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When skiing returns

flakeydog

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of course when a few thousand from points south flee to the perceived safety and tranquility of points north, that will add to the burden. Capacity that was not necessarily planned for. Vermont may be able to handle some of this but the Adirondacks are a different story. Lots of people flocking up there, buying out the food supply and hunkering down in their 2nd homes. All fine until they need legit medical care, then the shit really hits the fan. Beautiful country but remote in every sense of the word.
 

BenedictGomez

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I started my day with a very sobering conversation with the Director of Nursing of a hospital in VT. If the rate of infection in NYC hits VT, within 3 weeks the hospital will have to switch to a policy of no ventilators for patients over age 60. These heroes are very well used to DNR situations and see sad endings of life every day, but it's pretty much unprecedented they have to make the DNR choice for their patients and loved ones because they lack the resources to treat.

That's not media fear mongering. It's legitimate fear of the providers on the front lines. Let's hope it doesn't get that bad.

If. And it wont.

Vermont has a strong natural defense against massive, large scale numerical, communicable pandemic disease; it's called geography.
 

deadheadskier

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With elective surgeries on hold will this make a viable dent in the deficit?

https://poststar.com/news/local/loc...cle_fe2c16f5-9199-5b4a-ae1b-5c58e9bb4b33.html
It will help some for sure. A lot of my week has actually been reaching out to Anasthasia docs to let them know that the FDA has an emergency order in place that allows for the use of Anesthesia machines for off label use as ICU ventilators.

It's not ideal. Anesthesia machines are far more advanced to run than an ICU ventilator. The skill requirement to run a ventilator is a 2 year associate degreed Respiratory Therapist making $40-65k a year. Anesthesia machines require at least a CRNA making $120k+ if not a true Anesthesiologist in the $400k range.

The additional capacity is pretty minimal though. Annual sales in the US market for Anesthesia machines is roughly 6k units. Average lifespan of that equipment is about 12 years. Some hospitals and surgery centers push that limit out. So call it 100k certified Anesthesia machines in the country would be my guess. So when you see one state such as NY begging for 30k ventilators, you can see that pushing a portion of the 100k Anesthesia machines in the US in place as an ICU vent substitute is somewhat of a drop in the bucket.

Hospitals are for sure actively converting ORs to ICU isolation beds with Anesthesia machines as vents to increase critical care capacity.

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cdskier

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I guess you didn't actually read the details of the research I posted. If you did, you'd see that while yes, unemployment itself causes an increase in the mortality rate among the unemployed, it is also offset by a benefit to ALL groups of reduced risk factors during a slower economy.

Also, here's a second article since you seem to think there's only 1:
https://www.pnas.org/content/106/41/17290

I'm not saying I'm advocating a recession. I'm just saying it isn't necessarily anywhere near as bad as some of you want us to believe it would be. With COVID-19 we have actual REAL deaths occurring TODAY. With a recession we "may" have deaths based on some hypothetical scenarios. We can't just "open things up" because we're worried about the economic impact. And I'd love to hear some real solutions on how we would logistically implement a "isolate only high risk factor people" scenario. It really isn't anywhere near as simple as people pretend it is. There's far too much integration and potential "touch points" between different risk factor groups at least in major metro areas. More isolated rural areas could potentially find it easier to have more flexibility (assuming you can keep the higher-risk metro area people away somehow).

Maybe when you lose someone close to you from this you'll understand (especially when they are young and had a family). I take little comfort in statistics right now. Yes, emotion is playing a role in my responses here. Don't care... My view is largely unchanged from what it was previously. The only difference is I'm being more vocal about it now.

Someone else commented earlier (either in this thread or another one today) something along the lines of "you can think the media is over-hyping things and also think this needs to be taken seriously". I agree with that statement and line of thinking. I still think there are many people that don't take this seriously enough. I also think the media is nuts. The two are not mutually exclusive.
 

deadheadskier

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If. And it wont.

Vermont has a strong natural defense against massive, large scale numerical, communicable pandemic disease; it's called geography.
Likely so, but are you so confident to claim my suggested state capacity of about 50 serious Covid-19 patient rooms can't become overwhelmed by this?

I don't know that answer myself. I can only report that the people I talk with are scared shitless and scrambling for every bit of equipment that they can get their hands on.

This very hospital I was referring to I helped setup a temporary 8 bed ICU unit last week. I'm doing another one in NH tomorrow. I've got a couple hospitals in Maine looking to do the same next week.

We are the number three player in the business and are getting calls left and right for product from hospitals who traditionalky use the two top players because those companies have no equipment left in inventory to sell.

It will be months before the manufacturing capacity of the big players in the industry can catch up.

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BenedictGomez

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Someone else commented earlier (either in this thread or another one today) something along the lines of "you can think the media is over-hyping things and also think this needs to be taken seriously". I agree with that statement and line of thinking. I still think there are many people that don't take this seriously enough. I also think the media is nuts. The two are not mutually exclusive.

That was me. It's still my belief.

It's rare I see something in the media not bases on worst-case scenarios or unrealistic worst-case modeling which we already know is not going to be correct. I'm still seeing media peeps speculating over 1 Million to 2 Millions US deaths, which is beyond absurd.

They're stirring fear & panic irresponsibly, which doesnt help because it's probably part of why infected people from NYC are fleeing to uninfected areas. Cuomo's not helping either, he's very dramatic & saying terrifying things like thousands of New Yorkers are going to die because he needs 30,000 ventilators. The thing is, nobody ever flipping asks him how he arrives at that math, as in another post here I noted how I have no clue how he gets there.
 

cdskier

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That was me. It's still my belief.

It's rare I see something in the media not bases on worst-case scenarios or unrealistic worst-case modeling which we already know is not going to be correct. I'm still seeing media peeps speculating over 1 Million to 2 Millions US deaths, which is beyond absurd.

They're stirring fear & panic irresponsibly, which doesnt help because it's probably part of why infected people from NYC are fleeing to uninfected areas. Cuomo's not helping either, he's very dramatic & saying terrifying things like thousands of New Yorkers are going to die because he needs 30,000 ventilators. The thing is, nobody ever flipping asks him how he arrives at that math, as in another post here I noted how I have no clue how he gets there.

Fully agree with your comments here. Would be nice if the media would stick with reporting simply facts. But I guess that doesn't sell enough ads...
 

BenedictGomez

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Likely so, but are you so confident to claim my suggested state capacity of about 50 serious Covid-19 patient rooms can't become overwhelmed by this?

YES!

Let's do the math, and intentionally make it unrealistically bad. You approximated pop. @ 600k, let's go higher with the real pop. of 623k.

NYC pop. is exactly 8M more at 8,623,000. As of today, they have 21,393 cases, or 1 in 403 people.

It we extract that 1 in 403 people to Vermont, which is RIDICULOUS because people in VT dont all live on top of one another a few miles apart like in NYC, but whatever, I'm doing this to show the silliness of the math.

You get 623,000 / 403 = 1,553 COVID19+ Vermonters.

They say just slightly less than 5% will need ICU (we'll go with 5%), and that's 5% of 1,553 = 78 ICU patients
 
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icecoast1

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This virus isnt going anywhere until an effective vaccine is developed. Best case scenario for that is the end of this year. We supposed to just hide in our homes until then, or maybe longer?
 

BenedictGomez

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Fully agree with your comments here. Would be nice if the media would stick with reporting simply facts. But I guess that doesn't sell enough ads...

Would be nice if someone in the media has the balls to raise their hand and say, "Governor Cuomo, for a week now you've been saying NYC will very soon need 30,000 ventilators, or thousands of New Yorkers will soon die. What basis or who's model are you using for that math?"

FYI, for 30,000 vents you need 7% of NYC's 8.63M population to have COVID19, which is 600,000, or about 580,000 more NYC residents than have coronavirus today. And technically, you need quite a bit MORE than that figure because not all 30,000 will simultaneously be in use, as once someone comes off vent (or dies) the machine can be reused.
 

deadheadskier

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YES!

Let's do the math, and intentionally make it unrealistically bad. You approximated pop. @ 600k, let's go higher with the real pop. of 623k.

NYC pop. is exactly 8M more at 8,623,000. As of today, they have 21,393 cases, or 1 in 403 people.

It we extract that 1 in 403 people to Vermont, which is RIDICULOUS because people in VT dont all live on top of one another a few miles apart like in NYC, but whatever, I'm doing this to show the silliness of the math.

You get 623,000 / 403 = 1,553 COVID19+ Vermonters.

They say just slightly less than 5% will need ICU (we'll go with 5%), and that's 5% of 1,553 = 78 ICU patients

As of today there are 158 COVID+ Vermonters, so we can assume something like maybe 8 or 10 need ICU rooms.

I'm tired, so if I'm not following your math correctly, apologies. But I said VT has a capacity of about 50 ICU patients. You just said they could reach 78. That's a problem that will result in rationed care, which was the point I was making. The caregivers in VT are concerned with limited capacity.

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deadheadskier

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Also, one thing I want to clarify here BG is I hope you are using the term ICU loosely when calculating a medical facilitily's need for Vents. Vents are used all over a hospital, not just in the ICU.

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VTKilarney

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Vermont’s latest modeling shows just barely enough hospital beds and not quite enough ventilators. (Don’t ask me how I know.)

With a forecasted peak at the end of April, there is time to get the ventilators.

Overall, Vermont is in pretty good shape.
 

BenedictGomez

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I'm tired, so if I'm not following your math correctly, apologies. But I said VT has a capacity of about 50 ICU patients. You just said they could reach 78. That's a problem that will result in rationed care, which was the point I was making. The caregivers in VT are concerned with limited capacity.

No, I used outrageously silly numbers as if all 600k+ Vermonters lived right on top of one another like they're in one big city, and even then I could only get to 78. I guess I should have explained that better.

Point is, a logger in the northeast kingdom or a farmer in Chester does not have the same likelihood of getting COVID19 as the convenience store work next to the Essex train stop from NYC (which should be shut down) or the 13 college kids in a Burlington apartment building sharing the same common entry door handle.

And remember, this is all with the current NYC infection rate of 1:403 (as of today), which VT will never hit.

Even if the math gets way worse (and it may), I cant imagine VT being in bad shape.
 

JimG.

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Fully agree with your comments here. Would be nice if the media would stick with reporting simply facts. But I guess that doesn't sell enough ads...

Heh...the days of Walter Cronkite and Harry Reasoner are long gone.

Journalism today is as yellow as piss.
 

prsboogie

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I know its all doom and gloom out there, been following the stats for the coronavirus(I use to do this storm tracking in the winter). Anyway if you look at china, the outbreak started December 31st. by the middle of February companies we starting to open and most went back to work . That runs about 45 days. And today they just announced that Itlay's new cases have been slowing down for couple days. Again there's ran about 45 days. If you look at the United States the first case in Washington was the sometime around the first week of February. If it runs it course like the other countries, it would reach its peak in around the first week of April. Italy death rate was much higher because 3 generation of families normally live in the same complex. Majority of the deaths in Italy are people over the age of 70. The death rate in the united state currently is running 1.3% of known cases. Doctors have even come out saying they believe the infection rate is 20 to 30 times more than being reported. This thing will never go away. Very similar to malaria. There are always going to be outbreaks of this disease but the cases will be smaller and smaller.
Also I think the media way overhyped this thing. Yes the death rate will be higher than the flu but we haven't built up an emmune system yet. I do think its a bad situation but not as much as the media are over hyping it.
The only thing I will disagree with is the rest of the world knows how to lock down. Had we taken it seriously and sheltered in place for 2-3 weeks like China and Italy (without needing to be arrested) I would say we would have likely been spared the worst of it. Problem is while some took the warnings seriously many did not and still are not. Maybe what was done is enough but I'm not sure. I hope im very wrong, time will tell.

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uphillklimber

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Just to show some of the over hyping, I have found this quote:

Nine days ago, Imperial College London claimed that the US would lose up to 2 million Americans. Their new numbers? Just 84,000, again with two-thirds predicted to die within the next six months without Coronavirus (Ricochet). From White House coronavirus task force member Deborah Birx: “If you remember, that was the report that said there would be 500,000 deaths in the U.K. and 2.2 million deaths in the United States. They’ve adjusted that number in the U.K. to 20,000. So, half a million to 20,000.
 
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