Dear Colleagues
Everyone is closely watching and monitoring the COVID-19 outbreak. This global emergency is presenting major challenges for our profession as we attempt to anticipate, tackle and eventually get ahead of it.
As there are many new experiences with this type of virus, we need to learn from those with more experience. Information is vital. As you will have seen, Northern Italy is in the middle of a crisis and Lombardy in particular has been severely affected. Our colleagues coordinating the emergency ICU response in Northern Italy have sent me the following message which they wish to convey to all our members.
I salute all the work our colleagues are doing, globally, faced with this situation. ESICM will endeavor to do its part to share accurate information and resources.
Wishing you all the strength needed in the coming months,
Yours respectfully
Prof. Jozef Kesecioglu
President, ESICM
Milan, 4 March 2020
Dear friends,
At this moment in time, we believe it is important to share our first impressions and what we have learned in the first ten days of the COVID-19 outbreak.
We have seen a very high number of ICU admissions, almost entirely due to severe hypoxic respiratory failure requiring mechanical ventilation.
The surge can be important during an outbreak and cluster containment has to be in place to slow down virus transmission.
We are seeing a high percentage of positive cases being admitted to our Intensive Care Units, in the range of 10% of all positive patients.
We wish to convey a strong message: Get ready!
We also want to share with you some key points from our experience:
Get ready now - with your ICU’s networks - to define your contingency plan in the event of an outbreak in your community
Don’t work “in silo”. Coordinate with your hospital management and other healthcare professionals to prepare your response
Make sure your hospital management and procurement office have a protocol in place about which personal protection equipment (PPE) to stock and re-stock
Make sure your staff is trained in donning and doffing procedures
Use education, training and simulation as much as possible
Identify early hospitals that can manage the initial surge in a safe way
Increase your total ICU capacity
Get ready to prepare ICU areas where to cohort COVID-19 + patients - in every hospital if necessary
Put in place a triage protocol to identify suspected cases, test them and direct them to the right cohort
Make sure you set clear goals for care with the patients and their families early on
With our best regards
Prof. Maurizio Cecconi Prof. Antonio Pesenti Prof. Giacomo Grasselli
President elect, ESICM University of Milan University of Milan
Humanitas University, Milan
https://mailchi.mp/esicm/the-future-of-haemodynamic-monitoring-first-webinar-of-the-year-1009715
That is terrifying. If it spreads like a weak flu then there are not enough beds in all US hospitals to handle tht load MUCH LESS beds in ICU's.
My God this is from a First World Country. Anybody confirm this letter source?
GEORGIA
A second home-school co-op in Cherokee County — Compass Prep — has temporarily shut down after learning it “had contact” with the teenager who was diagnosed earlier this week with COVID-19, the disease caused by the coronavirus, the county’s public school system announced Thursday.
The Georgia Department of Public Health has asked parents of the students who shared classes with the teen to “self-quarantine in an abundance of caution,” said Cherokee schools spokeswoman Barbara Jacoby said. Some students who attend classes at Compass Prep and the other co-op — Living Science — have siblings who attend the county’s public school system, Jacoby added.“We’re communicating daily with DPH officials, and they are not recommending any … school closures at this time,” Jacoby said.
Comment:
Some history - the second GA case, is the 15 year old son of the first GA case, a man who returned from Italy on Feb 22. The father developed symptoms on Feb 25. The son attended 2 Cherokee county Living Science
co-op classes on the 25th. The son developed symptoms on the 27. They tested positive the 1st. The students/staff who were around the kid at the school. class were told to self isolate for 2 weeks. They did not tell the school to shut down, the school chose to shut down for two weeks. Some of the siblings of the kids told to self-isolate go to a nearby co-op called Compass, and that school is also choosing to close for two weeks as well. If anyone was exposed to this kid it would have been on the 25. None of the students at either school have symptoms. Praying they don’t. We know a lot of people in these 2 programs as well.
PS: some of the siblings of the kids who’d been around the boy on the 25th go to public schools. They are not closing