Here is the latest information coming from Seattle:
https://threadreaderapp.com/thread/1239290389963714562.html
I’ve been in touch with an intensivist at a Seattle hospital with one of the highest numbers of COVID-19 admissions in the US.
They’ve been too exhausted to post much themselves, so I am conveying some of what I’ve been told, which is… eye-opening. To say the least. /1
The Seattle situation isn’t quite at Lombardy levels yet… but it’s getting there.
First of all regarding the clinicians. None are sleeping more than a couple hrs a night. Everyone is utterly exhausted. My colleague has seen so many people die as to have become totally numb. /2
It’s also nearing Status Lombardosus with regard to resources. They haven’t run out of ventilators (yet), but every single ICU bed in Seattle metro is full. And the onslaught shows no signs of stopping. They’ve run out of other things as well. /3
My colleague saw a patient who had a half-full syringe left attached to her IV line. The syringe had an antibiotic. First thought was that this was some gross nursing error.
It turned out not to be a mistake at all, but rather an accomodation to dire circumstances. /4
It was a drug that was supposed to be infused over hours. But there were no IV pumps available. So the nurse had given some of it, left the syringe attached, and planned to come by to give more a little later, and then finish it.
Here in the wealthiest country in the world. /5
They are also at the point of having to ration some kinds of care. For the most severely ill patients, there’s a machine called ECMO — extracorporeal membrane oxygenation — which is basically like an external lung that oxygenates blood when the patient’s lungs won’t work. /6
Seattle has 12 machines, which is less than what’s needed. So a central committee there is deciding: you can’t go on ECMO if you’re >40 yrs old, if you have another organ system failing, or… incredibly… if your BMI is>25. Turns out these are all major poor prognostic signs. /7
(Note: that doesn’t mean that anybody with a BMI >25 is in trouble if they get COVID. Just that if you’re critically ill from it, that is apparently a poor prognostic marker. Not sure anybody has a clear idea why.) /8
Meanwhile the combo of exhausted health care workers & no open ICU beds has made a very hazardous health situation for the entire region. If you have a stroke, a heart attack, etc., it will be hard to get the best care. There are patients in ERs for hours waiting for ICU beds. /9
My colleague told me something else remarkable: COVID patients are not dying of lung disease.
This seems to be a very distinct syndrome, and in severe cases the pneumonia leads to ARDS, a condition in which the lungs leak fluid & the patient can’t breathe w/out a ventilator. /10
But apparently the ARDS is not too severe, and they can manage people through that part of it.
Instead, after several days, the virus suddenly attacks the heart, causing it to precipitously fail. The myocarditis phase is savage and kills people within a day or two. /11
My colleague has seen a number of cases in which multiple family members were in the hospital and critically ill. Maybe this means there’s some genetic predisposition, but it’s probably too soon to say. /12
And then there’s the fear that comes with an epidemic. Apparently people shopping wearing the hospital’s logo on their clothing have been asked to leave the store. And some who work in the hospital have been asked to move out of their apartment buildings for a few months. /13
Restaurants have refused food delivery, with some of them refusing to even leave the food on the ground outside. The hospital had to send the medics to go pick it up. One doc’s housekeeper refused to come clean for her. /14
In short, this is a nightmare, teetering on the precipice of even worse destruction. The goal of every American city should be to avoid becoming the next Seattle.
Everyone needs to understand not just how bad this could get, but HOW BAD THIS ALREADY IS in one major US city. /15x
P.S. This isn’t my first hand info.
Obviously the colleague who told me this has no reason to make stuff up. But on basic journalistic principles I would welcome anyone who can corroborate this picture.
Thank you for posting- the deniers need to read that.
Harrd to believe...
But interesting.
thank you for the update from Ground Zero.
Savage indeed.
RE:1005 I post this from the author of the thread. Please make of it what you will.
Scott Mintzer Brain
@scott_mintzer
·
4h
I had to delete the thread I Tweeted earlier today because of concerns about both the amount of attention is was getting and the accuracy of some of the information.
The common theme: don’t spread things that shouldn’t be spread. And be responsible for, and to, everyone else.
42
15
144
Scott Mintzer Brain
@scott_mintzer
Meanwhile, please take this seriously or we’ll wind up with a maxed-out medical system like Lombardy.
And I hope everybody supports their local newspapers and other media. Because otherwise there won’t be any local media. And no actual journalists to get us local stories.
Sorry I have many many friends in Seattle and I don’t buy a word of this!!!
I’m glad you were honest and posted that , “This isn’t my first hand info” kudos on that as there is so much exaggerated info out there. Here’s what I raise by data anayltics eyebrows when someone In WA says “My colleague has seen so many people die as to have become totally numb.”
Now, I don’t mean to diminish the suffering or the deaths or the sensitivity of the anyone but the facts are that a total of 41 have died in Washington State, the info in the posts makes it sound like tens of thousands (and most died from that rest home. For reference 69 people who have died of COVID-19 in the US)
The loss of anyone at any age is a loss but of the 41 people who died 10 were in their 90s, 13 in their 80s with pre-existing conditions- a loss never the less.
Furthermore Washington while reporting the most cases with 642, not yet thousands, and of those 642 cases 93% of those are rated as mild. Situation is serious yes and trying but panic and exaggeration only makes it worse.
There are well over 100 hospitals in Washington, and maybe half of them cannot handle this but that still means 6-12 patients per hospital.
Furthermore the US has the highest ratio of critical care beds per 100,000 population at 34.7. , With Washington State population of about 7.6 million that means there are close to 3,000 critical care beds available at any one time,plenty right now to accommodate 642 patients and many are not hospitlized. So the only way the info is not somebody’s earnest exaggeration, is if all the patients’ are being taken to just one hospital.
And I don’t doubt the person passing this one thinks they are passing on accurate info but that is what happens in a panic and with each retelling it gets distorted and exagerated.
What we know now is that the fatality rate is decreasing, . It is dropping as a % as more test are own and capture those with mild symptoms. That is why no one, repeat ZERO under the age of 10 has died anywhere in the world, Including China etc.
Dr Fauci said, “That’s because many corona virus cases are so mild they’re not even being reported. “ Dr. Robert Redfield, who directs the U.S. Centers for Disease Control and Prevention, and Dr. Clifford Lane, deputy director of the NIAID concurred, “”If one assumes that the number of asymptomatic or minimally symptomatic cases is several times as high as the number of reported cases, the case fatality rate may be considerably less than 1%,” Dr. Fauci and his colleagues explained
And the data supports this. The two countries that have done the most testing that can be relied upon is S Korea and Germany , they have tested well over 350,000 and have a combined 13,975 cases and 86 deaths for a fatality rate of .0061 or less than 1% and that rate has been falling. That is more than the flu but nothing like what some are reporting here and in the news.
The reason there is conjuncture that it may actually be much lower is that based on the R0 rate and the fact that Italy has long been the # 1 tourist destination for China and interestingly enough Italy has 350,000 Chinese nationals living in Italy with visas or citizenship, and backing the numbers against the timeline, it is almost certain that the number of people who actually have a mild version of COVID-19 is much higher-many never even know they have it.
In your post the 2nd-hand account said “Seattle has 12 [ECMO] machines, which is less than what’s needed.”
Farther down in the twitter feed (I just signed on to twitter so not sure what I’m doing!) there was a response that said Evergreen Hospital (Kirkland) has 12 of those ECMO machines.
Evergreen is a great hospital, but not as large as some of the others in Bellevue and Seattle. I would think that Harbor View would have the most ECMO machines, but a quick search didn’t give me any results on their number.