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'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'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 wapo.st/34CYPxk 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 bit.ly/2VuX01y 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 cnn.it/34Fd8RZ) & 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 bit.ly/3cmvpXc 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 bit.ly/3baLDSY 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 bit.ly/2VuZqgE 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 bit.ly/2RHTXBY @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 bit.ly/3cltOAF
More tomorrow…
More tomorrow…
