
NY hospitals pitch tents, nix surgeries to prepare for influx - hhs
https://www.bloomberg.com/news/articles/2020-03-14/n-y-hospitals-pitch-tents-nix-surgeries-to-prepare-for-influx
======
softwaredoug
My neighbor is a doctor, when he gets called to the quarantine unit, his
family doesn't know how long it'll be (weeks? months?) until they see him
again.

Last night he was headed to work. I saw him saying goodbye to his family with
a bag packed. It was horrible. Kids crying, chasing after him...

~~~
troughway
I've been hearing over the past week a lot of optimism about how things will
return to normal in two weeks (ie. schools are "closed until April <so and
so>")

Where did these people get the idea that this will be under control in such a
short amount of time?

Edit: Just to clarify I am not saying this to sow seeds of negativity, just
wondering myself how can anyone announce reopening without any basis in
reality.

~~~
dboreham
Probably there's a big concern about civil unrest.

~~~
troughway
Civil unrest should not occur. Society and order will not disintegrate, and
people will keep working (one of the better ways of dealing with the anxiety
of this situation for many people, I imagine).

There isn't a food shortage; there will be a slow down of cargo movement
because of extra safety precautions and less people working, but there is no
reason to expect people to go hungry and riot over this. Food shelters will
not be closing down. Water, electricity will continue working.

Things will get quieter for a little while, shopping malls will be empty and
then running in a reduced capacity as things return to normal.

~~~
inetknght
> _people will keep working_

> _less people working_

Something here doesn't make sense to me.

~~~
spacehome
He meant to say “fewer”.

------
etrautmann
My girlfriend is a physician at NYP in NY. It feels like there's almost
nothing I can do to help and the worst case projections sound like a true hell
I never thought we'd experience.

It's even scarier to hear how unprepared the whole system appears to be. The
hospitals are extremely concerned about mask supply and they all just received
an email on Friday recalling any boxes of masks from anywhere in the hospital
to central storage. Apparently patients and others have been walking out with
boxes of masks and it's impossible to order more.

I know a 60 year old who hasn't practiced medicine in a number of years who
expects to jump into service in a week or two when patients are overflowing
makeshift shelters.

~~~
dboreham
How many weeks have we had to spin up mask factories? They're not exactly high
tech items.

~~~
pmorici
There is only one medical mask factory still in business in the US.

Edit: you can read more about the mask supply issue here. There maybe more
than one but very few remain and 95% of masks are imported.

[https://www.washingtonpost.com/business/2020/02/15/coronavir...](https://www.washingtonpost.com/business/2020/02/15/coronavirus-
mask-shortage-texas-manufacturing/)

~~~
robocat
“He’s hesitant, however, to ramp up production at the facility outside Fort
Worth, scarred by the boom-bust mess that occurred after the swine flu
pandemic in 2009.”

“ But after the pandemic, demand declined, and it took months for hospitals
and distributors to go through the surplus of masks they had ordered but never
used. Prestige Ameritech had to let most of its new workers go. ‘Everybody
said they’d stay with us. The day after the pandemic they forgot who we were.
We nearly went out of business‘“

“A lack of planning on their part is not an emergency on my part,” Bowen said.
“They had their chance. I told them over and over.”

That article contains a great background on the lack of long-term preparation.

~~~
interblag
Wow. Seems like the easiest and simplest step imaginable for the CDC or some
other federal department to step in and give a large minimum volume commitment
immediately, and put this particular fear to rest...

~~~
yourapostasy
It wasn’t guaranteeing the initial manufactured volume that was the challenge,
it was the continuous orders after the crisis. All the US MBA’s and purchasing
departments went back to China-supplied JIT supply chains. To compound the JIT
mistake, they ignored the owner when he told them the next time this happens,
he’s not risking his business to bail out everyone.

This is a US Federal government-scale public utility problem space. Hand the
US factory-based US PPE companies a 35-year contract rolled over once a year.
They are to build out capacity in several separate facilities for up to 10% of
US population per day, paid entirely by federal taxpayer funds. Train skeleton
DOD and DHHS staff on how to maintain and run it, keep key personnel in
primary facility on alternating shifts with federal equivalents. Run skeleton
output for DoD and social welfare-related consumption. Improvements in primary
facility are simultaneously performed in national strategic facilities.
Company keeps manufacturing on a JIT basis as they are market-forced to today.

Develop standards and protocols to store the PPE for 30 year durations, and
intermixing with normal supplies to keep rotating them. Ideally design some
kind of factory-reusable retort pouch, and make the PPE reusable with
sufficient treatment, and easy-to-use validation testing. Normally let the
factory reman the used-once gear to identify and fix field problems. Set a
stockpile goal that gives the strategic factories time to spin up in enough
time to fluidly cover a pandemic response.

Then turn around and start contact tracing the JIT decisions, and tell them
they have 10 years to clean up their act and lay in stockpiles and best
practices. Hold natural persons responsible.

I’m guessing some kind of plan like this is languishing in the now-disbanded
CDC pandemic response leadership. Extreme risk planning has been a marked
oversight of American-style business leadership, and I see no incentive nor
reason it will ever change.

------
troydavis
Seattle hospitals are also postponing non-life-threatening surgeries, as much
to avoid consuming PPE as for beds and staff:
[https://www.swedish.org/patient-visitor-info/coronavirus-
adv...](https://www.swedish.org/patient-visitor-info/coronavirus-advisory),
[https://www.uwmedicine.org/coronavirus](https://www.uwmedicine.org/coronavirus)

The County is converting at least one motel and at least one parking lot to
recovery/isolation/medical support:
[https://www.kingcounty.gov/depts/health/news/2020/March/14-c...](https://www.kingcounty.gov/depts/health/news/2020/March/14-covid.aspx)
(scroll to "Temporary housing, isolation and quarantine facilities")

~~~
maxerickson
The surgeon general has asked hospitals nationwide to postpone elective
surgery.

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johnpowell
Shit...

I have a thing scheduled for early next month. Not a full on surgery but it is
pretty invasive and urgent and they require me to be in the hospital for a few
days.

I'm not in New York but I am in hotbed for the current problem.

Interventional Radiology is somewhat specialized so hopefully there aren't any
interruptions. But they do have about 20 beds in their unit of the hospital.

~~~
perlwle
I live in China. I have read many horror stories out of Wuhan, China after the
local hospital got overloaded with patient.

1\. People got infected couldn't be treated and had to stay home. See this
video that the daughter of a sick mom trying to get attention by drumming in
the balcony and crying for help. "My mom is dying and I am helpless"
[https://www.youtube.com/watch?v=cuvA0XooI5c](https://www.youtube.com/watch?v=cuvA0XooI5c)

2\. people with long term illness or scheduled surgery couldn't be treated,
such as leukemia patient need dialysis, because Major hospitals has directed
all resources to treat coronavirus patients.

Work from home, cancel meetings, stay away from the crowd.

Wash hands, wear mask if you have to go out.

Get medical advice from your doctors ASAP if you fall into the second
category.

Please get prepared for the worse and don't let this happen to you and your
loved ones.

EDITED: add a youtube video

~~~
softwaredoug
Thanks for sharing your experience. My Mom is undergoing Chemotherapy, with a
surgery scheduled in April. She has pancreatic cancer, which is a very tough
cancer. They caught it early, and we were hopeful - until Covid 19. Now we
have no idea how many delays, etc to expect.

Best wishes to you from an American. We're in this together!

------
muditgarg
Yeah, I hope it doesn't come to it but this is the right first step. Adapted a
flu surge model with folks at my company to estimate bed capacity shortage and
it's not pretty. [https://qventus.com/blog/predicting-the-effects-of-the-
covid...](https://qventus.com/blog/predicting-the-effects-of-the-covid-
pandemic-on-us-health-system-capacity/)

------
dminzi
I don't know what to do. I am in LA for school, but my family is in NYC. They
want me to come back, but it seems like the last place I should be going right
now. Being with family is important, but the idea of traveling and adding
another person to the population of NYC seems counterproductive to fighting
the virus.

~~~
travmatt
I’m in the exact same boat. I want to fly home and this is the only time I’ll
probably ever see super cheap tickets, but I’m young and the possibility that
I could expose and infect so many people along the way makes it look as though
shelter in place is the most responsible thing to do.

~~~
nate_meurer
Don't worry about it; if you want to go home now, you should go home. If
you're not symptomatic, and if you take even minimal precautions, you're
highly unlikely to spread anything.

To me, the far more important consideration is if there's benefit in you and
your family/friends being together now. That's what would make my decision.

------
deelowe
I'm terrified of what's coming. I feel so helpless.

~~~
troughway
Did you see the Louis CK skit about flying in a tin can and complaining about
not having wifi on your cell phone?

Existence is a very fragile thing. Nature is unforgiving. We as a species have
made incredible strides to be where we are today. People all over the world
wake up every morning, do their routine, and go about their daily lives.

Around them, they are surrounded by people, care free and oblivious to the
absurd amount of work it has taken to come to a point where people can relax
their minds and go for a walk, get fresh water to drink, go watch a movie with
their friends, or get in a fancy car and go for a drive.

We will make it through this. We are surrounded by all kinds of deadly shit
waiting to kill us, and we are still here, thriving. There are many competent
teams working on this to the best of their abilities.

Modern medicine is a technological marvel. Two days ago, a team of researchers
managed to reproduce the virus which will pave the path to figuring out how to
create antibodies.

It will take some time, and it has already impacted a lot of people. The death
count will not stop going up, but we won't give up either.

We have given a middle finger to just about anything that could have killed
us. We've erected hamlets, villages, towns, cities, metropolises. We have a
station floating in space. Built monuments to things we like and things we
despise. We've composed beautiful music to inspire ourselves to wage wars
against each other. We are relentless and unstoppable.

Hang in there, and don't let helplessness take over you.

~~~
Fezzik
Just to clarify, that was a Louis CK bit. I enjoy both of their comedic
styles.

Louis does it in a stand-up special, but here is a good Conan clip, with a
great title:
[https://m.youtube.com/watch?v=nUBtKNzoKZ4](https://m.youtube.com/watch?v=nUBtKNzoKZ4)

~~~
troughway
Thank you - I blanked out who it was!

------
davidw
And at the very same time, a bunch of bars are probably packed full of people.
Maddening.

~~~
JohnTHaller
They were here in NYC on Friday.

~~~
in3d
Restaurants had 50%+ drop in traffic in NY state on Friday (opentable data).

~~~
JohnTHaller
We were talking about bars. And some of the bars around the neighborhood were
packed on Friday night.

------
paganel
Tents work as long as you have enough artificial respirators and it's not too
cold outside. Also, you need to have enough medical personnel, if the Chinese
stats are correct about 40% of the Wuhan doctors got sick after 2-3 weeks of
the whole thing getting really serious and they had to airlift about 6000
medical personnel from other Chinese regions.

------
formercoder
Wish I could be doing something. I’ve just fled to Long Island and am staying
in the house reading the news.

~~~
troughway
It would not surprise me if there is a rallying call (state-sponsored
employment?) for younger and able people to help out in the coming weeks,
especially if a longer-term lockdown is happening. Things like picking
up/dropping off groceries and other tasks on behalf of the elderly and infirm.

~~~
Buttons840
Especially those who have been infected and are immune. (I'm not sure we know
to what extend people become immune though?)

~~~
troughway
I'm really at a loss on this subject because I'm trying to find out answers to
two questions that don't have much coverage so far (understandable):

1\. The people who "recovered" from this so far, do their CT scans or other
tests show alterations to their organs? I've read that survivors of SARS have
had permanent damage that later led to issues like cystic fibrosis, and
others.

2\. Has anyone really become immune to this thing yet? The "UK experiment" is
going to be an absolute shitshow if they are walking into this without knowing
that it's possible to be immune from it.

~~~
csnover
Regarding the second question, a preprint of study on SARS-CoV-2 immunity in
rhesus macaque indicates that they did develop an immunity. [0]

[0]
[https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1](https://www.biorxiv.org/content/10.1101/2020.03.13.990226v1)

~~~
troughway
Reassuring - thank you!

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Medicalidiot
I came here two weeks ago to downvotes and nonmedical people telling me how I
was inciting a panic. Welcome to the show, folks. A lot of my colleagues are
going to die soon and I'm beyond sad because of it.

