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pbmus
pbmus's Journal
pbmus's Journal
March 15, 2020
Big business and corporations will step up to the plate, NO, the trough, OF COURSE
https://twitter.com/speakerpelosi/status/1238997132620771330
March 12, 2020
I went to the grocery store this afternoon. As I was walking in I heard a woman yell to me from her car. I walked over and found an elderly woman and her husband. She cracked her window open a bit more, and explained to me nearly in tears that they are afraid to go in the store.
Afraid to get sick as they are in their 80’s and hear that the novel coronavirus is affecting older people disproportionately. And that they don’t have family around to help them out. Through the crack in the window she handed me a $100 bill and a grocery list, and asked if I
would be willing to buy her groceries.
I bought the groceries and placed them in her trunk, and gave her back the change. She told me she had been sitting in the car for nearly 45 min before I had arrived, waiting to ask the right person for help.
I know it’s a time of hysteria and nerves, but offer to help anyone you can. Not everyone has people to turn to.
Fear is spreading....
https://threadreaderapp.com/thread/1237891575897718791.htmlI went to the grocery store this afternoon. As I was walking in I heard a woman yell to me from her car. I walked over and found an elderly woman and her husband. She cracked her window open a bit more, and explained to me nearly in tears that they are afraid to go in the store.
Afraid to get sick as they are in their 80’s and hear that the novel coronavirus is affecting older people disproportionately. And that they don’t have family around to help them out. Through the crack in the window she handed me a $100 bill and a grocery list, and asked if I
would be willing to buy her groceries.
I bought the groceries and placed them in her trunk, and gave her back the change. She told me she had been sitting in the car for nearly 45 min before I had arrived, waiting to ask the right person for help.
I know it’s a time of hysteria and nerves, but offer to help anyone you can. Not everyone has people to turn to.
March 11, 2020
America's patient zero did everything right, but still wasn't enough...
https://twitter.com/bw/status/1237834749428871169
March 11, 2020
The Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care just published the most extraordinary medical document I’ve ever seen.
To help people from Germany to America understand what we’re about to face, I am publishing translated extracts here.
[Thread.]
Background:
A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care.
Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage.
Here’s the guidance for that.
"It may be necessary to establish criteria of access to intensive care not just on the basis of clinical appropriateness but inspired by the most consensual criteria regarding distributive justice and the appropriate allocation of limited health resources."
"This scenario is substantially comparable to the field of 'catastrophe medicine,' for which ethical reflection has over time stipulated many concrete guidelines for doctors and nurses facing difficult choices."
"In a context of grave shortage of medical resources, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.
It's a matter of giving priority to 'the highest hope of life and survival.'"
Recommendations:
Recommendations:
1)
The extraordinary criteria of admission and discharge are flexible and can be adapted in accordance with the local availability of resources.
These criteria apply to all patients in intensive care, not just those infected with CoVid-19.
2)
"Allocation is a very complex and delicate choice. […]
The foreseeable increase in mortality for clinical conditions not linked to the current epidemic due to the reduction of chirurgical activity and the scarcity of resources needs to be taken into consideration."
3)
"It may become necessary to establish an age limit for access to intensive care.
This is not a value judgments but a way to provide extremely scarce resources to those who have the highest likelihood of survival and could enjoy the largest number of life-years saved."
"This is informed by the principle of maximizing benefits for the largest number.
In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."
4)
"In addition to age, the presence of comorbidities needs to be carefully evaluated. It is conceivable that what might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."
"For patients for whom access to intensive care is judged inappropriate, the decision to posit a ceiling of care nevertheless needs to be explained, communicated, and documented."
I spent many years sitting in seminar rooms thinking about questions of distributive justice.
Let me be honest: It’s left me not one bit wiser about what to do in these kinds of dramatic circumstances. So I don’t don’t mean to pass judgment on the contents of this document.
BUT here’s the point I do want everyone to take away from this:
Doctors in America will likely be faced with similarly heartbreaking dilemmas very soon.
But we can avoid that if we:.
* Start engaging in extreme forms of social distancing
* Radically expand ICU capacities
The moral choices involved in figuring out who gets care when hospitals do not have the resources to treat all critical patients are heart-breaking.
But the moral choices involved in doing what we can today to avert that situation are straightforward.
Here is the full document.
(Undoubtedly imperfect) translation of it is by me.
[End.]
siaarti.it/SiteAssets/New…
To help the people from Germany to America...
https://threadreaderapp.com/thread/1237731864233807872.htmlThe Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care just published the most extraordinary medical document I’ve ever seen.
To help people from Germany to America understand what we’re about to face, I am publishing translated extracts here.
[Thread.]
Background:
A week ago, Italy had so few cases of corona that it could give each stricken patient high-quality care.
Today, some hospitals are so overwhelmed that they simply cannot treat every patient. They are starting to do wartime triage.
Here’s the guidance for that.
"It may be necessary to establish criteria of access to intensive care not just on the basis of clinical appropriateness but inspired by the most consensual criteria regarding distributive justice and the appropriate allocation of limited health resources."
"This scenario is substantially comparable to the field of 'catastrophe medicine,' for which ethical reflection has over time stipulated many concrete guidelines for doctors and nurses facing difficult choices."
"In a context of grave shortage of medical resources, the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.
It's a matter of giving priority to 'the highest hope of life and survival.'"
Recommendations:
Recommendations:
1)
The extraordinary criteria of admission and discharge are flexible and can be adapted in accordance with the local availability of resources.
These criteria apply to all patients in intensive care, not just those infected with CoVid-19.
2)
"Allocation is a very complex and delicate choice. […]
The foreseeable increase in mortality for clinical conditions not linked to the current epidemic due to the reduction of chirurgical activity and the scarcity of resources needs to be taken into consideration."
3)
"It may become necessary to establish an age limit for access to intensive care.
This is not a value judgments but a way to provide extremely scarce resources to those who have the highest likelihood of survival and could enjoy the largest number of life-years saved."
"This is informed by the principle of maximizing benefits for the largest number.
In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."
4)
"In addition to age, the presence of comorbidities needs to be carefully evaluated. It is conceivable that what might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."
"For patients for whom access to intensive care is judged inappropriate, the decision to posit a ceiling of care nevertheless needs to be explained, communicated, and documented."
I spent many years sitting in seminar rooms thinking about questions of distributive justice.
Let me be honest: It’s left me not one bit wiser about what to do in these kinds of dramatic circumstances. So I don’t don’t mean to pass judgment on the contents of this document.
BUT here’s the point I do want everyone to take away from this:
Doctors in America will likely be faced with similarly heartbreaking dilemmas very soon.
But we can avoid that if we:.
* Start engaging in extreme forms of social distancing
* Radically expand ICU capacities
The moral choices involved in figuring out who gets care when hospitals do not have the resources to treat all critical patients are heart-breaking.
But the moral choices involved in doing what we can today to avert that situation are straightforward.
Here is the full document.
(Undoubtedly imperfect) translation of it is by me.
[End.]
siaarti.it/SiteAssets/New…
March 5, 2020
Trump officials saying a couple of hours to a day...!
https://twitter.com/thisisashima/status/1233289014708523008
March 5, 2020
Coronavirus questions answered...
https://twitter.com/livescience/status/1235188381081948160
March 1, 2020
What is the Dark Triad?
Three core personality trait dimensions that underlie the Dark Triad are:
Psychopathy: The tendency to show little regard for the thoughts, feelings, and outcomes of others.
Narcissism: The tendency for one to show a particularly high focus on oneself.
Machiavellianism: The tendency to manipulate others for one’s own personal gain.
The Big Con is the Dark Triad...
https://twitter.com/watchdogsniffer/status/1234217272396267520What is the Dark Triad?
Three core personality trait dimensions that underlie the Dark Triad are:
Psychopathy: The tendency to show little regard for the thoughts, feelings, and outcomes of others.
Narcissism: The tendency for one to show a particularly high focus on oneself.
Machiavellianism: The tendency to manipulate others for one’s own personal gain.
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