COVID-19 and the States

[Volkonski]

[bill_g]

One of my coworker has needed a minor surgery on his foot for a bit. It got worse. They put a cast on it. Last week they took the cast off after he complained of severe pain. They found an infection. Now there's a possibility he'll lose his foot.

[Volkonski]

[FiveAcres]

Idaho hospitals begin rationing health care amid COVID surge

https://apnews.com/article/business-hea ... afb1518259

BOISE, Idaho (AP) — Idaho public health leaders announced Tuesday that they activated “crisis standards of care” allowing health care rationing for the state’s northern hospitals because there are more coronavirus patients than the institutions can handle.

The Idaho Department of Health and Welfare quietly enacted the move Monday and publicly announced it in a statement Tuesday morning — warning residents that they may not get the care they would normally expect if they need to be hospitalized.

[Volkonski]

[Phoenix520]

This breaks my heart, not only for patients but for staff. This isn’t why they became medical caregivers. And now comes the backlash.
Ignorant anti-vaxxers will scream that the Deep State is trying to kill them off so we can enjoy our Communist paradise in peace, there will be increased violence against the medical community, especially hospitals, and all this has the potential to change the way we do medicine. Forever.

I have deep sympathy for those who CAN’T be vaccinated, and none at all for those who won’t. It should be obvious by now that: far from being untested, the vaccine has had the largest clinical trial ever in the history of clinical trials and passed with flying colors; the state has a responsibility toward all citizens that you don’t, of course they’re allowed to mandate vaccines. Don’t be ridiculous. TB, MMR, chicken pox, polio, smallpox - all these were once endemic, too.

I wish there was something organized groups of citizens around the country could do. During WWII we rationed sugar, saved tin foil, went to work in factories, planted Freedom Gardens. Except that it’s so dangerous, our medical community needs physical support, not just tots and pears, and that would be a good start. Schools, too.

This plague is an unprecedented situation for our current society and most of the world is failing to deal adequately. Except for Jacinda, and she’s even in trouble now.

I’d like to give the world a coke….

[LM K]

One of my coworker has needed a minor surgery on his foot for a bit. It got worse. They put a cast on it. Last week they took the cast off after he complained of severe pain. They found an infection. Now there's a possibility he'll lose his foot.

I colleague told me that the rate of amputations has skyrocketed in OR because timely medical care is now impossible.

[LM K]

Idaho hospitals begin rationing health care amid COVID surge

https://apnews.com/article/business-hea ... afb1518259

BOISE, Idaho (AP) — Idaho public health leaders announced Tuesday that they activated “crisis standards of care” allowing health care rationing for the state’s northern hospitals because there are more coronavirus patients than the institutions can handle.

The Idaho Department of Health and Welfare quietly enacted the move Monday and publicly announced it in a statement Tuesday morning — warning residents that they may not get the care they would normally expect if they need to be hospitalized.

Most healthcare workers are now experiencing mental health issues. Rationing care to this extreme will cause more suicides among healthcare professionals.

Frontline Health Care Workers Aren’t Feeling the ‘Summer of Joy’

A largely unmasked nation will celebrate the nation’s return to near-normalcy this weekend with a ticker-tape parade in New York City, a dazzling fireworks display over the Washington Monument and countless Independence Day gatherings in cities and towns across the country.


Dr. Terrence Coulter, a critical care specialist at CoxHealth, said he and his colleagues were stunned to find themselves back in the trenches after the briefest of respites. “With everyone masked, you learn to read the emotions in your co-workers’ eyes,” he said. “They’re weary and they’re also disappointed that the country has started the end zone dance before we cross the goal line. The truth is we’re fumbling the ball before we even get there.”

America’s health care workers are in crisis, even in places that have had sharp declines in coronavirus infections and deaths. Battered and burned out, they feel unappreciated by a nation that lionized them as Covid heroes but often scoffed at mask mandates and refused to follow social distancing guidelines. Many of those same Americans are now ignoring their pleas to get vaccinated.

Doctors and nurses are also overworked, thanks to chronic staffing shortages made worse by a pandemic that drove thousands from the field. Many are struggling with depression and post-traumatic stress; others are mourning at least 3,600 colleagues who won’t be around for the celebrations.

“People don’t realize what it was like to be on the front lines and risking your own safety without adequate protective gear while dealing with so much death,” said Mary Turner, a registered nurse in Minneapolis who was unable to comfort her own father as he lay dying alone of Covid in a nursing home in the early days of the pandemic. A few months later, she found herself sobbing uncontrollably in a hospital room as she held up a phone so a man could say goodbye to his father. “A lot of us are still dealing with PTSD,” she said.


Dr. Clay Smith, an emergency room doctor who travels between two distant hospitals in South Dakota and Wyoming, said he worried about his children, who are both too young to get inoculated. “It’s really disconcerting to work in a community where people are doing so little to protect themselves and others from the virus,” Dr. Smith said.

With fewer than a third of adults in the counties served by the hospitals fully vaccinated, he has been treating a small but steady stream of Covid patients, some of whom insist the coronavirus is a hoax even as they struggle to breathe. “People think they are exercising their rights by refusing to get vaccinated, but in reality they’re exposing themselves and others to risk,” Dr. Smith said.


Nurses, she said, face a welter of indignities at work. Dire staff shortages are preventing many from taking much-needed vacations, and some hospitals are still requiring employees to reuse disposable N95 masks even though supply chain bottlenecks have eased. Then there is the open hostility from patients who have spent months steeped in right-wing commentary and conspiracy theories that have turned health workers into adversaries.

“I’ve been in the field for 45 years and I’ve never seen things this bad,” said Ms. Burger, who is a registered nurse. “It’s really frustrating and dispiriting that the pandemic has been turned into a political event, rather than a public health crisis, and it’s health care workers who are left to deal with the aftermath.”


Infuriated patients, she said, often scream at her; others will storm out before they can be treated. “It’s very anxiety provoking to have 30 patients in the lobby and not being able to take them because we have no nurses,” said Dr. Windsor, who has been forced to scale back her hours and take a pay cut because of the drop off in admissions. “What if someone has a heart attack? The whole environment has become really challenging.”


The interactions she has with Covid patients, many of them African American, often leave her shaken. She recalled a recent exchange with a woman in her 40s who was struggling to breathe. When Dr. Chopra asked whether she had been vaccinated, the woman shook her head defiantly between gasps, insisting that the vaccines were more harmful than the virus. The patient later died.


The emotional fallout of the last 16 months takes many forms, including a spate of early retirements and suicides among health care providers. Dr. Mark Rosenberg, an emergency room doctor at St. Joseph’s University Medical Center in Paterson, N.J., a predominantly working class, immigrant community that was hit hard by the pandemic, sees the toll all around him.

He recently found himself comforting a fellow doctor who blamed himself for infecting his in-laws. They died four days apart. “He just can’t get past the guilt,” Dr. Rosenberg said.


Most of the suffering goes unseen or unacknowledged. Dr. Rosenberg compared the hidden trauma to what his father, a World War II veteran, experienced after the hostilities ended.

“My dad didn’t like to talk about the war but once in a while he did and what he said was that so many of his fellow soldiers died after they came home,” he said. “We would now describe this as PTSD, and I see the same thing happening among health care workers.”

Dr. Rosenberg said he had mixed feelings about the festivities planned for July 4. He is proud of the camaraderie and self-sacrifice he witnessed among colleagues who bravely faced down a deadly virus, but he is uncomfortable with the expression “health care heroes,” especially given the widespread resistance to vaccinations.

“We’re ready to stand shoulder to shoulder again and face whatever comes our way,” he said. “But to be honest, we’re wiped out and we just want society to show us that we really are appreciated — by getting vaccinated.”

Article by Cassandra Alexander, author of Year of the Nurse: A 2020 Covid-19 Pandemic Memoir

A Year As A Nurse In The COVID ICU Gave Me PTSD. Now It’s Happening All Over Again

It’s hard to admit to needing help when your concept of self revolves around being strong for others: assessing critical patients quickly, making life-and-death decisions, and communicating effectively with people on the phone who may have just experienced the worst day of their lives ... but for you it has to be just another Tuesday.

Even before last year, roughly 4 million nurses across the nation were burned out. Our jobs are intellectually demanding, emotionally exhausting and physically laborious. Pre-COVID our post-traumatic stress disorder rates were 1 in 5 or 1 in 4 depending on the study.

I guarantee you they are higher now, and I know, because it happened to me.

I don’t think most Americans realized what it was they asked of nurses last year. It was easy to call us heroes, but far harder to understand what we were put through at the bedside. Nursing in COVID times, both then and now as it continues, is being forced to bear witness to a cavalcade of preventable tragedy.

People who die of COVID die the worst deaths imaginable. (I used to be a burn nurse, so please understand that when I say that it means something.)

Most Americans will never understand what it is like to look someone in the eyes as they pant in increasing terror, forced to choose between talking on the phone to a loved one they know they might never see again and breathing enough to survive. To hear their distant loved ones shrieking over FaceTime, trying to tell your patient that they love them as they die.

How would you feel if you were forced to watch this every day for up to 16 hours? Every single shift of yours, over the course of an entire year?

There’s a certain amount of braggadocio in health care.

Because the consequences of any of our mistakes can be so dire, many of us have a hard time admitting that we have ever made any. And thus, because we want to think ourselves infallible, it is often hard to recognize the signs when we are not.

When we go home, unable to stop thinking about what happened on a certain shift.

When we have recurring nightmares about being trapped or unable to help.

When we have trouble regulating our emotions because for so long to have even acknowledged their mere existence would have been the difference between functioning another day versus ceaseless weeping.

I cracked at work in late April, in the middle of a shift.

I told my closest friends I wanted to die, started crying, and didn’t stop for about three weeks. I wound up being placed on temporary leave and diagnosed with PTSD.

At the time, it felt incredibly shameful to be having problems. We didn’t have any COVID patients anymore.

But I actually think that’s what triggered it. The fact that, for the first time in 13 months, I had a chance to breathe.

To rest.

And when I looked back at what I had “accomplished” last year as a COVID ICU nurse, which was mostly nothing, through no fault of my own, I couldn’t bear it. Being forced to witness so many absolutely needless deaths, hearing so many family’s hopes dashed on the phone, and listening to people at the highest levels of government lie without consequence?

I had given my all, for a whole year, and I’m used to succeeding, dammit.

And yet for most of 2020, and the beginning of 2021, I couldn’t.

No matter how hard I tried.

And it broke me.

I am still working on coming back. I’ve come to accept that recovering and keeping my mental health is not something I can count on, but instead a lifelong goal.

It is frustrating, though. When someone is physically ill, you have metrics to judge their progress with ― have they recovered mobility, are their labs now good? But when you’re newly mentally ill, while you can hold up the image of the person that you used to be, there comes a time when you realize that you might not get that person back.

I so dearly want to go back to the time when I thought that my government was invested in the health of its citizens ― and when those citizens themselves seemed to care about one another.

But now I have seen truths that I cannot ignore nor put away. I am learning to cope with them, via therapy, and to desensitize myself to the most intrusive images, via eye movement desensitization and reprocessing, the therapy modality they use on combat veterans, which is great.

I wrote a book about my experiences, at my therapist’s urging, because she knows I like to write, and that helped too ― it gave me a chance to honor the version of myself that was trying so hard last year.

But I still grieve her loss, knowing that the “me” that I once was is not a “me” I can attain again, not until ― unless ― America changes its heart, soul and mind.

If someone came to your house and told you to take all the batteries out of your fire alarms, you’d report them to someone, right? Because that’s literally insane. We all know that fire alarms save lives, no questions asked.

So why do we tolerate anti-vaccine conspiracy theorists moving among us? Or any political figure that decries wearing a little scrap of fabric on their face because of “freedoms!”?

Knowing what we do about COVID now, how quickly it transmits, and how lethal it can be, allowing either of these groups any foothold in American society is the same level of insanity as someone who sabotages fire alarms on purpose.

Every nurse in America right now is staring down this summer and this fall like it’s the barrel of a gun. All of our hospitals are seeing COVID cases rise again, and with the rare exception of immunologically compromised patients for whom the vaccines are less effective, none of these deaths had to happen.

Each of us is being forced to be a handmaiden to atrocity.

And ... for what?

Why?

I mean it, really.

Why?

If you tell me it’s because “God knows when it’s your time,” I just want to tell you from the bedside, none of my patients looked peaceful dying, nor did their families find one whit of comfort in their deaths.

Each time you say that phrase you are spitting on over half a million graves ― and the time, attention, care, love, respect and dignity of the 4 million nurses whom you are forcing to keep watch.

I know this essay’s going to piss some people off, and I know I don’t 100% speak for all nurses.

But if it does piss you off, know this ― the real emotion you should be feeling right now is shame.

Because for some soulless reason you are OK with wanton, needless carnage. You are OK with people dying. There is no in between.

To be a good nurse you by definition have to care ― and truly caring requires making oneself vulnerable.

So here America is, asking us to step up to the ledge again, to open up our hearts and souls and minds. Some of us are going to step back to protect ourselves, and some of us are going to step over. (Nurse suicide rates are more than double the non-nurse female population.)

You deserve the best of us, but I am here to tell you that we don’t have much more to give.

So please. Change. Do better. Get vaccinated. Wear a mask. Tell your neighbor to wear a mask.

Help us help you this time, or we will not be around the next.

[LM K]

More about healthcare providers and mental health issues.

‘Why do I put my life on the line?’ Pandemic trauma haunts health workers

A provision aimed at addressing the mental distress of health care workers is included in the $1.9 trillion COVID-19 relief package President Joe Biden signed last week. Named for Dr. Lorna Breen, an emergency physician who died by suicide after caring for COVID-19 patients in New York City at the height of the first surge, the initiative will provide $40 million in grants providers can use to promote mental and behavioral health among their workers.

The provision also includes $80 million to train health care and public safety professionals in strategies to reduce suicide, burnout and mental and behavioral health conditions, and $20 million for a federal Centers for Disease Control and Prevention awareness campaign to encourage health care workers and first responders to seek treatment for their own behavioral health concerns and identify and respond to risk factors in themselves and others.

4 Unspoken Truths About Nurses, PTSD and the Pandemic Link

‘Dealing with the monster again’: COVID-weary Parkland nurses battle staffing crisis and PTSD
Link

For providers with PTSD, the trauma of COVID-19 isn’t over
Link
-good article with data

[Volkonski]

Cassandra Alexander's experience is shocking and infuriating. All those overworked unappreciated medical staff.

It shouldn't be this way. Antivaxers and antimaskers are the worst.

[Volkonski]

[scirreeve]

Baby died in Douglas County Oregon. Another AP article says <1 year old.
https://www.nrtoday.com/news/health/cor ... 70002.html

A Douglas County infant has died from COVID-19 complications, according to the Douglas County COVID-19 Recovery Team.

The infant reportedly was diagnosed with COVID-19-related symptoms on Aug. 20 and died Monday. The child was one of 13 deaths listed in the recovery team's Wednesday report.

[LM K]

Several members of the infant's family are calling media to say that the infant didn't have covid.

Several people who say they are related to the child have contacted the newsroom and disputed the county's characterization of the death as COVID-related.

Our newsroom is working to verify their identities and speak to the family, as well as clarify the concerns they raise with the county.

We reached out to the county about the situation and they tell us they stand by their report.

"We thoroughly investigate all deaths, and review all medical records to make sure that everyone meets the requirements for a COVID related death as per the Oregon Investigative Guidelines," Dr. Dannenhoffer said in the county's weekday report announcing the death. "But, more important than all of that is the fact that they were all someone’s family, someone’s friends and our neighbors, who all died too soon. Please, keep you and your family healthy, and protect those you love the best way you can."

[sugar magnolia]

https://www.wjtv.com/health/coronavirus ... -covid-19/
JACKSON, Miss. (WJTV) – Leaders with the Mississippi State Department of Health (MSDH) reported another pediatric COVID-19 death. This is the seventh pediatric death due to COVID-19 in the state.

State Epidemiologist Dr. Paul Byers said the child was less than a year old.

In recent weeks, health leaders said there’s been a rise in pregnant women not surviving their battle with COVID-19 in recent weeks. They said eight pregnant women have died due to COVID-19, and all of them were unvaccinated.
******

More at the link.

[Lani]

This happened fast. Gov. Ige issued an executive order not long after Pres. Biden's speech.

All contractors entering, working, or providing service in any state facility must: identify all employees accessing State facilities and attest whether each is fully vaccinated for COVID-19, partially vaccinated, or not vaccinated. The contractor must provide weekly verification for any unvaccinated/partially vaccinated employee that testing has occurred once or twice per week (as determined by the State).

Visitors to the state facilities must show proof of vaccination or a negative test result within 72 hours before entering the facilities.



I especially like that the part about (potentially) testing twice a week.

[Kendra]

WA:

[AndyinPA]

https://www.washingtonpost.com/health/2 ... ssissippi/

Mississippi has recorded 72 fetal deaths in unvaccinated pregnant women infected with the coronavirus, state health officials announced Wednesday, sounding the alarm on the virus’s danger in pregnancy.

Speaking during a news conference, Mississippi State Health Officer Thomas Dobbs said those deaths had occurred since the start of the pandemic. The number, which includes only deaths that occurred past 20 weeks of gestation, “is twice the background rate of what would be expected,” he said.

“That’s quite a number of tragedies that, sadly, would be preventable right now,” Dobbs said, referring to the availability of vaccines.

He said the state is also investigating the deaths of eight pregnant women who were infected with the virus. Those deaths occurred over approximately the past four weeks, during the delta variant-fueled surge, he said. Many underwent emergency Caesarean sections in an attempt to save their babies.

Citing those cases, Dobbs and other state health leaders urged those who are pregnant to get the shot that can protect them from the virus.

[Volkonski]

[Notaperson]

A Georgia hospital that's stretched beyond capacity with COVID-19 patients has asked for help from firefighters and the sheriff's office

AdventHealth Gordon hospital in Calhoun, Georgia, has 69 beds but more than 100 patients, most of whom have COVID-19, according to officials.

"People's nerves have been frayed with the pandemic and they don't always want to mask. Some people have been getting testy about that, so that's something our police could help with that would take a lot of stress off hospital staff," he said, as reported by Chattanooga Free Press.

The county has fully-vaccinated 38% of its population, according to Covid Act Now. The US average is 53.8%.

https://www.businessinsider.com/covid-g ... nty-2021-9

[Frater I*I]

Calhoun, GA, is in GA-14, Tinfoil-Greed's district...

[Notaperson]

Mississippi Now No. 1 in All-Time COVID Deaths Per 100,000, Dethroning New Jersey

Mississippi now leads the nation in COVID-19 deaths per 100,000, usurping New Jersey, an early pandemic hotspot that until last week had held the title for 15 months. The Magnolia State claimed the unenviable title following a month in which the delta variant surge pushed hospitals to the point of collapse with coronavirus patient levels at all-time highs for both children and adults.

Mississippi State Health Officer Dr. Thomas Dobbs predicted the state would exceed New Jersey earlier this month, shortly after Mississippi surpassed the nation’s earliest pandemic hotspot, New York, which now ranks third in COVID deaths per 100,000. But it did not have to happen, he stressed.

Since COVID-19 arrived in the Magnolia State in March 2020, the state’s COVID-19 deaths per 100,000, also known as the crude death rate, has climbed to 306 per 100,000 residents. New Jersey, now in second place, has reported 292 deaths per 100,000 residents, while New York, the nation’s earliest pandemic hotspot, has reported 269 COVID deaths per resident.

At the start of the delta-variant surge in July, Mississippi ranked no. 50 nationwide in COVID-19 vaccination. The Magnolia State has since risen to 46th place, now leading Alabama, Idaho, West Virginia and Wyoming. About 41% of Mississippians are now fully vaccinated. Nationally, about 55% of Americans are fully vaccinated.

https://www.mississippifreepress.org/15 ... ew-jersey/

Congratulations, Mississippi.

[Notaperson]

Overwhelmed Kentucky hospitals fear the worst as federal Covid-19 assistance is scheduled to leave Friday

A Covid-19 surge in Kentucky has led to so many patients at St. Claire Regional Medical Center that the workers are unsure how they'll handle the growing numbers when a medical team sent by the federal government leaves Friday.

The Morehead hospital, about 65 miles east of Lexington, is one of the hardest-hit due to the influx of Covid-19 patients. It's the largest health care facility serving 11 counties in rural northeastern Kentucky and -- as of last week -- was at 130% above capacity, according to St. Claire Health Care CEO Donald Lloyd.

"The only reason we are holding this lifeboat together is I have a federal disaster medical assistance team here, 14 people who have just been heroes to us. And, unfortunately, their deployment is over on Friday," Dr. William Melah, the chief medical officer for St. Claire Health Care, told CNN's Kate Bolduan on Monday. "I'm going to lose 14 health care professionals, and I literally have no idea what we're going to do on Friday."

Gov. Andy Beshear said during a Covid-19 briefing Monday that hospitals in Kentucky are "struggling more today than at any other point during the pandemic." Because of this, Beshear said about 400 National Guard troops will be deployed across 25 hospitals in the state.

https://www.cnn.com/2021/09/13/us/kentu ... index.html

[Volkonski]

Alaska

[AndyinPA]

West Virginia

https://www.theguardian.com/us-news/202 ... accination

West Virginia was once one of the leading US states in rolling out Covid-19 vaccinations. Now it is one of the least vaccinated, with the fastest-growing rate of infections in the country. Health systems are overwhelmed, with record numbers of patients in hospital, in intensive care units and on ventilators.

What happened?

West Virginia rushed to vaccinate those over the age of 65 and residents of long-term care facilities, reaching good levels of protection among those groups.

But reaching younger West Virginians has been much more of a challenge.

Governor Jim Justice, a Republican, has been a vocal supporter of vaccination, regularly urging constituents to get the jab. The state was among the first to offer vaccination incentives, including $100 savings bonds and a lottery, named for Justice’s English bulldog Babydog, to award scholarships, a car, a pontoon boat and more. He has spoken out sharply against conspiracy theories and criticized health workers who turn down the vaccine, calling the decision “asinine”.

Even so, only 39.9% of West Virginians are fully vaccinated, according to Our World in Data, tying with Wyoming for the lowest rate in the country. According to West Virginia’s health department, that rate is much higher, at 51.7%; the reason for the discrepancy is not clear.

And with the dominance of the Delta variant, West Virginia is experiencing its worst surge yet.

[sugar magnolia]

Meanwhile in CA....

City of Dinuba
PUBLIC ADVISORY
Effective immediately and until further notice:
Due to conditions regarding local hospitals and ambulance provider staffing and capacity within this EMS region, patients not meeting criteria for transport to an emergency room can no longer be transported by ambulance. Hospitals are operating at disaster levels and there is limited patient bed capacity available. Most of our hospital emergency departments are holding ICU patients, which requires significant emergency department space and resources that are no longer available to the emergency department.
The EMS system is struggling at times to provide ambulance services to Dinuba and surrounding communities. Changes have been made to assure that patients with emergent medical conditions are being taken care of with the limited resources that are available. If you feel you are having an emergency call 911. EMS providers will assess you and determine if you meet criteria for transport to the emergency room. For non-emergency medical complaints you are encouraged to seek treatment through your primary care physician, tele-medicine or local urgent care facilities.
Jordan Webster
Fire Chief
City of Dinuba Fire Department