Covid 19 Thread for HCPs (& PH specialists, Epidemiologists, research scientists etc)

[EgonSpengler2020]

I have been following and occasionally commenting on both the AIBU and Prepping Coronavirus threads (under a different user name), but thought I would try to start a thread for HCPs and other professionals who will be on the frontline if this does turn into a Pandemic.

I'd like to keep it as evidence based as possible, so links to peer reviewed studies, or try to make a little note if it looks like the link you are posting has yet to be peer reviewed as things are moving super fast.

I also hope it can be a place for peer to peer support if/when the shit hits the fan.

For non HCPs/health science professionals, your're welcome along, but please try not to derail the thread or turn it into an AMA.

I'm a Paramedic by the way.

A few links to get started
www.worldometers.info/coronavirus/ (up to date data and lots of clicky links to further info)

www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30066-7/fulltext (correspondent article about protecting Healthcare workers)

www.medrxiv.org/content/10.1101/2020.02.05.20020750v2 (Epidemic doubling times - not peer reviewed yet)

www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext (Clinical features of Covid 19)

Thanks for the thread. I'm a nurse in general practice, so not as front line as you are. Hopefully you have a lot more in the way of effective PPE than we do at the moment!

Welcome Gammel

We do have PPE, but I still need to be fit tested for my mask. What worries me is how unfamiliar most staff are with the PPE. We have small SORT teams and HART teams who are well rehearsed in dressing in PPE, working in it and then striping it, but the rest of us will have only dressed up in it once or twice in our career in an office or classroom environment. It's scary that the next time I wear it might be for real.

Link to The Lancet Covid 19 Resource Centre www.thelancet.com/coronavirus?dgcid=kr_pop-up_tlcoronavirus20

A review of 1099 cases. www.medrxiv.org/content/10.1101/2020.02.06.20020974v1

What's has me twitching is:
*Only 43.8% of cases had a temperature at the time of hospital admission.
*93.6% of patients remained in hospital at the conclusion of the study. (The resource implications of that are stark.)
*Even the non-serious cases don't begin to recover until the 3 week point. By 4 weeks, only 25% of non-serious cases have recovered.

I'm a clinician in community healthcare. Being slightly vague as in a niche role and don't want to be outing. Not quite on the frontline, but will be at high risk of exposure should this kick off.

Ohhhh, and I use PPE routinely. We are running into issues with supply of PPE and all decon products. Not to the point of impacting on routine service provision, but I can see that that might come.

I'm the OP of the Preppers thread...I'm not in healthcare so will just be lurking on here out of interest

I'm a clinician in community healthcare. Being slightly vague as in a niche role and don't want to be outing. Not quite on the frontline, but will be at high risk of exposure should this kick off.
This is similar to me too but I'm part of a multi-disciplinary team in a GP surgery. The GPs I work with are fairly evenly split between "Meh it'll be fine" and "this is scary"

I’m not an HCP but work for the police, we seem to get dragged to most things!

We have a Covid-19 page on the work intranet buried amongst the HR pages frontline rarely visits....not even a message from our civil contingencies buddies.

We’re literally pared to the bone resource wise so it wouldn’t take too many of us going sick for a big problem. I don’t think people that are worried are necessarily worrying about how many will die, it’s the knock on effects....especially in a country where all the services that are key in such situations have been decimated in the last decade or so.

@Bunnyfuller - that's my primary concern right now. All our suppliers are out of stock on masks, some lines of gloves are going out of stock. One of my job's for monday is to stocktake and decide at what stock level we stop seeing routine patients in order to conserve supplies for emergency care.

Plus we're short staffed with long waits as is. If we have to start cancelling clinics en masse due to lack of PPE then the knock on effects of that aren't great for anyone.

I work in a hospital setting with severely immunosuppressed patients so watching the thread with interest.

PPE stocks are wiped out across the board, people who genuinely need PPE now struggling because stupid selfish wholesalers allowed panic buyers and price gougers to strip all the stock. P3 masks going for over £15 on ebay labelled up as "coronavirus mask".

Webinar from the Royal College of Physicians with Chief Medical Officer, Public Health England, Virologist, Mathematician etc.

www.kaltura.com/index.php/extwidget/preview/partner_id/2012451/uiconf_id/32750761/entry_id/1_6qg432gr/embed/iframe?

If you don't have two hours to watch it, the CMO is the final speaker (man in suit if scrolling through) and he gives a good short talk about the possible phases of response. Clear that lots is being done behind the scenes, and there is a plan for what happens if it does spread in UK.

Thanks, will have a look at the links shortly. I'm a midwife and pregnant woman are often disproportionately affected by such outbreaks.

Thanks for the link Mrs sneeze will definitely watch that.

Thank you for this. I’m an ITU nurse so very used to flu and using PPE. We are having problems with stock already.

We are so underprepared. We are cut to the bone before this so we will not cope with anything else.

I remember having a suspected Ebola patient in during the epidemic. We had to break into an office to get locked up PPE and we put a chair with a sign on outside the room as that was the best we could do. This is 30 bed Critical Care unit in a large city. We are so under resourced if this does become serious

@VivaLeBeaver
I imagine midwifery is any area that can easily be overlooked in these circumstances. But the virus will still effect heavily pregnant women, and trying to do your job in full PPE must be very challenging, and very distressing for the Mums.

This makes an interesting read about female medical workers:

www.inkstonenews.com/health/coronavirus-womens-advocates-ship-period-products-center-outbreak/article/3050653

I'm a community pharmacist so no doubt will be first port of call for many who are feeling a little rough but don't think about corvid19. It's already a joke that we catch everything from our customers and I doubt that this will be any thing different.

ITU and I honestly am really concerned. we have had a bad winter already, turning patients away who are then shipped out of region into any available bed. On a few occassions there have been no available beds within a 100 miles. There have already been some nasty winter viruses going round this year and despite assurances that the NHS is prepared I honestly dont think they could cope with even a small spike in ICU patients never mind a pandemic.
Where would all the equipment and staff come from for a start. Nursing patients on a ventilator takes extra training on top of regular nurse training and if this virus is causing ARDS then those patients are amongst the sickest and would require an icu nurse with at least level 3 experience which is 1 to 2 years of experience post training.
Services havebeen running at 85% + capacity, there is no room in the system. Also we have had no training in advanced PPE . all we have is masks , gloves and plastic aprons which are thinner than cheap carrier bags. Hospitals have put plannign in place but its a link to their plans and policies on the intranet which requires staff to find it, click through and actually have the time to read through pages of policies. They arent getting breaks as it is. when are they supposed to have time for this.

I work in theatres. Not on frontline (far from it) but will see patients when they potentially need ecmo etc. My dept is fit testing anaesthetics and recovery for ffp3 masks but those away from the head end are not yet. We are by an international airport and so far not even a suspected case. We aren’t far from Brighton though so might make its way up.

Well, I've now been fit tested and issued with my full PPE get up, which must be carried on the ambulance with us at all times.

Not sure how I feel about it. It's good to be prepared, but all seems a lot more real now.

Now need to sit down this week and read through my trusts Covid 19 policy (which gets longer by the day).

www.bmj.com/content/368/bmj.m621

This might be of interest to any ambulance/community/primary care HCPs.

Would it be an idea to get this thread moved to HCP Chat?

Less people will see it who aren't so involved, (yet need to see the chat) , if its moved into there?