Coronavirus: The Sick Elephant In The Room
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There was a Himalayan yogi that I personally knew who lived a very unique life. Half of his life was spent alone in a cave high in the Himalayan mountains. He threw various wild yams and tubers on the fire and ate fruits and vegetation and drank from pure mountain streams to sustain himself.
He lived and came in contact constantly with the wild life of the mountains, bears, tigers, cobras, crocodiles and never held a weapon and took no modern medicine against the sicknesses of the city folk. He also was tutored in many languages and became an eloquent and intelligent speaker and opened hospitals and institutions for scientific study. When he came to America in the 1970's he walked through ill-advised dangerous neighborhoods at night unprotected with anything but his own consciousness.
I asked once him how it was possible to live such an existence amid so much danger and he told me something very significant that I will never forget, "Fear invites danger."
He lived and came in contact constantly with the wild life of the mountains, bears, tigers, cobras, crocodiles and never held a weapon and took no modern medicine against the sicknesses of the city folk. He also was tutored in many languages and became an eloquent and intelligent speaker and opened hospitals and institutions for scientific study. When he came to America in the 1970's he walked through ill-advised dangerous neighborhoods at night unprotected with anything but his own consciousness.
I asked once him how it was possible to live such an existence amid so much danger and he told me something very significant that I will never forget, "Fear invites danger."
This point is absurd. Influenza has been around for a long time, bu this is something new. Therefore people are going to react to it. It's not fully understood yet, and it spreading very quickly. Do I think people should be panicking and hoarding toilet paper? No. But it is reasonable to react to and fear a new virus that is spreading worldwide quickly.
Came across this on the net. Not to believe everything, but was an insight into the Wuan COVID19 virus in a Health care workers words.
Posted a few minutes ago.
ITALY RIGHT NOW: "THIS IS LIKE WAR SURGERY. YOU ONLY SAVE THOSE WHO HAVE A CHANCE. THIS IS WHAT IS HAPPENING NOW. You don't have the slightest idea what goes on in hospitals and you don't want to know. Stay at home."
An incredible interview with Christian Salaroli, anaesthetist in Bergamo from 'Corriere de la sera' from 9.3.2020:
So you really make a choice?
Of course I do. Only people who have pneumonia with respiratory insufficiency due to COVID19 are included in this unit. The others: go home !
What happens then ?
You will receive non-invasive ventilation. This is the first stage.
What are the next stages?
Early in the morning, the anaesthetist comes with the emergency room nurses. His opinion is crucial.
Why is his decision so important?
In addition to age and general condition, he evaluates the patient's ability to survive an invasive ventilation procedure.
What does this mean exactly?
The infection caused by coronavirus is interstitial pneumonia. A very aggressive form that brutally hinders the supply of oxygen to the blood. The most aggressive patients suffer from a lack of oxygen : they do not have enough oxygen in their bodies.
When is the choice made ?
Immediately after the anaesthetist's visit. We must make this choice. Maximum one or two days after the admission. The non-invasive ventilation is only an intermediate step. Unfortunately there is a mismatch between the hospital resources, the available beds in the intensive care unit and the number of patients in a critical condition. We cannot intubate everyone, [i.e. the breathing tube is connected directly to the trachea after an incision in it, invasive ventilation].
What is happening at this moment?
Those for whom we have decided to continue care will be intubated immediately. We place them on their abdomen to facilitate ventilation of the lower lungs.
Regarding the decision, is there a written rule ?
Currently, contrary to what I read, no. In reality, even if it sounds terrible to say, we very carefully examine the patients who also have serious cardio-respiratory diseases and those with serious coronary problems, because they tolerate very badly an acute lack of oxygen and have little chance of surviving the critical phase.
And then?
If someone is between 80 and 95 years old and has severe breathing problems, we usually do not continue the treatment. The same applies if a person infected with the virus has an insufficiency in three or more vital organs. These people statistically have no chance of surviving the critical stage of infection. These people are already considered dead.
So you send them away?
That too, that is a terrible sentence, but the answer is yes. We don't have the resources to attempt what's commonly called a miracle. That is also the sad reality.
Isn't that usually the case?
No. In normal times, there is also an evaluation to know if a person has a slight chance of survival in an operation. But now we are dealing with a completely different number of cases.
And you, as doctors, do you tolerate this situation well?
Some of us are dying. Especially the youngest, the very young, who have just started their work and suddenly have nothing to decide about the life and death of a person.
And you?
So far I still manage to sleep at night. Because I know that the selection is based on the hypothesis that some cases, almost always the younger ones, have better chances of survival than others. At least that's comforting.
What do you think of the latest decisions the government has made?
A quarantine to confine the virus to certain areas is a good idea. But it's a measure that comes two weeks too late. Anyway, the most important thing is somewhere else.
So?
Stay at home, stay at home, stay at home. I can't repeat it enough. I see too many people walking in the street as if nothing happened.
You don't have the slightest idea what goes on in hospitals and you don't want to know. Stay at home.
Are you short of personnel?
Yes. We work almost 24 hours a day and we are exhausted. Physically but emotionally. I've seen nurses crying, nurses with 30 years' experience, doctors having nervous breakdowns. No one can imagine what is happening in the hospitals right now. That is why I have accepted this interview.
Is there still a right to treatment?
At the moment it is threatened by the fact that you cannot manage an ordinary situation and an exceptional situation at the same time. Standard treatments can be delayed and this can have serious consequences.
Can you give an example ?
Normally a call for a heart attack is handled within minutes. Today you have to wait an hour or more.
Do you have an explanation for all this?
I prefer not to look for it. I tell myself that it is like war surgery. You only save those who have a chance. This is what is happening now.
Posted a few minutes ago.
ITALY RIGHT NOW: "THIS IS LIKE WAR SURGERY. YOU ONLY SAVE THOSE WHO HAVE A CHANCE. THIS IS WHAT IS HAPPENING NOW. You don't have the slightest idea what goes on in hospitals and you don't want to know. Stay at home."
An incredible interview with Christian Salaroli, anaesthetist in Bergamo from 'Corriere de la sera' from 9.3.2020:
So you really make a choice?
Of course I do. Only people who have pneumonia with respiratory insufficiency due to COVID19 are included in this unit. The others: go home !
What happens then ?
You will receive non-invasive ventilation. This is the first stage.
What are the next stages?
Early in the morning, the anaesthetist comes with the emergency room nurses. His opinion is crucial.
Why is his decision so important?
In addition to age and general condition, he evaluates the patient's ability to survive an invasive ventilation procedure.
What does this mean exactly?
The infection caused by coronavirus is interstitial pneumonia. A very aggressive form that brutally hinders the supply of oxygen to the blood. The most aggressive patients suffer from a lack of oxygen : they do not have enough oxygen in their bodies.
When is the choice made ?
Immediately after the anaesthetist's visit. We must make this choice. Maximum one or two days after the admission. The non-invasive ventilation is only an intermediate step. Unfortunately there is a mismatch between the hospital resources, the available beds in the intensive care unit and the number of patients in a critical condition. We cannot intubate everyone, [i.e. the breathing tube is connected directly to the trachea after an incision in it, invasive ventilation].
What is happening at this moment?
Those for whom we have decided to continue care will be intubated immediately. We place them on their abdomen to facilitate ventilation of the lower lungs.
Regarding the decision, is there a written rule ?
Currently, contrary to what I read, no. In reality, even if it sounds terrible to say, we very carefully examine the patients who also have serious cardio-respiratory diseases and those with serious coronary problems, because they tolerate very badly an acute lack of oxygen and have little chance of surviving the critical phase.
And then?
If someone is between 80 and 95 years old and has severe breathing problems, we usually do not continue the treatment. The same applies if a person infected with the virus has an insufficiency in three or more vital organs. These people statistically have no chance of surviving the critical stage of infection. These people are already considered dead.
So you send them away?
That too, that is a terrible sentence, but the answer is yes. We don't have the resources to attempt what's commonly called a miracle. That is also the sad reality.
Isn't that usually the case?
No. In normal times, there is also an evaluation to know if a person has a slight chance of survival in an operation. But now we are dealing with a completely different number of cases.
And you, as doctors, do you tolerate this situation well?
Some of us are dying. Especially the youngest, the very young, who have just started their work and suddenly have nothing to decide about the life and death of a person.
And you?
So far I still manage to sleep at night. Because I know that the selection is based on the hypothesis that some cases, almost always the younger ones, have better chances of survival than others. At least that's comforting.
What do you think of the latest decisions the government has made?
A quarantine to confine the virus to certain areas is a good idea. But it's a measure that comes two weeks too late. Anyway, the most important thing is somewhere else.
So?
Stay at home, stay at home, stay at home. I can't repeat it enough. I see too many people walking in the street as if nothing happened.
You don't have the slightest idea what goes on in hospitals and you don't want to know. Stay at home.
Are you short of personnel?
Yes. We work almost 24 hours a day and we are exhausted. Physically but emotionally. I've seen nurses crying, nurses with 30 years' experience, doctors having nervous breakdowns. No one can imagine what is happening in the hospitals right now. That is why I have accepted this interview.
Is there still a right to treatment?
At the moment it is threatened by the fact that you cannot manage an ordinary situation and an exceptional situation at the same time. Standard treatments can be delayed and this can have serious consequences.
Can you give an example ?
Normally a call for a heart attack is handled within minutes. Today you have to wait an hour or more.
Do you have an explanation for all this?
I prefer not to look for it. I tell myself that it is like war surgery. You only save those who have a chance. This is what is happening now.
I beg to differ. My point is not absurd. Yes, influenza has been around a while and is better understood, but it's killing 9,000 plus people a month. I would say that's a seriously high statistic. Despite this, the public and the media brush it off as a way of life. COVID-19 is a crisis for sure. I'm not downplaying that. Yet, despite the cloud of 46,000 deaths, how many people do you know that have not gotten a flu shot (even if it's not 100% effective) dismiss the issue saying, "Well, I've never gotten the flu. I don't need it." Not smart.
"The 1918 influenza pandemic was the most severe pandemic in recent history. It was caused by an H1N1 virus with genes of avian origin. Although there is not universal consensus regarding where the virus originated, it spread worldwide during 1918-1919. In the United States, it was first identified in military personnel in spring 1918. It is estimated that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States."
I guess my point is this. There is "the flu" which is known and feared to some extent. I didn't used to get flu shots until two years ago when I had the flu so bad I could barely stand up for days. Now I will always get a flu shot. So when something different comes around it could be over hyped to sell clicks and newspapers (and toilet paper,) but it's unknown therefore it makes sense to take a little extra precaution until all the facts are in. When people bring up that "the flu" kills so many people a year I get it, but I will always take extra precaution when a new virus comes around until all the facts are in.
I guess my point is this. There is "the flu" which is known and feared to some extent. I didn't used to get flu shots until two years ago when I had the flu so bad I could barely stand up for days. Now I will always get a flu shot. So when something different comes around it could be over hyped to sell clicks and newspapers (and toilet paper,) but it's unknown therefore it makes sense to take a little extra precaution until all the facts are in. When people bring up that "the flu" kills so many people a year I get it, but I will always take extra precaution when a new virus comes around until all the facts are in.
Life is a very queer (strange) phenomenon. Each individual, although living within the same environment, is subject to their own experience. We can buy into or be influenced by another's experience but in reality we are all islands governed by our own unique energies.
I subscribe to this belief based on observations, stories and legends passed down from time immemorial.
Within the very same locality in every form of chaos and disaster, some survive and some do not. And it is not always based on survival of the fittest.
It is just based on your unique make-up, what you will allow yourself to succumb to and what you utterly deny.
My father was a rugged WW2 Marine. He fought in many battles and was assured when enlisting that his chances of survival were bleak. Every one of his buddies that he enlisted with died in battle. My father was filled with bullet holes, shrapnel, bomb concussions and also subjected to myriad forms of jungle diseases, malaria, jungle rot, loss of most of his body weight, narrow escapes from Japanese capture, complete mental and emotional breakdown, being in the same foxhole and seeing his buddy blown away, while he remained unharmed, propeller bombs landing in his foxhole that were duds and even threats of being murdered by fellow Marines that discriminated his ethnicity. And also a bout with lymph cancer.
He was a troubled man after all of that, fearless and sometimes violent when unduly provoked but he had a side of him that was utterly magic and awe-inspiring when he reminisced countless escapes and with wide eyes he would shake his head and say that there is no way that he should still be here.
We all meet in this mutual theatre of life, yet in reality we are all self-sustaining islands that can either succumb to the chaos all around us or instead take refuge in the safety of our own strengths.
I subscribe to this belief based on observations, stories and legends passed down from time immemorial.
Within the very same locality in every form of chaos and disaster, some survive and some do not. And it is not always based on survival of the fittest.
It is just based on your unique make-up, what you will allow yourself to succumb to and what you utterly deny.
My father was a rugged WW2 Marine. He fought in many battles and was assured when enlisting that his chances of survival were bleak. Every one of his buddies that he enlisted with died in battle. My father was filled with bullet holes, shrapnel, bomb concussions and also subjected to myriad forms of jungle diseases, malaria, jungle rot, loss of most of his body weight, narrow escapes from Japanese capture, complete mental and emotional breakdown, being in the same foxhole and seeing his buddy blown away, while he remained unharmed, propeller bombs landing in his foxhole that were duds and even threats of being murdered by fellow Marines that discriminated his ethnicity. And also a bout with lymph cancer.
He was a troubled man after all of that, fearless and sometimes violent when unduly provoked but he had a side of him that was utterly magic and awe-inspiring when he reminisced countless escapes and with wide eyes he would shake his head and say that there is no way that he should still be here.
We all meet in this mutual theatre of life, yet in reality we are all self-sustaining islands that can either succumb to the chaos all around us or instead take refuge in the safety of our own strengths.