Update no.1026

 Update from the Sunland

No.1026

6.9.21 – 12.9.21

Blog version:  http://heartlandupdate.blogspot.com/

 

            To all,

 

OK! For all of you anti-vaxxers, political resisters, freedom-over-survival advocates out there, let’s put a bright face on this pig. A respiratory therapist at Community Memorial Hospital in Ventura, California, wrote an explicit op-ed column to articulate plainly and directly what she has been dealing with for the last 17 months of the pandemic. She presents the seven (7) stages of COVID-19 hospitalization.

“Op-Ed: On the front lines, here’s what the seven stages of severe COVID-19 look like”

by Karen Gallardo

Los Angeles Times

Published: AUG. 26, 2021; 3:01 AM PT

https://www.latimes.com/opinion/story/2021-08-26/pandemic-covid-19-stages-vaccination-intensive-care-respiratory-therapist

The following words are Ms. Gallardo’s verbatim:

Stage 1. You’ve had debilitating symptoms for a few days, but now it is so hard to breathe that you come to the emergency room. Your oxygen saturation level tells us you need help, a supplemental flow of 1 to 4 liters of oxygen per minute. We admit you and start you on antivirals, steroids, anticoagulants or monoclonal antibodies. You’ll spend several days in the hospital feeling run-down, but if we can wean you off the oxygen, you’ll get discharged. You survive.

Stage 2. It becomes harder and harder for you to breathe. “Like drowning,” many patients describe the feeling. The bronchodilator treatments we give you provide little relief. Your oxygen requirements increase significantly, from 4 liters to 15 liters to 40 liters per minute. Little things, like relieving yourself or sitting up in bed, become too difficult for you to do on your own. Your oxygen saturation rapidly declines when you move about. We transfer you to the intensive care unit.

Stage 3. You’re exhausted from hyperventilating to satisfy your body’s demand for air. We put you on noninvasive, “positive pressure” ventilation — a big, bulky face mask that must be Velcro’d tightly around your face so the machine can efficiently push pressure into your lungs to pop them open so you get enough of the oxygen it delivers.

Stage 4. Your breathing becomes even more labored. We can tell you’re severely fatigued. An arterial blood draw confirms that the oxygen content in your blood is critically low. We prepare to intubate you. If you’re able to and if there’s time, we will suggest that you call your loved ones. This might be the last time they’ll hear your voice.
We connect you to a ventilator. You are sedated and paralyzed, fed through a feeding tube, hooked to a Foley catheter and a rectal tube. We turn your limp body regularly, so you don’t develop pressure ulcers — bed sores. We bathe you and keep you clean. We flip you onto your stomach to allow for better oxygenation. We will try experimental therapeutics.

Stage 5. Some patients survive Stage 4. Unfortunately, your oxygen levels and overall condition have not improved after several days on the ventilator. Your COVID-infested lungs need assistance and time to heal, something that an ECMO machine, which bypasses your lungs and oxygenates your blood, can provide. But alas, our community hospital doesn’t have that capability.
If you’re stable enough, you will get transferred to another hospital for that therapy. Otherwise, we’ll continue treating you as best we can. We’re understaffed and overwhelmed, but we’ll always give you the best care we can.

Stage 6. The pressure required to open your lungs is so high that air can leak into your chest cavity, so we insert tubes to clear it out. Your kidneys fail to filter the byproducts from the drugs we continuously give you. Despite diuretics, your entire body swells from fluid retention, and you require dialysis to help with your renal function.
The long hospital stay and your depressed immune system make you susceptible to infections. A chest X-ray shows fluid accumulating in your lung sacs. A blood clot may show up, too. We can’t prevent these complications at this point; we treat them as they present.
If your blood pressure drops critically, we will administer vasopressors to bring it up, but your heart may stop anyway. After several rounds of CPR, we’ll get your pulse and circulation back. But soon, your family will need to make a difficult decision.

Stage 7: After several meetings with the palliative care team, your family decides to withdraw care. We extubate you, turning off the breathing machinery. We set up a final FaceTime call with your loved ones. As we work in your room, we hear crying and loving goodbyes. We cry, too, and we hold your hand until your last natural breath.

Thank you, Ms. Gallardo, for helping all of us understand the reality of COVID infection at a sufficient level to cause hospitalization and what happens next. To all of you non-believers out there, how does Ms. Gallardo’s illumination make you feel. It is a horrible death at extraordinary cost, and untold collateral damage beyond your family and friends. Read and re-read Ms. Gallardo’s description of COVID-19 hospitalization and death. Is your defiance of CDC COVID-19 pandemic guidelines worth this kind of slow suicide? I think not, get vaccinated, now!

 

Since this edition appears to be all related to COVID-19 and the associated vaccination efforts, I offer an important and relevant historical note. On the 20^th of February 1905, the U.S. Supreme Court upheld by a vote of 7-2 that compulsory vaccination laws intended to protect the public's health were legal and in accordance with the Constitution—Jacobson v. Massachusetts [197 U.S. 11 (1905)]. In such programs, the U.S. Government (USG) is doing exactly what it is chartered to do by the Constitution—protect public safety. The Jacobson ruling remains applicable law. Just because some folks do not trust the USG does not alter the constitutional charge and responsibility of the USG. 

 

On Thursday, from the White House, President Biden presented his six-point COVID-19 pandemic plan for dealing with our situation going forward.

1. Vaccinating the Unvaccinated

2. Further Protecting the Vaccinated

3. Keeping Schools Safely Open

4. Increasing Testing & Requiring Masking

5. Protecting Our Economic Recovery

6. Improving Care for those with COVID-19

Each point has multiple sub-points to illuminate what specifically would be done to fulfill the plan objectives. The details can be found at the White House website.

https://www.whitehouse.gov/covidplan/

One particular line from the president’s speech struck resonance with me. “We have been patient with the unvaccinated. Our patience is wearing thin.” To that, I say yea verily! I am very tired of being threatened by and carrying the burden for the unvaccinated. They have NO right whatsoever to infringe upon my freedom. I fully support the freedom of choice, fundamental right to privacy, and personal integrity of every citizen, including the unvaccinated. However, what I do not and cannot support is the imposition of their choices on me or anyone else who has done their civic duty. With 178M Americans fully vaccinated, there is overwhelming evidence that the vaccines are safe and effective. Either get vaccinated, or stay out of the public domain and especially out of our hospitals.

 

            Comments and contributions from Update no.1025:

Comment to the Blog:

“U.S. military operations in Afghanistan have ended, but the military-industrial complex remains prosperous. See the new budget proposals for evidence of that.

“The ‘spy on your neighbor’ aspect of the Texas abortion law smells of tyranny. Speaking of smells, the Supreme Court is over-ripe.

“Another aspect of the Texas law is that many abortions nowadays are performed by means of pills. The doctor involved can be seen via telemedicine. Those nosy neighbors would have to be nosy indeed to detect that one. (The background music for the video on this is “Smuggler's Blues” by Glenn Frey, played over video of a routine Postal Service delivery.)”

My response to the Blog:

There is no doubt that the military-industrial complex remains prosperous. It has been that way for a very long time.

Yeah, as the SCOTUS dissenters noted, Texas SB 8 is a novel attempt by the state to avoid responsibility and accountability by deputizing citizens to do what they cannot do. I am not surprised the Texas conservatives chose to abdicate their responsibility, but I am truly shocked by the five conservative Supremes who allowed the law to go into effect, claiming there was no injury. For all the screaming the conservatives have done about legislation from the bench, the Jackson ruling is far beyond that threshold. Yeah, stinks to high heaven.

Beyond the obvious, I wonder how anyone will have sufficient evidence that an abortion was performed. The only ones in the room are the patient, a nurse and a doctor. I doubt any of them will disclose private information. A key element in such judicial cases is standing. How can anyone other than the people in the room establish standing for such lawsuits. That said, just bringing a lawsuit causes costs to be incurred by medical service providers; multiply that by potentially thousands of those baseless claims can become fatal, kind of like the business practice of the [person who shall no longer be named]. Good point re: chemical abortion.

 . . . follow-up comment:

“The Texas abortion law remains important due to its dubious nature. However, activists have already caused disruption on the sites used for reporting your neighbors. Keep in mind that anti-abortion laws are essentially used to keep the base loyal, not to achieve serious policy objectives.”

 . . . my follow-up response:

Dubious, indeed! The political purpose(s) aside, just the uncertainty created by SB 8 causes injury to more than one woman in Texas. The fact that the conservative Supremes could rationalize that injury away and suspend their precedent & practice to justify their personal bias is what strikes me as so morally wrong. My conclusion, if they can do that, they can do anything, which makes McConnell’s unilateral action in 2016 so bloody infuriating.

 

            My very best wishes to all.  Take care of yourselves and each other.

Cheers,

Cap                  :-)