WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

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jserraglio
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WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Post by jserraglio » Thu Mar 26, 2020 3:49 am

Hospitals consider universal do-not-resuscitate orders for coronavirus patients

PLEASE NOTE: The Washington Post is providing this story for free so that all readers have access to this important information about the coronavirus.

https://www.washingtonpost.com/health/2 ... utType=amp

lennygoran
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Re: WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Post by lennygoran » Fri Mar 27, 2020 8:56 am

jserraglio wrote:
Thu Mar 26, 2020 3:49 am
Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Thanks for the link-where's the Defense Production Act when we need it? Regards, Len :(

Barry
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Re: WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Post by Barry » Fri Mar 27, 2020 10:31 am

https://www.realclearpolitics.com/video ... lysis.html

DR. DEBORAH BRIX: I'm sure you have seen the recent report out of the U.K. about them adjusting completely their needs. This is really quite important. If you remember, that was the report that says 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. Half a million to 20,000. We are looking at that in great detail to understand that adjustment.

I'm going to say something that is a little bit complicated but do it in a way we can understand it together. In the model, either you have to have a large group of people who a-asymptomatic, who never presented for any test to have the kind of numbers predicted. To get to 60 million people infected, you have to have a large group of a-symptomatics. We have not seen an attack rate over 1 in 1,000. So either we are measuring the iceberg and underneath it, are a large group of people. So we are working hard to get the antibody test and figure out who these people are and do they exist. Or we have the transmission completely wrong.

So these are the things we are looking at, because the predictions of the model don't match the reality on the ground in China, South Korea or Italy. We are five times the size of Italy. If we were Italy and did all those divisions, Italy should have close to 400,000 deaths. They are not close to achieving that.

Models are models. We are -- there is enough data of the real experience with the coronavirus on the ground to really make these predictions much more sound. So when people start talking about 20% of a population getting infected, it's very scary, but we don't have data that matches that based on our experience.

And the situation about ventilators. We are reassured in meeting with our colleagues in New York that there are still I.C.U. Beds remaining and still significant -- over 1,000 or 2,000 ventilators that have not been utilized.

Please for the reassurance of people around the world, to wake up this morning and look at people talking about creating DNR situations, Do Not Resuscitate situations for patients, there is no situation in the United States right now that warrants that kind of discussion. You can be thinking about it in the hospital. Certainly, hospitals talk about this on a daily basis, but to say that to the American people and make the implication that when they need a hospital bed it's not going to be there or a ventilator, it's not going to be there, we don't have evidence of that.

It's our job collectively to assure the American people, it's our job to make sure that doesn't happen. You can see the cases are concentrated in highly urban areas and there are other parts of the states that have lots of ventilators and other parts of New York state that don't have any infected. We can meet the needs by being responsive.

There is no model right now -- no reality on the ground where we can see that 60% to 70% of Americans are going to get infected in the next eight to 12 weeks. I want to be clear about that. We are adapting to the reality on the ground and looking at the models of how they can inform but learning from South Korea and Italy and from Spain and I know you will look up my numbers.
"If this is coffee, please bring me some tea; but if this is tea, please bring me some coffee." - Abraham Lincoln

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barney
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Re: WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Post by barney » Fri Mar 27, 2020 11:13 am

Thanks for posting that, Barry. It does seem to match the facts better - at least, so far. And Italy has one of the oldest populations in the world, so you'd expect that if anywhere was going to have casualties at that rate it would be Italy.

jserraglio
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Re: WAPO: Hospitals consider universal do-not-resuscitate orders for coronavirus patients

Post by jserraglio » Fri Mar 27, 2020 7:19 pm

Dr. Deborah Birx wrote:You can be thinking about it [DNR] in the hospital. Certainly, hospitals talk about this on a daily basis, but to say that to the American people and make the implication that when they need a hospital bed it's not going to be there or a ventilator, it's not going to be there, we don't have evidence of that
The concern inside hospitals extends not only to the sheer volume of patients who might need resuscitation but to the unacceptable risk doctors and nurses resuscitating a patient will incur if they must do so without adequate protection (masks, gloves, gowns and face shields). The threat to medical personnel administering resuscitation posed by shortages of personal protective equipment (PPE) appears to be driving the internal conversations about DNR the Post reported on, not simply concern about high rates of infection in the general population.

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