Covid (@UCSF) Chronicles, Day 10
1/ Cases cont. to grow slowly @ucsfhospitals. Covid+ pts now 14 (9->11->14 in last 3 d). Now 8 in ICU: change in ICU:floor ratio concerning. Are others seeing this? SF cases continue slow rise (279, up from 223). Still far cry from NYC's horrors
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2/ Given modest growth & now-fair supply of PPE/testing/workforce, we’ll restart some surgical cases next wk… carefully, ready to de-escalate if we see surge. But our non-Covid patients also need our services: waiting to have your cancer removed can’t feel all that “elective”…
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3/ New today:
@ucsfhospitals switch to “universal mask policy”–every HCW/staff will get 1 surgical mask at shift start & wear at all times. While old policy was safe, this may be a bit safer (given [v. small] risk of transmission in asymptomatic pts) & def more comforting to HCWs9 replies 57 retweets 218 likesShow this thread -
4/ Why didn’t we do it sooner? a) Until now, not enough masks to be sure we wouldn’t run out; b) Old policy consistent with nat’l guidelines & good evidence. But people’s concern understandable. A few other places have done this; I suspect it’ll become norm if PPE stock adequate
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5/ Great response (38K views) to our grand rounds last wk on Covid clinical/epi/virology https://bit.ly/2WODDT6 2 new conferences: a) Impact of Covid on
@UCSF Medical Education https://bit.ly/39jByBm & b) UCSF research response to Covid: https://bit.ly/3dDR1jg Both excellent1 reply 16 retweets 73 likesShow this thread -
6/ This wk, several articles on ethics of Covid in ICU. I especially like
@JAMA_current piece by D. White & B. Lo https://bit.ly/2Jn4yhc It includes@UPMC algorithm for these brutally hard decisions; note it avoids any age cut-off (except as “tiebreaker”)...2 replies 19 retweets 63 likesShow this thread -
7/ To
@UPMC algorthm, might add 2 Covid-specific factors: a) v. low survival rate for intubated COVID pts (~10-20%) & b) contagion risks w/ CPR. But (a) is tricky–2nd@JAMA_current paper shows improvmnt in ICU w/ convalescent plasma https://bit.ly/2QMSERG (Warning: v. small#s!)2 replies 7 retweets 37 likesShow this thread -
8/ A high note: I mentioned in tweet last week that it would be great if we had iPads to help patients & families connect, given no-visit policy.
@ddubinsky & Len Shustek have donated 100 of them! So great. Other ways to help@ucsf covid response here:https://bit.ly/3ds5T3R8 replies 23 retweets 186 likesShow this thread
Hi @Bob_Wachter - i want to donate my ipad. How can i do this?
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