Community Chat

[tansy]

Watching the press conference today adds to the uneasiness that many of us are feeling.

[Porcelain]

---

@CrazyDaisy wrote:

---

@Porcelain wrote:

---

@CrazyDaisy wrote:

---

@x Hedge wrote:

---

@Isobel Archer wrote:

@x Hedge  Yes I'm wondering why the homeless community - especially in Washington State hasn't been extremely affected.  They would seem to be at maximum risk.

---

Perhaps they are independent and self sufficient enough to find it much easier to restrict frequency of close contract with other persons.

edit...i don't like that answer. It's too broad. Have to think.

---

I don't know, I work accross the street from a big mens shelter.  There are a hundred or so lined up each night for a meal and bed.  They are in close contact everyday, yet nothing about a big outbreak.

---

Why would you think hospitals would be going out and using up their precious COVID-19 tests on homeless people?

---

I would think that that many people in such close proxomity would have a much better chance of passing the virus to eachother and getting sick.  So you feel that if a homeless person gets sick they do not deserve testing of medical help?

---

Well sure I think they should be treated like anyone else. However there aren't enough tests for anyone right now. So we can't know whether any of us have the virus or not, except under very limited circumstances. So those unfortunate men you watch across the street might have it. Your concern for them is laudable and valid. But you should not assume they have been tested and received negative results. You could keep tabs on them when you have time and note if any of the men you recognize on sight seem particularly sick. That might be helpful. You might be able to lobby for a test for that person. I think it's wonderful that you care.

[CrazyDaisy]

---

@Porcelain wrote:

---

@CrazyDaisy wrote:

---

@Porcelain wrote:

---

@CrazyDaisy wrote:

---

@x Hedge wrote:

---

@Isobel Archer wrote:

@x Hedge  Yes I'm wondering why the homeless community - especially in Washington State hasn't been extremely affected.  They would seem to be at maximum risk.

---

Perhaps they are independent and self sufficient enough to find it much easier to restrict frequency of close contract with other persons.

edit...i don't like that answer. It's too broad. Have to think.

---

I don't know, I work accross the street from a big mens shelter.  There are a hundred or so lined up each night for a meal and bed.  They are in close contact everyday, yet nothing about a big outbreak.

---

Why would you think hospitals would be going out and using up their precious COVID-19 tests on homeless people?

---

I would think that that many people in such close proxomity would have a much better chance of passing the virus to eachother and getting sick.  So you feel that if a homeless person gets sick they do not deserve testing of medical help?

---

Well sure I think they should be treated like anyone else. However there aren't enough tests for anyone right now. So we can't know whether any of us have the virus or not, except under very limited circumstances. So those unfortunate men you watch across the street might have it. Your concern for them is laudable and valid. But you should not assume they have been tested and received negative results. You could keep tabs on them when you have time and note if any of the men you recognize on sight seem particularly sick. That might be helpful. You might be able to lobby for a test for that person. I think it's wonderful that you care.

---

I simply made a statement concerning the close proximity of those who stay at the homeless shelter and the spread of the virus.  That is all.

[x Hedge]

---

@CrazyDaisy wrote:

---

@x Hedge wrote:

---

@Isobel Archer wrote:

@x Hedge  Yes I'm wondering why the homeless community - especially in Washington State hasn't been extremely affected.  They would seem to be at maximum risk.

---

Perhaps they are independent and self sufficient enough to find it much easier to restrict frequency of close contract with other persons.

edit...i don't like that answer. It's too broad. Have to think.

---

I don't know, I work accross the street from a big mens shelter.  There are a hundred or so lined up each night for a meal and bed.  They are in close contact everyday, yet nothing about a big outbreak.

---

I admit I was thinking of some specific homeless people when I wrote that. They avoid the shelters.

Some live in their car. Others stay out of sight in parks, woodlands, big cemeteries. 

I'd say they were seldom within coughing distance from others.

However, our overnight shelters and meal centers all have very good attendance.

 So this remains a puzzlement.

[pitdakota]

---

@goldensrbest wrote:

Wow, here we go again, people keep informed,watch the news, it was on cnn this morning. Federal stock pile ,is not enough, read.

---

__________________________________________________--

This is exactly right @goldensrbest.  There are hospitals really facing shortages and facing some difficult decisions to be made, especially in areas that have seen quite a few numbers of cases.

Most ICU beds at this point in time across the country are already full so any sudden increase in a number of patients needing ICU beds and ventilators is a major source of concern.  Not to mention that we have nurses that don't have PPE (personal protective equipment) that are working in long term care areas, etc. where the risk is quite signficant to those nurses.  

And lots of media attention given to ER physicians in different areas sounding the alarms, op-eds by docs in newspapers, etc.  

[pitdakota]

I meant to also add that critical medications used in critical care areas to support respiration and blood pressure are now in the limited supply category on the FDA lists.  Some of those medications include dopamine, dobutamine, sodium bicarb, and aminophylline.  Any critical care nurse or doc knows those meds well as they are commonly used in critical care.

And in the case of Adult Respiratory Distress Syndrome (ARDS) which is the pulmonary complication of COVID-19 all of those medications would potentially be used on such a patient.

Not to mention the patients already in ICU due to flu, COPD, cardiogenic shock, etc.  

ETA:  Just in case someone would like to verify that information, here is the list:

https://www.accessdata.fda.gov/scripts/drugshortages/default.cfm 

[pitdakota]

---

@Isobel Archer wrote:

We've always been told free speech stops when yelling fire in a crowded theatre.

How is this different?

It would be one thing to report how this lack of equipment/doctors has actually caused death/lack of care, but to create hysteria and panic by telling people - oh oh oh there won't be enough - that is just wrong.

---

_____________________________________________________-

As health care professionals, then it is too late.  We do disaster planning and drills every year to make sure we are as prepared as we can be for the at risk man-made disasters most likely to occur in an area.

We take an oath to do no harm, and when a health care professional sees a possible crisis about to occur in the system, they have to speak out.  They may not be heard, but they have an obligation to try and call attention to the fact that there is a real potential problem looming.

And by using your scenario, we shouldn't worry about people having heart attacks.  Never mind what puts you at risk, we will just go about our business and wait until you present to the emergency room with a heart attack.  No need to call attention to what symptoms to look for, when to have an ECG, just don't worry until you have to go to the ER and then we will see if you live or die from your heart attack.

[lovesrecess]

Why does the media want to make people panic and freak out when there is no need?They seem to be exaggerating the number of deaths and the number of actual infected persons in some areas....shame on them. 

[lovesrecess]

ERs are not overrun. On the contrary, people are avoiding ERs out of fear of contracting the virus. Biggest problem right now is younger people refusing to stay away from public areas in large groups; they are the biggest threat of continued spread of the virus.

[pitdakota]

---

@Isobel Archer wrote:

@x Hedge  Yes I'm wondering why the homeless community - especially in Washington State hasn't been extremely affected.  They would seem to be at maximum risk.

+++++++++++++++++++++++++++++++++++++++++++++++

And how do you know that they are not?  We have a shortage of testing kits, in most areas you must subscribe to a certain list of qualifications to even be tested (have traveled out of the country with an outbreak, have a known exposure to someone diagnosed with COVID-19, etc). Homeless individuals would certainly not meet those specifications. 

Then in some areas health departments with limited numbers of tests also put age restrictions on the tests.  For example, someone in their 20s even with symptoms and high risk such as overseas travel does not qualify to be tested.  Look those cases up.....lots of doctors out there talking about their frustrations of trying to get people tested.

Then to top it off, we are now facing a shortage of reagent used for the tests and a shortage of swabs to even obtain the nasal and throat specimens.  

So there may all kinds of homeless people and all kinds of other people high risk because of crowded condions that don't meet the requirements for testing.

As of yesterday the governor of Conn was calling alarm that he had 200 nurses on furlough because of potential exposure and he couldn't get them tested to see if they could come back to work.

So there may be a number of homeless individuals with the disease and no one knows it.  A further complication is that the homeless usually do not like to see medical care.  Although I don't want to put anyone in a box, it is fairly typical of the homeless to even stay out of shelters if they can, let alone seek medical care.  So who would even know when nameless Joe Blow is found dead under a park bench or interstate overpass.  Happens all the time.  And under most circumstances, the coroner will not request an autopsy so who knows exactly how they died, if they do in fact do die.