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1/ Covid ( @UCSF) Chronicles, Day 29
V stable @ucsfhospitals: 18 cases (down 2), 4 on vents (see last tweet for outcome of one). ZSFG: 25 pts (down 9 from 2d ago), 11 intubated (no change). Drop is a bit misleading since a few pts transfered to other hospitals. No homeless surge
V stable @ucsfhospitals: 18 cases (down 2), 4 on vents (see last tweet for outcome of one). ZSFG: 25 pts (down 9 from 2d ago), 11 intubated (no change). Drop is a bit misleading since a few pts transfered to other hospitals. No homeless surge
2/ SF also remains stable. 1013 total cases; only 26 new cases today. 17 deaths since start, up 2. People have gotten over aversion to saying we& #39;ve flattened curve (for fear of jinxing or changing behavior). Obviously so, thank goodness.
3/ @UCSF rate of positive tests 3.5%. 2nd day in row w/ no pos tests. Now testing all pre-op patients & will start testing all hospitalized pts @ucsfhospitals on Monday. Suspect very few positives but hope it& #39;ll reassure pts & workers that it’s safe to be in hospital: it is.
4/ SF scrambled to create new capacity ( @ucsf, opening Mt Zion; @SaintFrancis_SF opened floor; Cal Pacific opened old hosp). Suspect we won’t need most of it, but won’t be surprised if there is late surge of non-Covid patients who will need care after they feel OK leaving home
5/ Underuse of frantically-built capacity seems universal. Even @ NYC, Javits Ctr & Navy hospital ship mostly empty https://wapo.st/34CYPxk ">https://wapo.st/34CYPxk&q... Why? Combo of “where did all the other pts go?” & hospitals have improvised (2 pts in ICU built for 1; Covid pts in ORs & recovery rooms)...
6/ And, since Covid pts can go sour fast, I’m guessing my colleagues in NY & other hard-hit cities felt like – if somebody’s sick enough to be in hospital, they could crash quickly. To have them in Javits, w/ no real ICU, doesn’t sound great. Ergo, mostly empty. Lesson learned.
7/ Today: some musings & interesting reads. Plenty written re: next phase as we head to May. My fave: “Our Pandemic Summer” @EdYong209 @TheAtlantic https://bit.ly/2VuX01y ">https://bit.ly/2VuX01y&q... Great line @choo_ek: “[Hospitals] don’t expect our disasters to be stuttering.” Other highlights below:
![7/ Today: some musings & interesting reads. Plenty written re: next phase as we head to May. My fave: “Our Pandemic Summer” @EdYong209 @TheAtlantic https://bit.ly/2VuX01y&q... Great line @choo_ek: “[Hospitals] don’t expect our disasters to be stuttering.” Other highlights below:](https://pbs.twimg.com/media/EVsbobfVAAEiyeU.jpg "7/ Today: some musings & interesting reads. Plenty written re: next phase as we head to May. My fave: “Our Pandemic Summer” @EdYong209 @TheAtlantic https://bit.ly/2VuX01y&q... Great line @choo_ek: “[Hospitals] don’t expect our disasters to be stuttering.” Other highlights below:")
![7/ Today: some musings & interesting reads. Plenty written re: next phase as we head to May. My fave: “Our Pandemic Summer” @EdYong209 @TheAtlantic https://bit.ly/2VuX01y&q... Great line @choo_ek: “[Hospitals] don’t expect our disasters to be stuttering.” Other highlights below:](https://pbs.twimg.com/media/EVsbqkWUYAA1KT4.jpg "7/ Today: some musings & interesting reads. Plenty written re: next phase as we head to May. My fave: “Our Pandemic Summer” @EdYong209 @TheAtlantic https://bit.ly/2VuX01y&q... Great line @choo_ek: “[Hospitals] don’t expect our disasters to be stuttering.” Other highlights below:")
8/ Yong’s piece has great riff on antibody testing. He notes accuracy of tests unclear (& new report says many are flunking validation https://cnn.it/34Fd8RZ )">https://cnn.it/34Fd8RZ&q... & there are big ethical/practical issues in granting “immunity passports.” It’ll be fascinating to see how we use tests
9/ Also, a couple of big @nejm studies on covid epi. One finds 13.7% (!) of asymptomatic pregnant women in NYC tested pos https://bit.ly/3cmvpXc ">https://bit.ly/3cmvpXc&q... Impact on maternal outcomes unclear. The # highlights high prevalence of asymptomatic Covid, & the enormous spread of the virus in NYC
10/ Less scary: study from Iceland; tested a big chunk of population. In 13,080 pts w/ no or minimal symptoms, 0.8% were pos https://bit.ly/3baLDSY ">https://bit.ly/3baLDSY&q... Per yest’s herd immunity discussn, in non-hammered regions, this kind of # (<5%) will be what we find when we do widespread testing
11/ Baseball in 2020? Hope so (esp for my son Doug; does Moneyball @braves). In @vanityfair intervu https://bit.ly/2VuZqgE ">https://bit.ly/2VuZqgE&q... Fauci addresses it (& lots else). His verdict: Let’s Play ball! Start July 4, sans fans. Economics might be dicey for @MLB, but would be a huge salve for US
12/ Couldn’t be prouder @ucsf – instinct to help is awesome. On top of 20 of our MDs/RNs now @nyphospital, a few of our palliative care docs doing goals of care discussns via telemed w/ pts/families in ER @ Columbia/NYP https://bit.ly/2RHTXBY ">https://bit.ly/2RHTXBY&q... @stevepantilat @alexsmithMD @ewidera
13/ And several @ucsfmedicine residents & students have built an “iPad Consult Team” @ucsfhospitals & #ZSFG to connect patients w/ their families & friends. You page them and they set it up. They’re putting to great use the 100 iPads donated to us by @ddubinsky & Len Shustek
14/ Finally, here’s Martiano leaving our ICU @ucsfhospitals after a long stay on a ventilator, cheered on by my amazing colleagues. As horrible as this is, it also brings out so much good – it’s worth reminding ourselves of that https://bit.ly/3cltOAF
More">https://bit.ly/3cltOAF&q... tomorrow…
More">https://bit.ly/3cltOAF&q... tomorrow…
