but we have minimised people in the mail depot (some of the contractors are sorting from home etc) and Signature parcels no longer get signed for.  Most of my IT work has been remote (setting up other people to work from home). 

Called into the supermarket on the way home to grab a couple of things. They are open, most things in stock, but pretty quite compared with the last couple of weeks. A lot of places have "skeleton" staff, like you can phone and get parts for your Tractor etc, as farming is "essential", not to mention the animal welfare  issues. 

Anyway, that's our "new normal" for the next month at least. At least I have the shed and a good stash of wood to work with, so I have a bolt hole there. 

[thecfarm]

Went to a small store that sells pizza, sandwiches, beer. They had a sneeze guard up too. Hardware/feed store I work at reduced hours. We was open 7:30 to 6. Now 8 to 4. Won't be late for supper now. We been making quota, so can't say it's because it's slow.
The store I posted about the first guard had a pound of bacon for $3!! Went back today and bought some more!! I have 8 pounds of bacon that I bought in the last week. Most times they have a sale like that, it's gone like toilet paper.  :D  Seem like everyone is more concerned about TP. That is good, leaves more bacon for me.

[Ianab]

That is good, leaves more bacon for me.

There are alternatives for TP, there isn't any for Bacon :D

[nativewolf]

Went to a small store that sells pizza, sandwiches, beer. They had a sneeze guard up too. Hardware/feed store I work at reduced hours. We was open 7:30 to 6. Now 8 to 4. Won't be late for supper now. We been making quota, so can't say it's because it's slow.
The store I posted about the first guard had a pound of bacon for $3!! Went back today and bought some more!! I have 8 pounds of bacon that I bought in the last week. Most times they have a sale like that, it's gone like toilet paper.  :D  Seem like everyone is more concerned about TP. That is good, leaves more bacon for me.

Glad to see that someone is a thinking man in this crisis.  

[dgdrls]

  COVID-19 Updates: Canada

Built by a graduate from the B.C. Institute of Tech
  Consolidates COVID 19 info for Canada
and has a global statistics tab.
Other pertinent tabs including one for the sources it uses.

stay healthy,

D

[alan gage]

I heard yesterday that my cousin and her husband in NYC likely have the virus. Came down with the symptoms (including respiratory) so they went to the hospital. They were told that they probably had the virus but no test kits were available. They were sent home to isolate and return if things got worse.

Made be curious if people like this, who haven't officially been tested, are counted?

Alan

[SwampDonkey]

I heard yesterday that my cousin and her husband in NYC likely have the virus. Came down with the symptoms (including respiratory) so they went to the hospital. They were told that they probably had the virus but no test kits were available. They were sent home to isolate and return if things got worse.

Made be curious if people like this, who haven't officially been tested, are counted?

Alan

Yes, counted and marked as probable most likely. Here in NB we just don't have the capacity to keep up with demand on testing. As of yesterday I think less than 1800 tests in 2 weeks. Basically being told to assume we have it until proven otherwise, is what it boils down to.

[SwampDonkey]

Canadian grocery stores and Walmart, maybe others, are offering delivery to those in self isolation, leaving groceries and such at their door.

Walmart Canada grocery purchase.
https://www.walmart.ca/en/grocery/N-117
Walmart Canada has a $50 minimum purchase and $9.95 delivery fee.

Atlantic Superstore Instacart delivery service.

Instacart
Canadian towns delivery available
$30 minimum purchase

Instacart is available in the USA as well.
Food and Grocery Delivery On Demand - Instacart Locations

[sprucebunny]

The data at the "corona virus act now" website has been called in to question. I did read that they used 'general US' for a demographic though that wasn't clearly explained. Several of thier predictions have not come to pass but that may be due to the whole US staying pretty much home which might not have been factored in.

I've seen some states have thier own similar charts and that's good.

Also in my visiting different state's dept. of health websites, many of them aren't testing anyone besides healthcare workers, hospital patients and group home type situations so data about actual illness seems pretty thin.

[Ljohnsaw]

actual illness seems pretty thin.

I've come to the conclusion that, although the curves have gone exponential of reported/presumed cases, it is VERY under reported.  My hope is that most are very minor cases (unnoticed or slight illness) and the "herd" is becoming immune. :-\  The reported/presumed cases in my state are doubling every couple/three days.  If the new 45 minute quick test gets rolled out in sufficient numbers that they freely test (like SK), I think the graphs will go into orbit.

[SwampDonkey]

Wow, right now, China, US and Italy are all pretty much the same numbers. And we've got 125,000 more cases globally in 2 days. The China numbers seem to be stable actually though, assuming they have not cut us off.

[Hilltop366]

Russia seems quite low according to the link that dgdrls posted.