[Health] The Infectious Diseases Thread

[Max Peck]

Ontario Enacts Declaration of Emergency to Protect the Public

As a result of this declaration and its associated orders, the following establishments are legally required to close immediately:

• All facilities providing indoor recreational programs;
• All public libraries;
• All private schools as defined in the Education Act;
• All licensed child care centres;
• All bars and restaurants, except to the extent that such facilities provide takeout food and delivery;
• All theatres including those offering live performances of music, dance, and other art forms, as well as cinemas that show movies; and
• Concert venues.

Further, all organized public events of over fifty people are also prohibited, including parades and events and communal services within places of worship. These orders were approved by the Lieutenant Governor in Council and will remain in place until March 31, 2020, at which point they will be reassessed and considered for extension, unless this order is terminated earlier.

Ontario is also investing up to $304 million to enhance the province's response to COVID-19 by providing the following:

• $100 million for increased capacity in hospitals to assist with the effective treatment of COVID-19 patients both in critical care and medicine beds.
• $50 million for more testing and screening through public health, including additional funding to support extraordinary costs incurred to monitor, detect and contain COVID-19 in the province. This includes contact tracing, increased laboratory testing capacity and home testing.
• $50 million to further protect frontline workers, first responders and patients by increasing the supply of personal protective equipment and other critical supplies and equipment to protect them.
• $25 million to support frontline workers working in COVID-19 assessment centres, including the creation of a new fund to provide respite care, child care services and other supports as they are needed.
• $50 million for long-term care homes to support 24/7 screening, additional staffing to support infection control and additional supplies.
• $20 million for residential facilities in developmental services, gender-based services and protective care for children and youth to support additional staffing, respite for caregivers impacted by school closures, personal protective equipment and supplies and transportation costs to minimize client exposure and to support social distancing, as well as additional cleaning costs.
• $5 million to protect seniors in retirement homes through increased infection control and active screening procedures.
• $4 million for Indigenous communities to support transportation costs for health care professionals and the distribution of critical supplies.

[Punisher]

We got an email from the owners of our clinics (eye care) and they basically said "We're staying open. If you feel unsafe with that, feel free to eat your PTO. If you get sick, stay home and eat your PTO. If you get sick at work and we have to close an office, you're eating your PTO. If the CDC closes us, guess what, eat your PTO."

I'm not sure how they'll tell if someone got sick from one of the clinics or from one of their associates outside the office. Their plan is the very definition of why many Americans are going to continue working anywhere they can during this. Most of the employees are hourly, and most likely have less than 2 weeks of accrued time off. No one can afford to not go to work with no other alternative.

I still think what they're doing is irresponsible since the majority of our patients are 65+

Both physical therapy clinics I've been to in the past couple of years have sent me emails saying they're staying open.

My 76 year old mother is going to a hand doctor appointment today.

Health care isn't closing down anywhere.

Totally location dependent. My Dentist just cancelled my appt to fix an old filling for tomorrow. My MRI on my knee was also cancelled for next week.

In Bergen County NJ, all dentists were one of the places ordered closed except for emergencies.

[gameoverman]

Thoughts on ordering contactless delivery for meals? We've been eating in 100% of the time, and plan to keep it up. But I received a plea from a local restaurant essentially saying if everyone does that, the entire local industry will be toast by the time this blows over, and that they as a restaurant deal with cross-contamination daily, etc.

I'm pretty sure the safe answer is don't do it, but this seems like a humanitarian/societal question, as well. Is there a 'safe enough' way to do this?

I plan to do it, as long as someone is willing to deliver. I'll tip a lot more than usual too, I consider it hazard pay. I have a small nightstand kind of table on the front porch. It'll be like in an rpg, I'll put payment on the table, then they collect payment/tip and leave what I bought on the table. Keep in mind I'm not concerned with getting infected, I'm trying to not spread it. I assume I have already been exposed to the virus. If I was concerned with getting infected then I'd probably avoid touching objects, like whatever the food is packaged in, that have been recently touched by people outside the home.

[Punisher]

Bay Area orders ‘shelter in place,’ only essential businesses open in 6 counties

Six Bay Area counties announced “shelter in place” orders for all residents on Monday — the strictest measure of its kind yet in the continental United States — directing everyone to stay inside their homes and away from others as much as possible for the next three weeks in a desperate move to curb the rapid spread of coronavirus across the region.

The directive was set to begin at 12:01 a.m. Tuesday and involves San Francisco, Santa Clara, San Mateo, Marin, Contra Costa and Alameda counties — a combined population of more than 6.7 million. It is to stay in place until at least April 7. The three other Bay Area counties — Sonoma, Solano and Napa — did not issue similar mandates.

Just outside the Bay Area, Santa Cruz County late Monday also announced a “shelter in place” order for its 275,000 residents.



The orders — which are all similarly worded — fall just short of a full lockdown, which would forbid people from leaving their homes without explicit permission. The orders (read San Francisco’s here in its entirety at tinyurl.com/waddyqv) call for county and city sheriffs and police chiefs to “ensure compliance,” and local authorities said they would not “rush to enforce” the directives as residents adjusted to understand what activities are no longer allowed. Violation of the orders is considered a misdemeanor punishable by a fine or jail time.

BTW, I suspect similar "shelter in place" orders are likely coming to NYC and other major cities. It's somewhat surprising that such an order for the better part of 7 million hasn't received more coverage. But most media companies tend to be more focused upon the East coast, so there will likely be plenty of coverage if and when orders go into effect there.

Hoboken, NJ has now ordered self-isolation for all residents, sick or otherwise. Current plans are low key enforcement such as just asking people to go home or disperse.

[Punisher]

We got an email from the owners of our clinics (eye care) and they basically said "We're staying open. If you feel unsafe with that, feel free to eat your PTO. If you get sick, stay home and eat your PTO. If you get sick at work and we have to close an office, you're eating your PTO. If the CDC closes us, guess what, eat your PTO."

I'm not sure how they'll tell if someone got sick from one of the clinics or from one of their associates outside the office. Their plan is the very definition of why many Americans are going to continue working anywhere they can during this. Most of the employees are hourly, and most likely have less than 2 weeks of accrued time off. No one can afford to not go to work with no other alternative.

I still think what they're doing is irresponsible since the majority of our patients are 65+

So if you catch the virus because you were at work, would that be covered under workers comp?
Plus since it is possible that you HAVE Covid-19 and do not show any symptoms, you could still be a carrier for a while without knowing.

[Kurth]

Oregon just extended school closures to 4/28.

Knew this was coming, and, frankly, don’t really expect they’re going back this school year. But still. Kind of sucks to actually see it.

[Punisher]

Drove past a nursing home across from my office on my way back from lunch today and saw a bunch of news crews out front....and

Two dead from coronavirus at Fort Lauderdale assisted living facility, mayor says

Not great. Don't think I'll be eating local again.

Just how often were you eating at the assisted living facility anyway?

[wonderpug]

Oregon just extended school closures to 4/28.

Knew this was coming, and, frankly, don’t really expect they’re going back this school year. But still. Kind of sucks to actually see it.

Yeah, I think that’s where I’m at. Not surprised by news reports, just depressed seeing it actually play out.

[LawBeefaroni]

We received word from the large, multiple-hospital healthcare system for which I work in CT that they will be postponing all elective surgical procedures effective this Thursday and lasting until 4/15. They published very specific criteria for defining procedures as either 'emergent,' 'urgent,' or 'elective,' and included a pretty comprehensive list delineating what will currently be allowed by surgical speciality. It's a pretty impressive document that shows someone has put in a great deal of effort over the last few days, and starts with a few guiding principles for what will be allowed; anything else is being rescheduled...

1. Cancer surgery – both diagnostic and therapeutic
2. Cases where delay can result in acute loss of function - examples include spinal surgery to alleviate cord compression
3. Acute life or limb threatening condition (i.e. unstable angina, peripheral arterial disease with tissue loss)

I've been saying we needed this days ago, but while a big part of me applauds the decision and knows how important this is at this time, it now puts me (an anesthesiologist) in an interesting position. If surgery isn't happening, my group doesn't generate revenue, and we can't be paid normally...but when I do go to work, I'm at high risk for exposure. With dramatically less work to do, we'll probably be having a few stressful days working, mixed with a few days off every week. The one comfort through it all is knowing that I do have a fair bit of money tucked away to fall back on... can't imagine what it's like, and have a huge amount of sympathy, for those who aren't so lucky.

Life is getting very interesting...

I mentioned it in the other thread but we've been on this path since Monday. All elective surgery cancelled, wellness visits, AHAs, etc. Revenue is down up to 50% in some service lines. This is come to Jesus type shit for hospital finance teams.

[hepcat]

I think today I finally realized the gravity of the situation. My 401k was doing so well at the start of the year, I was contemplating an earlier than originally planned retirement. But now I’ll be lucky if it doesn’t get wiped out within the next year at this rate.

As for the actual state of things, I have actually started wondering if we’ll recover within my lifetime from this. This is honestly unlike anything I ever imagined. Never in a million years would I have guessed we’d be discussing multiple bankrupt airlines, the death of a large number of small businesses, hundreds of thousands (if not more) in danger of losing everything, and entire states shuttering their doors and asking people to stay inside.

Someone help me find a ray of hope in all this. I just need a dandelion break.

[Daehawk]

Mashed potatoes, peas, pudding, and prune juice is tasty.

[Punisher]

So, here's a question (if there is even a definitive answer yet): We have an elderly 'high risk' relative we semi-care for. She lives elsewhere, but we run most of her errands and such. If we were to get sick, one or all of us, how long from the first cough would it take before we would be able to help her out again? I need to get plans in place in case we get sick, and I'm trying to figure out how long to plan for.

Keep in mind that you can have the virus and still not show any symptoms.

On a side note, in the people are assholes category, my son is an EMT. He had a diabetic patient today who said he wasn't feeling well due to his blood sugar. They asked the guy 4 separate times the normal Covid question (did you leave the country, have any symptoms, been in contact with someone who has, etc) and the guy kept saying no.
Their current protocol is that if the patient says no and aren't exhibiting any other symptoms they use normal PPE precautions which generally means gloves. If it's yes to either of those, they go full PPE with custom-fitted masks, face shields, gowns, booties, etc..
When they are almost at the hospital, the guy suddenly recants his story. He was just released from the Hosptial for a respiratory issue, cough, and fever (apparently the hospitals are NOT testing anyone unless they have a strict series of symptoms. My son isn't sure what the actual list is or why this guy wasn't tested (unless he was tested and released to home quarantine until the results come back and he's lying about that too)
So now, he (and the rest of his crew) need to be extra careful and watchful of themselves. Their hospital is not advising them to self-quarantine yet though.
If the guy had just been truthful from the start, they would have gone full PPE and been much less at risk.
I did ask him if they punched the guy dead in the face and asked him why he lied, but apparently, they have cameras in parts of the ambulances now. I personally think he could have properly articulated the justifiableness of it in court.

[Daehawk]

Really tired of getting all these emails from companies telling me how clean they are. I think ill write a letter and copy paste it to them all saying how Im licking everything in my house, not bathing, and eating out of my dog's bowl at the local park but I might swing by with my friends

Awww frak! I just now noticed I forgot to get milk while Iwas out. Oh well. It will have to wait until next month. Stupid brain.

[LawBeefaroni]

[He was just released from the Hosptial for a respiratory issue, cough, and fever (apparently the hospitals are NOT testing anyone unless they have a strict series of symptoms. My son isn't sure what the actual list is or why this guy wasn't tested (unless he was tested and released to home quarantine until the results come back and he's lying about that too)

Hospitals are sending confirmed cases home for self-quarentine if they aren't deemed life threatening anyway. So if someone is suspected but not a mortality risk, and test kits are scarce, they'll just send home with self quarantine orders without the test. Same as if they test positive.

[Kraken]

Wife's employer said in the best-case scenario, 20% of staff will be allowed back on-site in April. Worst case, nobody's going back and the whole university will shutter indefinitely.

I'm going to start tracking severity with the Kraken Pants Index. It is currently 0 days since I stopped wearing pants, so severity is low. A KPI of 1-3 is still in the normal range. If the KPI gets over 3, it's time to be concerned.

[Kasey Chang]

FWIW, one of the "Indian Casinos" about 2 hours from San Francisco, is announcing that it's cutting back operating hours and limiting "bus programs" that carries passengers from San Francisco. It's expected all the other ones will do so or probably have done so. As technically sovereign nations within the state, they can choose to ignore the governor's orders, but they probably won't.

[Ralph-Wiggum]

I was told by my supervisor today (via email) that I should work from home as much as possible. That would be fine, but today was my first day at a new job so I really have no idea what I should be working on. I downloaded a few things to read over and give feedback on, but really I imagine most of my time will be spent working on projects from my last post-doc.

Also, that same supervisor has been really sick the last few days with a respiratory illness. He said he started feeling bad on Sunday night. I had gone out to lunch with him on Thursday.

[Daehawk]

Got a couple emails. All Express and Belk stores are closing.

[mori]

FWIW, one of the "Indian Casinos" about 2 hours from San Francisco, is announcing that it's cutting back operating hours and limiting "bus programs" that carries passengers from San Francisco. It's expected all the other ones will do so or probably have done so. As technically sovereign nations within the state, they can choose to ignore the governor's orders, but they probably won't.

I would think they would since their communities were hit especially hard a century ago. But $$$.

[Skinypupy]

Just talked to a buddy who manages a sushi place that has 4 local locations. They laid off 380 people yesterday, kept 23 on staff to handle to-go orders.

[Archinerd]

Someone help me find a ray of hope in all this. I just need a dandelion break.

Today I started working at a new office.

The good news is, I'll be doing all the exact same things I did at my previous job and don't need any training and my benefits kick in immediately.
But my new boss seems very immature, and she's constantly doing crazy shit. She's very demanding and insists I drop whatever I'm doing to work on her projects, and the tasks she assigns me range from pointless (filling easter eggs with green monopoly houses?(wtf?)) to down right inappropriate (literally wiping her ass). At one point she screamed at me for 20 minutes because I told she looked tired.

I've already put in my 2 weeks notice and I just started.

[Anonymous Bosch]

Today I started working at a new office.

The good news is, I'll be doing all the exact same things I did at my previous job and don't need any training and my benefits kick in immediately.
But my new boss seems very immature, and she's constantly doing crazy shit. She's very demanding and insists I drop whatever I'm doing to work on her projects, and the tasks she assigns me range from pointless (filling easter eggs with green monopoly houses?(wtf?)) to down right inappropriate (literally wiping her ass).

Yeesh. I certainly hope you're using that term incorrectly and instead meant "figuratively".

[Archinerd]

Nope.

[hitbyambulance]

Nope.

OK, this sounds entirely made up. storytime is requested.

[Isgrimnur]

He’s at home with his kid.

[Zaxxon]

Yeah, working with the kiddos at home is... well, imagine Jonathan Frakes constantly querying...

[Anonymous Bosch]

He’s at home with his kid.

D'oh!

[Archinerd]

He’s at home with his kid.

D'oh!

[Kurth]

McMennamins is a local OR chain of breweries/hotels/restaurants in mostly odd locations (old schools, prisons, theaters, etc). Very Portland. But they’re everywhere. And today they announced they are laying off nearly everyone - 3,000 employees. This thing just sucks.

[Paingod]

FWIW, one of the "Indian Casinos" about 2 hours from San Francisco, is announcing that it's cutting back operating hours and limiting "bus programs" that carries passengers from San Francisco. It's expected all the other ones will do so or probably have done so. As technically sovereign nations within the state, they can choose to ignore the governor's orders, but they probably won't.

I would think they would since their communities were hit especially hard a century ago. But $$$.

Dark humor: This is payback for the blankets.

[Max Peck]

Someone help me find a ray of hope in all this. I just need a dandelion break.

Today I started working at a new office.

The good news is, I'll be doing all the exact same things I did at my previous job and don't need any training and my benefits kick in immediately.
But my new boss seems very immature, and she's constantly doing crazy shit. She's very demanding and insists I drop whatever I'm doing to work on her projects, and the tasks she assigns me range from pointless (filling easter eggs with green monopoly houses?(wtf?)) to down right inappropriate (literally wiping her ass). At one point she screamed at me for 20 minutes because I told she looked tired.

I've already put in my 2 weeks notice and I just started.

[hepcat]

Someone help me find a ray of hope in all this. I just need a dandelion break.

Today I started working at a new office.

The good news is, I'll be doing all the exact same things I did at my previous job and don't need any training and my benefits kick in immediately.
But my new boss seems very immature, and she's constantly doing crazy shit. She's very demanding and insists I drop whatever I'm doing to work on her projects, and the tasks she assigns me range from pointless (filling easter eggs with green monopoly houses?(wtf?)) to down right inappropriate (literally wiping her ass). At one point she screamed at me for 20 minutes because I told she looked tired.

I've already put in my 2 weeks notice and I just started.

[stessier]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

Not sure I get your post. Mine was about how crappy they take care of their customers and just how nasty their nursing homes are as a company.

Your take is based on the fact that people got sick in Washington. I believe they had a visitor from Wuhan or some close connection to that. They weren't stopping that infection short of barring visitors - which no one was doing on Feb 29th. So your post sounds like the virus is searching out their facilities which is looney at best.

[Sudy]

Co-worker's mother (shared residence) has been confirmed to have it. Co-worker isn't symptomatic and hasn't been tested yet. We've obviously told her to stay home and seek medical advice. Apparently and understandably, the public health hotlines are jammed. In fact, it's causing timeouts on calls to other toll free numbers.

Things are about to get very bad. Work from home has not yet been broadly implemented. (We're about alarm monitoring call center.) I will be working 60+ hours this week minimum, and even though I'm one of the few who's already set up to WFH, I can't since it will exacerbate panic and morale issues.

My wife's had some kind of chronic respiratory issue for the past six months, and I'm terrified if I infect her it could kill her. Our apartment's too small for me to isolate from her.

But those are just my concerns as a moderately healthy non-senior who's extremely unlikely to be laid off... many have it fat worse, and this is just the beginning. *hobbyhorse*

[morlac]

Today we have lay off 10 people. 90% of the rest are being moved from Salary to hourly with a max hours of 32 a week but could be lower based on how much of our work continues to get cancelled. This way we can keep as many people as possible for as long as possible with some sort of income and FULL benefits intact. No lapse in insurance or anything. Employees are free to use their accrued PTO to fill in the gaps until it runs out if they like. Things could change in a hour lately so I fully expect more full layoffs to happen at some point.

[Zenn7]

My work place has changed from "Work from home if you can" to "WFH is mandatory - have to get approval of some super high up person if you need to go into the office".

I was planning on my wife going out of town and taking 3 days off (Tu-Th). Then the virus came and she thought casino=bad idea (especially since she's asthmatic, diabetic and high blood pressure (amongst other things) - but these 3 seem to be high risk for this new virus.

We were also going to get some remodeling done during this time (just came up early last week). Got new doors Friday, have to postpone new flooring throughout living room/kitchen, painting and some other stuff until this blows over.

But hey, I decided to take the 3 days off anyhow, already scheduled and I have taken very few days off in the last few years that weren't related to dealing with some personal (family/extended family) issues - or failed vacations (having one's vehicle break down 4 hours away from home, at midnight, in a town that is having their biggest event of the year so no motels for miles around = failed trip to visit the in-laws). And knock on wood, I am highly unlikely to be let go from my job.

[LordMortis]

My work place has changed from "Work from home if you can" to "WFH is mandatory - have to get approval of some super high up person if you need to go into the office".

That was us effective Monday. I am the command center so I get to work at work. I'm glad for this. WFH is exceptionally inconvenient for me, especially as I facilitate communication with EVERYONE else.

[Kasey Chang]

You know how bad the myths are around COVID-19 when WHO had to make up graphics and slides to dispel rumors and myths and urge them to be shared on social media

[Kraken]

McMennamins is a local OR chain of breweries/hotels/restaurants in mostly odd locations (old schools, prisons, theaters, etc). Very Portland. But they’re everywhere. And today they announced they are laying off nearly everyone - 3,000 employees. This thing just sucks.

I read that there are 300,000 restaurant workers in MA, and probably 80% of them are jobless now. One chain alone, the 110 Grill, laid off 1,000 workers on Monday. Most of them, of course, don't have savings or qualify for benefits under ordinary guidelines (which are being loosened), even if they could get through to claim them.

[raydude]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

Not sure I get your post. Mine was about how crappy they take care of their customers and just how nasty their nursing homes are as a company.

Your take is based on the fact that people got sick in Washington. I believe they had a visitor from Wuhan or some close connection to that. They weren't stopping that infection short of barring visitors - which no one was doing on Feb 29th. So your post sounds like the virus is searching out their facilities which is looney at best.

Yeah, I wasn't getting that vibe. My take was more like:

Huh, Life Care Center operates that nursing home in Washington where all those people died.
I know Life Care Center. They built big nursing homes in my town. I knew some people who lived there.
They turned the old dead mall into their offices.
Given what I know about them, I wonder how conditions are in their nursing homes?

Granted - he skipped a few sentences in the initial post, like how he has first or second-hand knowledge of their crappy customer service and poor conditions of their homes but it still seems reasonable to post "Huh, people died in place A. I know the folks who run place A. They are crappy folks. They run place B in my town. I wonder if it is equally as crappy and potentially a death trap?"