Cont: 2019-nCoV / Corona virus Pt 3

[smartcooky]

Good NYT article on how the Chinese system set up after SARS, to give early warning of exactly the sort of zoonotic threat like SARS-COV-2, failed: “China Created a Fail-Safe System to Track Contagions. It Failed.”

&#)*@&$) for some reason I don’t seem to be able to post a link ...

https://www.nytimes.com/2020/03/29/...YUGeeDCLAXCAjHb9oLAbSf3xMkA7lhd1t4ZscR4uEcLA4

Clearly the system itself didn't fail as such, its just the political climate of fear in China prevented it from working

 

[Kings Full]

Clearly the system itself didn't fail as such, its just the political climate of fear in China prevented it from working

Pretty much this. The Chinese government can have any plan it wants until the **** hits the fan.

IOW, everybody has a plan until they get punched in the mouth.

 

[Trebuchet]

We spent a quiet hour googling wireless intercoms, that is what we really need, also to let patients communicate to us easily. Wireless ones appear expensive and it is not realistic to wire in intercoms in the middle of an outbreak. If a company could rapidly produce a cheap battery powered short range intercom, with restricted channels so other rooms couldn't listen in they would probably have a market.

Have you no wifi? Every hospital I've been to recently does. I think it's even how the patient monitoring equipment gets its data to the nursing station. Stick a cheap laptop in there and leave it. Caregivers type their notes into a file that's on the network.

 

[Planigale]

Write the notes directly on the window with a whiteboard marker. The person on the outside, photographs it with a smartphone (it will be back to front to them so they flip the image with an editing app) and PXTs it to the transcriber. When done, wipe off the note and move to the next one.

This way, there is no need for materials such as notepaper or forms inside the quarantine that require disposal. The only things that need to be carried from room to room are a whiteboard marker and a wiper. You could even set up each window with a pre-written "form" using a spirit based permanent marker, with the whiteboard marker being used to fill in the form. Only the variable data gets wiped.

We have lots of alcohol based wipes and hand rub etc. We have some white board markers in the seminar room so might give this a go. Good for quick messages so long as people are good at mirror writing (or reading).

 

[angrysoba]

Write the notes directly on the window with a whiteboard marker. The person on the outside, photographs it with a smartphone (it will be back to front to them so they flip the image with an editing app) and PXTs it to the transcriber. When done, wipe off the note and move to the next one.

This way, there is no need for materials such as notepaper or forms inside the quarantine that require disposal. The only things that need to be carried from room to room are a whiteboard marker and a wiper. You could even set up each window with a pre-written "form" using a spirit based permanent marker, with the whiteboard marker being used to fill in the form. Only the variable data gets wiped.

You dont even need to carry the pen from room to room. Pens are cheap. Each room should have two or three, attached with clips (or magnets if there is a place to attach them) - the one being used is closest to the window. When the one closest to the window runs out, move them all down and replace on the next visit.

 

[casebro]

We have lots of alcohol based wipes and hand rub etc. We have some white board markers in the seminar room so might give this a go. Good for quick messages so long as people are good at mirror writing (or reading).

Geeze. Every hospital bed I've ever been in had an inter-com to the nurse's station. And a land line. Use one of those.

Or are you so far back in the woods you use rotary dialed party lines? Put your finger in the hole, rotate the dial, remove your finger, let the hand piece go spark-spark-spark- for every digit?

And you disconnected the intercomm- the patient had to start it by blowing in the hose, the nurse heard the whistle, removed the plug, listened to the patient " More steeam! Full Steam Ahead! I want to lick this Virus the Finnish way!" I guess covid patients can't blow hard enough for the whistle?

 

[angrysoba]

We have lots of alcohol based wipes and hand rub etc. We have some white board markers in the seminar room so might give this a go. Good for quick messages so long as people are good at mirror writing (or reading).

Why not actually have a mirror in the room opposite the window? Is that feasible?

 

[Sherkeu]

Clearly the system itself didn't fail as such, its just the political climate of fear in China prevented it from working

It worked in the favor of Hong Kong and Taiwan.

The Hong Kong protests had been going on for months, travel was restricted as you could imagine. When I was in Shanghai last summer, CNN news reports were replaced with yogurt ads. China likes a harmonious message!
But even for those allowed to travel, the protesters had damaged the cross-border trains and stations to the point where most of them at some point had to close for repairs. That was just last fall. I'll bet ridership was lower even when reopened.

By Jan 4, Hong Kong already reported 8 cases, had a new alert system in place, and had installed additional thermal sensors and staff at rail stations and the airport. They knew.

For Taiwan, China had revoked an agreement to allow travel from major cities in China - mainland Chinese being Taiwans largest source of tourism dollars. That'll show them!! Taiwan was coming up on a Presidential election in early January that pitted pro and anti China parties against each other.

So these 2 places, normally with many more mainland visitors, got lucky with the timing of Chinese restrictions and seeing early reports of the new 'mystery disease'. Add in their experience with SARS-1 and they were well placed to react and control.

 

[Skeptic Ginger]

Another candidate for the Covid Anger thread - that's bloody disgraceful.



I'm not wearing a mask because there aren't any to be had.

I have yet to see definitive evidence that even droplets being inhaled are the major source of infection.

Why the modifier, 'major'? It only has to be the source of a small percentage of patients to be a significant issue. If only one person gets it via aerosolized and they spread it to several more, you cannot get this thing under control.

Having mapped a very large number of norovirus outbreaks over many years, the way Covid-19 is spreading is identical to those models and completely unlike influenza models I've seen.

Are you aware norovirus is airborne spread? It's aerosolized when people vomit and when one flushes the toilet.

 

[Skeptic Ginger]

The numbers I had heard were 180 patients, 120 staff. 37 dead patients I've seen, they are in the one-foot-in-the-grave cohort. We don't know the medical history of that dead visitor, different cohort. So back to the Staff Cohort, which most closely matches the general population, "those healthy enough to clock in": One month after exposure started: Death rate, zero. Known ICU cases, 1. Let me know when we get more data.

I'm not going to argue with you. This nursing home is a few miles from my house and I know what's going on there.

Think about it, how could 120 people take care of 180? That includes 3 shifts, covering 7 days/week, including housekeeping, nurses, aides, administration, maintenance, therapy staff....

We do know the medical history of the deceased visitor, he was a diabetic and he was overweight.

 

[Skeptic Ginger]

nvmd

 

[William Parcher]

nvmd

nvmd = norovirus doctor

 

[dudalb]

Fucie projecting 100 Thousand deaths in the US is a best case scenario.
My god. That is more then US Casualaties in every war since World War 2 combined.

 

[casebro]

I'm not going to argue with you. This nursing home is a few miles from my house and I know what's going on there..

That's a new one: Argument from Proximity. Cudos

We do know the medical history of the deceased visitor, he was a diabetic and he was overweight.

Okay, fine. Put him in the one-foot-in-the-grave cohort.

Please Please Please let us know when you get more data on the staff. INCLUDING the overall number.

And do you have to be always with the pedantry, never with the concept? I know, you are a nurse, follow orders to the letter. But can't you see I am trying to see the effect of the epidemic on the common man, while all the statements at this time reflect the most vulnerable? Try to think outside the hospital, where the rest of us live.

 

[rjh01]

Pretty much this. The Chinese government can have any plan it wants until the **** hits the fan.

IOW, everybody has a plan until they get punched in the mouth.

It is a common reason for something to fail. People do not want to tell the big boss that something has gone wrong. The big boss does not want to know that something has gone wrong. The culture must change so that this can happen. For example the doctor that blew the whistle and then died should be handsomely rewarded. Even after death. Plus an apology to how he was treated.

 

[Kings Full]

It is a common reason for something to fail. People do not want to tell the big boss that something has gone wrong. The big boss does not want to know that something has gone wrong. The culture must change so that this can happen. For example the doctor that blew the whistle and then died should be handsomely rewarded. Even after death. Plus an apology to how he was treated.

I don't disagree... but....

I believe that the Chinese government has in fact changed their tune on the Dr. in question. Even charging two of the policemen that arrested him. But I don't have a citation for that.

But, even if that is true, I doubt that there is any chance the culture will change. The Chinese culture is amongst the oldest in the world. What are the chances they change any time soon?

 

[angrysoba]

The Chinese culture is amongst the oldest in the world. What are the chances they change any time soon?

I don't think the age of the culture makes so much of a difference as the political system. If you have a top-down authoritarian system where you are punished for making a mistake or defying the authorities then you are more likely to stifle creativity and innovation.

But if you argue that the political system is simply an extension of this culture, then you would have to explain why countries with Chinese or Confucian roots such as Taiwan, Hong Kong, Singapore and South Korea have ended up doing better.

South Korea, in particular, shows the difference in outcomes between political systems when you consider the stark divide between North Korea and South Korea.

 

[Kings Full]

I don't think the age of the culture makes so much of a difference as the political system. If you have a top-down authoritarian system where you are punished for making a mistake or defying the authorities then you are more likely to stifle creativity and innovation.

But if you argue that the political system is simply an extension of this culture, then you would have to explain why countries with Chinese or Confucian roots such as Taiwan, Hong Kong, Singapore and South Korea have ended up doing better.

South Korea, in particular, shows the difference in outcomes between political systems when you consider the stark divide between North Korea and South Korea.

Fair enough. You have a point.

Regardless, I don't think it's likely that the Chinese culture will change any time soon.

 

[Solitaire]

Oh, by the way, a mask is only good for a short time. I learned the hard
way that repeated use causes germs to build up and they get to be a source
of infection. And strictly speaking, the masks should be changed each time
a doctor goes from one possible infected patient to the other.

Hm.

I wonder if cooking them in a dutch oven at 175 degree or even 200 degrees
for an hour would kill them germs and make them re-usable? No matter.


P. S. Do you speak Korean?



For some strange reason Again Boss has become my favorite soap opera.
Then again, I might be going insane from being shut in my home all day.

 

[The Atheist]

Can't stop the chickenfights! I really want to see legislation where some level of Darwin Award attempt exempts healthcare from risking their lives to work on you

I'd second that.

Why the modifier, 'major'? It only has to be the source of a small percentage of patients to be a significant issue.

If only one person gets it via aerosolized and they spread it to several more, you cannot get this thing under control.

With social distancing and masks, it would be under control in no time.

Are you aware norovirus is airborne spread? It's aerosolized when people vomit and when one flushes the toilet.

The tiny amount of aerosol virus from vomiting can be pretty much ignored. Certainly being in the way of droplets will get you. Norovirus incidents in restaurants & aeroplanes show that it's spread by droplets, not in aerosol form.

I'll grant the toilet will create aerosol particles, but I don't think it would be all that unusual to shut it when flushing.