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[Frumple]

Has anyone other than the US actually done that yet? Only news I've seen on that was the states doing it, so far.

[wierd]

A thought keeps coming back to me that I can't shake.

In the 40s and 50s, during the polio epidemic, many iron lung style vents were manufactured, and because of how big and scary they were, they became museum pieces.

I wonder if they could be grabbed from said museums and put into service. That 40s tech was some mil-spec shit.


@frumple

The conversion of BVMs into emergency vents thing-- or the stealing of orders thing?

[ChairmanPoo]

Has anyone other than the US actually done that yet? Only news I've seen on that was the states doing it, so far.

Turkey seized 150 Spanish ventilators which were enroute from China

A thought keeps coming back to me that I can't shake.

In the 40s and 50s, during the polio epidemic, many iron lung style vents were manufactured, and because of how big and scary they were, they became museum pieces.

I wonder if they could be grabbed from said museums and put into service. That 40s tech was some mil-spec shit.


@frumple

The conversion of BVMs into emergency vents thing-- or the stealing of orders thing?

We'd need an ICU guy to give you the details but I think iron lungs wouldn't cut it... polio caused paralysis, not really lung disease. I'm not sure just making chests inhale would be any good with SARS, given that the underlying condition is a primary lung disorder

[wierd]

It combined with something like a cpap or bipap and an O2 feed, it might work.  The air being pulled in would be enriched, and not just room air.

[MetalSlimeHunt]

A quick read suggests that iron lungs do force a more natural breathing pattern than positive pressure ventilators, and that they're useful for people who have lost their autonomic breathing response. Probably not worth the trouble of finding space for them or training people to use them, assuming they're actually effective against this to begin with. I don't have a specific reason to believe otherwise, but I'm also no doctor.

[wierd]

MSH:

the issue is that the inflammatory response in the lung tissue from the infection actively retards the efficacy of the alveolar tissue in the lungs from performing efficient gas exchange.   Iron lung was designed to work with paralyzed diaphram, not deal with reduced lung function.

However, combining with a bipap and a good oxygen feed (which the bipap is designed to accept), could be useful. 

[ChairmanPoo]

It combined with something like a cpap or bipap and an O2 feed, it might work.  The air being pulled in would be enriched, and not just room air.

maybe... TBH so many things are worth a try in these situations....

We'll see how the SEAT ventilator turns out. TBH if it gives people a fighting chance, even if slim....


Oh and I learned something new today.

Apparently private hospitals in Spain have a grand total of 2000 free ICU beds. With ventilators.

In all honesty, all this drama about Turkey is SMALL POTATOES if you have that strategic resource just there and you're not using it.

I think our goverment is trying to make the crisis budget as low as they can (eg: this, their constription of last year medical residents, their constription of last year medical students...). I'm not impressed.

[Frumple]

The conversion of BVMs into emergency vents thing-- or the stealing of orders thing?

The stealing orders thing. The U.S. one was the only one I'd seen mention of so far. Turkey would make two.

And yeah, re: private stuff, I'm very much at the point for that front where you're either a part of the solution or a problem to be dealt with. Fuckers can go back to ripping people off and hoarding shit when we don't have the crow plague looking to replicate a world war death count. Either shape up and help out or get you shit seized and your owners jailed, or somethin' along those lines.

[ChairmanPoo]

But they OFFERED THEM. Goverment ignored them. Allegedly.
Of course we'd have to know the details. But the way the goverment in Spain has been trying to run this... has been low budget. The pattern holds: they constripted last year med students cause they are free. They forced residents who were finishing in May to stay as residents longer to avoid paying them as consultants.

I can see them refusing the offer of 2000 ICU beds because when the crisis passes they'd get a bill (ICU beds dont run themselves). So they are trying to cut as many corners as they can.

Mind you.  I'm not a defender of private heslthcare. But bemoaning lossing 150 respirators to the turks while leaving 2000 private ones unused... I dont get it.
I'd understand it better if they tried  to seize them without paying and deal with the dallout later
(Of course the reason they dont do that is because of the elephant in the room in this international respirator crisis... THERE ARE NOT THAT MANY ICU SPECIALISTS EITHER - and they'd need to hire the private ones. Thats why Dyson and Tesla are making BiPAPs. Gicing a quick NIMV course to other specialities is probably viable. Getting other specialities to manage regular ventilators, not so much)

[MetalSlimeHunt]

So late is the stage of our late stage capitalism, that the liberal governments won't even take private property when some capitalists are offering it.

[Starver]

Last I heard about it (a news item, not a more precise announcement of detail), there'd been a deal done with UK private health providers to add their capacities to the NHS 'at cost'/for no profit.

(I'm sure drilling into this could expose typical PPP behaviour of short-term savings for the public purse get offset by being tied into longer term corporate profiteering, or it could just be "nobody wants our elective procedures at the moment, let's offset null income with some income that has some subtle PR on top". Depends on cynicism levels.  It was just a brief sentence, though, so I may have the wrong end of the wrong stick. Still, relevent to favourably compare to the alleged Spanish situation - whether it was an offer made at too high a cost tied to it or there were more unreasonable failings in the governnental declining to take it up. Even with the caveats I'm suggesting.)

[ChairmanPoo]

The Spanish goverment is dropping the ball bad. These people are clearly way out of their depth. Since most healthcare competences are devolved to the regional goverments the ministry of health was largely regarded as a white elephant post rather than a real ministry. That's why over the last twenty years less than a handful of health ministers have been medical professionals. The current one is a philosopher. He didn't know what hydroxychloroquine was when he was asked by the press recently. He goes on TV and looks like a deer-about-to-become-roadkill. He's waaaay out of his depth


There are more benign explanations though. Those 2000 ventilators... it's all over the country. And the only areas threatening an ICU collapse are Madrid and Barcelona. In the rest of the country the pressure is easing up slowly. They might intend to use other region's ICU capacity rather than the private sector's.
This is not really off-mark. Despite successive funding cuts the Spanish healthcare system is fairly well equipped, and ICU wise I think it was the third or fourth with the highest ration per capita. It could be that by shuffling people around (which they might have to do anyway if they took the private sector's offer) they can rely purely on public resources.

[Jimmy]

Our Australian government is going 50% with the private hospitals on costs for ICU.

So far, we've got 28 dead from COVID-19. That's about the average number of people who die each year from kangaroos, crocodiles and other assorted Australian wildlife. We haven't seen the end of this though, not by a long shot.

Our town's still going well. Haven't had a day off work for the last week, and looking like it'll stay that way for as long as we can still keep getting stock into our pharmacy. We're getting into the swing of things, and looking at putting on a few more staff to cover the busiest times, which is great since we're facing a streak of unemployment nationally.

[ChairmanPoo]

So far, we've got 28 dead from COVID-19. That's about the average number of people who die each year from kangaroos, crocodiles and other assorted Australian wildlife. We haven't seen the end of this though, not by a long shot.

That you know of. As it has been stated elsewhere: everyone is counting the dead in a different way, and noone is doing it particularily well.

On the plus side in theory humidity and heat help push the virus back. And I assume Australian coastal cities are plentiful on both of those?
I know that the Canary Islands outbreaks were surprisingly self-limited, despite the disease getting there first. Tenerife is the only island with a significant number (and Tenerife has the particularity that some of the cities up in the mountain are surprisingly cold for an otherwise subtropical island... and indeed those are the worst hit places.)

[Starver]

That's why over the last twenty years less than a handful of health ministers have been medical professionals. The current one is a philosopher.

UK's Sec of State for Health, Matt Hancock[1] isn't particularly medical. Straight from the currently fashionable PPE road towards politics, seemingly with the emphasis (and most recent advisor experience) on the Economics element. Opinion varies whether that's more or less practical in this (or any other) cass than the Philisophy section - no comment at all will be made on the Politics one! (His predecessor, Jeremy Hunt, was/is an acknowledged car-crash across the board and in other departments too, with similar PPE origins. Prior to hm, Andrew Lansley had Shadowed in Health before, at least, and had a pathologist father.)

He's funny, though. Unintentionally. Most recent Coronavirus Briefing, I think, you could tell the scripted notes from the ad-libs. Strange breaks in flow like "There are two main points: One, <main point one>, and <long aside>, and <long aside>, and <long aside>...*breath*... And Two, <main point two>...” And another disconnection like "For the scientific information, we have expert <named>, here. He is a top doctor, immunologist, epidemiologist and virologist who has made many publications and will be telling you all about that at length."


Something was (unintentionally) said by someone the other day that I almost put in the Bad Jokes thread. I'm afraid that in the "Comedy equals Tragedy plus Time" equation it's severely lacking in Time, but...
Of one of the nurses who lost her life the other day, from COVID, there was a glowing memorialising from a colleague who knew her: When the situation was tough in the department, she'd always be there, and was always happy to help out preparing food in busy times and giving loads of hugs to people who felt bad.




[1] Keep wanting to call him Nick Hancock (comedian) though so far I've not confused him with Tony Hancock (comedy performer).