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COVID-19 2nd wave - Texas only - Stats and such

justhookit

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Stella Link

Stella Link 534

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1 hour ago, whithou said:

Long time lurker but decided to bite the bullet and register since I can offer some perspective on this.  I'm an ICU RN in Houston and the ICUs at my hospital are definitely overwhelmed. Elective procedures had started back up at my hospital that required ICU admission afterwards but I have a feeling that will come to a halt now with us having no empty beds. My ICU became a COVID overflow unit in March but we are now at capacity with the majority of our patients with COVID and intubated. The main ICU where COVID patients go has been full for awhile now but they have been able to always downgrade a patient just in time for them to take another sick one. That is not the case anymore as the intubated COVID patients are not getting better and stay for several weeks. The last shift I worked they had intubated patients just chilling in the EC because we were out of beds. Texas Children's and MD Anderson are going to start taking patients from at capacity hospitals since certain hospitals are out of space. 

Thank you for the information.  For me, this type of information from someone like yourself who is working the front lines is MUCH BETTER than ciphering the daily stats.  Please come back and let us know more what you are seeing.  I appreciate your assessments, thoughts and opinions.  Thank you for the work you are going.  Please stay safe.  

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whithou
whithou

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit

South Austin
South Austin

He didn't get COVID.  He just ran out of immunity.

safe sex
safe sex

I cannot stress this enough for anyone who lives in Austin (although this really applies to pretty much everywhere at this point) BE SAFE. What this means is don't get on your motorcycles. D

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justhookit

justhookit 4178

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29 minutes ago, Stella Link said:

Thank you for the information.  For me, this type of information from someone like yourself who is working the front lines is MUCH BETTER than ciphering the daily stats.  Please come back and let us know more what you are seeing.  I appreciate your assessments, thoughts and opinions.  Thank you for the work you are going.  Please stay safe.  

The problem is that you have to attempt to decipher the daily stats, because once you get that type of information from the hospital, it’s already way too late to do anything about it.

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BradInATX

BradInATX 9208

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Long time lurker but decided to bite the bullet and register since I can offer some perspective on this.  I'm an ICU RN in Houston and the ICUs at my hospital are definitely overwhelmed. Elective procedures had started back up at my hospital that required ICU admission afterwards but I have a feeling that will come to a halt now with us having no empty beds. My ICU became a COVID overflow unit in March but we are now at capacity with the majority of our patients with COVID and intubated. The main ICU where COVID patients go has been full for awhile now but they have been able to always downgrade a patient just in time for them to take another sick one. That is not the case anymore as the intubated COVID patients are not getting better and stay for several weeks. The last shift I worked they had intubated patients just chilling in the EC because we were out of beds. Texas Children's and MD Anderson are going to start taking patients from at capacity hospitals since certain hospitals are out of space. 

If we all concentrate really hard and make "Italy in 2 weeks!!" jokes, we'll be able to wish this all away.
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atomheartbevo

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A few days ago, I mentioned there was an uptick in daycare cases in Texas.

Guess what?

https://www.texastribune.org/2020/06/23/texas-coronavirus-child-care-safety-rules/

Quote

Gov. Greg Abbott directed a state health agency Tuesday to enact new safety standards for child care centers during the coronavirus — more than a week after prior rules for the centers were made optional.

His order, which comes as new COVID-19 cases and hospitalizations surge in the state, doesn’t immediately make clear what the standards will be. A spokesperson for the governor told The Texas Tribune that the state health commission will be releasing the guidelines Wednesday. A spokesperson for the Health and Human Services Commission said Tuesday evening that the emergency rules are still in development.

 

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atomheartbevo

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From the same article

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Abbott also gave local officials the green light Tuesday to impose more restrictions on public gatherings of more than 100 people. Previously, local officials could only regulate outdoor gatherings of more than 500 people.

So it sounds like they are trying to get things below whatever metric they needed, before we head back towards a total shutdown.  And it sounds like the state is going to stop fighting the locals over a lot of things.

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atomheartbevo

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New York, Connecticut, and New Jersey want travelers from Texas to self-isolate

https://www.cnbc.com/2020/06/24/new-york-new-jersey-and-connecticut-impose-14-day-quarantine-on-travelers-from-coronavirus-hotspot-states.html

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Travelers arriving in New York, New Jersey and Connecticut from regions with spiking Covid-19 infections rates will be subject to a 14-day quarantine, New York Gov. Andrew Cuomo said Wednesday. 

As of Wednesday, the states that are above that level are Alabama, Arkansas, Arizona, Florida, North Carolina, South Carolina, Washington, Utah and Texas, he said.

Cuomo said the infection rate is based on the number of infections per 100,000 residents on a seven-day rolling average.

 

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South Austin

South Austin 52130

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11 minutes ago, atomheartbevo said:

From the same article

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Abbott also gave local officials the green light Tuesday to impose more restrictions on public gatherings of more than 100 people. Previously, local officials could only regulate outdoor gatherings of more than 500 people.

 

Wait, have I been missing something?  Other than the protests and worship ceremonies, what kind of gatherings over 500 people -- hell, even 100 people -- have been going on over the past couple months? 

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sidis

sidis 9732

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3 minutes ago, South Austin said:

Wait, have I been missing something?  Other than the protests and worship ceremonies, what kind of gatherings over 500 people -- hell, even 100 people -- have been going on over the past couple months? 

 

 

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InkaUtexas

InkaUtexas 25497

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4 minutes ago, South Austin said:

Wait, have I been missing something?  Other than the protests and worship ceremonies, what kind of gatherings over 500 people -- hell, even 100 people -- have been going on over the past couple months? 

This is a question I had as well. Do 500 people on 6th street count? 500 people floating the river or at the river park having BBQ's? 

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justhookit

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My guess is the next “shutdown” is closing the bars and having restaurants go back to takeout only. I also wouldn’t be surprised for some of the beach towns and other tourist places to limit hotel capacity.  There’s a bunch of people in Corpus and Port A wanting to close the beach again, but I don’t think that happens.

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justhookit

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7 minutes ago, Skipper said:

Back when this reopening first started in May, I suggested we plan on having a mandatory 2 week shut down beginning Monday after July 4th that could always be lifted if things went ok. Might have been a good strategy!

I remember when you said that. I had no idea that we’d actually be needing to do it 2 weeks earlier than that.

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Surly Bevo

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Focusing on outdoor events seems like not the best prioritization of people's patience....but that's me.  Indoor gatherings...and yes that means places of business, is by far the most likely vector for this uptick and Is what needs to be handled up on.   

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Blotto

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48 minutes ago, atomheartbevo said:

New York, Connecticut, and New Jersey want travelers from Texas to self-isolate

https://www.cnbc.com/2020/06/24/new-york-new-jersey-and-connecticut-impose-14-day-quarantine-on-travelers-from-coronavirus-hotspot-states.html

 

I was already 50/50 on an August visit to the east coast to see my sister and hopefully my mom (she's in assisted living), but looks like that decision will be made for me. I wasn't really looking forward to the air travel part, but would have liked kicking it on the Cape for a few days. 

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whithou

whithou 149

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3 hours ago, Stella Link said:

Thank you for the information.  For me, this type of information from someone like yourself who is working the front lines is MUCH BETTER than ciphering the daily stats.  Please come back and let us know more what you are seeing.  I appreciate your assessments, thoughts and opinions.  Thank you for the work you are going.  Please stay safe.  

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones.

Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. 

This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.  

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Posted
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4 minutes ago, whithou said:

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones.

Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. 

This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.  

Nevermind

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I can't read
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Pato del Muerto

Pato del Muerto 52340

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9 minutes ago, whithou said:

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones.

Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. 

This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.  

I want any and all information. Thank you. 

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Newdoc

Newdoc 3429

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9 minutes ago, whithou said:

I know that I'll eventually get COVID if I haven't already

Hang in there. Baylor Scott and White has shown  medical staff has a low convertion rate to Covid with PPE and hygiene measures. We’ve been bathed in Covid at our clinic with standard PPE and so far so good, but our only aeroslized procedures are the deep nasopharyngeal swabs.

We are at the part of the roller coaster where your stomach jumps to your throat. 

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Bartles

Bartles 769

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26 minutes ago, whithou said:

I did not realize how there really is no definitive treatment for the illness until we got COVID patients.

Thank you for the info and especially this important point about how you are actually learning on the fly. I keep seeing HCPs from Texas posting as if they still think the country overreacted and this really isn't that bad. I wonder if the influence of their friends and family, who have been bitching about restaurants being closed, makes them reluctant to admit the severity of the crisis.

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Stella Link

Stella Link 534

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26 minutes ago, whithou said:

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones.

Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. 

This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.  

Thank you so much @whithou.  This is exactly what I and others are looking for.  Can't put this type information into graphs and spreadsheets.  More people need to know what is going on behind the scenes to really understand the devastating effects of this virus, not only with patients, but with healthcare workers such as yourself.   

Please come back and post as often as you like.  Please use your CAPS to yell and scream your frustrations.  We really appreciate your dedication to your patients and the healthcare industry and certainly appreciate your insights. 

 

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NAVY

NAVY 6738

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3 minutes ago, NeverMarryAStripper said:

Hopefully you haven't been banging them

 

Thought about it but no. 
 

Back in late March the next door neighbor on the other side of my house tested positive. She’s a healthcare worker. Also didn’t bang 

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XYZ

XYZ 2154

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1 hour ago, whithou said:

It has been a disheartening journey and it is only starting. I did not realize how there really is no definitive treatment for the illness until we got COVID patients. When they first come on our unit they are not intubated yet and are on maximum supplemental oxygen. They are all agitated and keep pulling off their oxygen devices so we are constantly running into the room to hold the oxygen device onto their face. The doctors don't like intubating as it is hard to extubate/take them off the breathing tube. Eventually though the patients need to be intubated as their oxygenation numbers aren't so hot. After they are intubated the patients usually have to be paralyzed so they can tolerate the breathing tube. Then starts the waiting game of hoping they'll start to improve on the various trial medications and proning them. Meanwhile, COVID wrecks havoc on all of the other organs in these patients. We have only have a few success stories and those patients were the younger ones.

Everyone I work with is emotionally drained and the last shift we had two COVID patients that coded. I have family members calling around the clock and I never have anything positive to tell them. We still don't have enough PPE and I rewear my N95 until is breaks. I know that I'll eventually get COVID if I haven't already but at least I'm young and healthy. The older nurses are very nervous and one kept saying "I don't feel safe/I'm scared" the last shift I worked. 

This is probably more information than you wanted to know but it was therapeutic to type this out. Thanks for reaching out on what it has been like.  

Is there any kind of sharing of intelligence between hospitals? Like, if some ICU in a hospital in Ohio is giving patients this and that medication and it seems to be working alright for them, how do they communicate that to every other hospital?

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Eastwood

Eastwood 4394

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39 minutes ago, InkaUtexas said:

Can anyone verify this? 

I can't verify, but can absolutely believe it. I had to search the Travis County District Clerk records and the computers seemed like they were 20 years old and running Windows Millennium Edition. I'm not being hyperbolic when I say that. Small, rural counties that I had been to had better computer systems  than the Travis County DCR.

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Bevo

Bevo 13525

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We aren't use to mass testing such as what we are seeing with COVID-19 so manually entering data hasn't been a big problem. There is no universal patient management software. In fact, a friend of mine thought he would be let go as chief radiologist at Henry Ford (Detroit) because the hospital spent over $100 million to develop its own patient management system only to scrap it and go with a prepackaged system. Then because of the money lost, it let go of a bunch of staff. So depending on where the lab testing was done, it has to be sent to the doctor so that he can inform the patient.

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Bert Orange

Bert Orange 1115

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20 minutes ago, Bevo said:

We aren't use to mass testing such as what we are seeing with COVID-19 so manually entering data hasn't been a big problem. There is no universal patient management software. In fact, a friend of mine thought he would be let go as chief radiologist at Henry Ford (Detroit) because the hospital spent over $100 million to develop its own patient management system only to scrap it and go with a prepackaged system. Then because of the money lost, it let go of a bunch of staff. So depending on where the lab testing was done, it has to be sent to the doctor so that he can inform the patient.

Universal patient management. Henry Ford. I see the irony. 

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jinx

jinx 2635

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3 hours ago, South Austin said:

Wait, have I been missing something?  Other than the protests and worship ceremonies, what kind of gatherings over 500 people -- hell, even 100 people -- have been going on over the past couple months? 

image.thumb.png.11ecedc9ad51468df427116856f0c4ae.png

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