You’ll be interested to know that they had a Death due to the flu… in Buffalo, a few days ago…ECMC, I think. 4 years old, the kid was.
Dunno about you, sounds fairly serious to me….

[Eric, this year isn't especially dangerous for kids. There was a year, oh, three or four years ago, that was unusually bad. We're above epidemic levels for deaths in the total population but not a great deal above. It's the worst year in several but no where near pandemic levels. Most of the increase is a type A and a Type B that were not in the vaccine for this year.]

“So, cheer up everyone. There is a silver lining to the plague.” — Kurt9

….one way or another….if….

….you’re a REAL christian.

Regards,

Chuck(le)
[We preach the Lord. The pay is lousy, but the retirement benefits are Out of This World.]

“I read (Samizdata blog?) recently the government in Britain mandated all patients to the ER must by law be seen by a doctor within four hours of arrival.” — Bruce Long

Big deal…..

It won’t happen if there are not enough doctors in the system. And, based on my observation, the AMA’s lock on supply would preclude that, if they thought it was in the best interest of their ‘bottom line’.

The ‘work-around’ you describe—security turns back the ambulances—seems like a superb approach to skating around the ‘law’.

Regards,

Chuck(le)

After the plague is when the fun begins. Since I am an automation engineer, there will be lots and lots of contract work for me automating all of the mines and factories because half of the work force is gone. No one will ever tell me or anyone else that “you’re not qualified”. Also, plagues lead to golden ages. You see, by killing half to three-quarters the population, plagues efficiently destroy social rigidities and bureaucracy that kept Europe in the dark ages. People were free to innovate and create. This is how the “guild” system went away in Europe and the renaissance came about. It almost makes you want that plague to happen.

So, cheer up everyone. There is a silver lining to the plague.

THAT right there is a major player in all that ails society as a whole. Bring common sense back along with personal responsibility and many of the fears of “preperation” for a pandemic could be alleviated.

Thank you Sue for keeping me company in wondering where it all went.

I read (Samizdata blog?) recently the government in Britain mandated all patients to the ER must by law be seen by a doctor within four hours of arrival. The NHS has met this new mandate. It really wasn’t that hard to arrange. Hospital security simply turns away all arrivals unless the ER is ready. The sick and injured wait in the in ambulances or private cars for several hours before the “official” four hour clock starts. ….

….is that the current state of ‘affairs’—government, medical industry, whathaveyou—is NOT prepared for a pandemic. And, in my honest opinion—based on years of planning for disaster—it NEVER will be, in it’s current money-grubbing modus operandi.

So. Whether now?

If you’re serious about being prepared….forget getting help from hospitals; as their professionals—based on historical evidence—will flee from anyone who has a contagious disease they think they may contract.

If you doubt this, please read Barbara Tuchmann’s classic treatise on what happened during the Black Death; A Distant Mirror: The Calamitous 14th Century.

Dry. But informative…..

“….any hammerlock exists because the government has chosen to allow it.” — Chuck Simmins

True. Or…maybe…because the government, like most people, still labor under the illusion that hospitals are operated by charitable organizations.

“A hospital has its size dictated to it by the government, its prices, its policies and its costs.” — Chuck Simmins

Interesting idea, that.

Tell me. How is it that I see the hospital across the street from me is unconstrained by your concept? Indeed, it’s CEO says his reason d’etre is to increase the corporate bottom line.

This sounds like it is anathema to the concept of providing the best possible medical support to the surrounding community.

“The AMA itself is a dino, a majority of MD’s do not belong.” — Chuck Simmins

It’s a very active and powerful ‘dino’, if you see it in the legislatures, as i have.

As for whether or not MDs belong to it….show me your statistics and sources.

“And most MD’s are so scared of lawsuits that they treat sniffles like the Black Plague.” — Chuck Simmins

Maybe if there were a tad more ‘competition’, instead of the current monopoly, they might treat ‘sniffles’ appropriately.

Just a thought……

Regards,

Chuck(le)
[All professions are a conspiracy against the laity.”

In my personal opinion….

….the cause of all the concern over health care services in a pandemic, or ever DAILY, situation is the hammer-lock the AMA/Medical-Industry has on health care in the first place.

Yeah. Lots of people like to point fingers as health insurance, but, tell me…..

….why does a liter-bag of physiological saline solution cost over $200?

People got upset about the US Air Force’s $600 hammer in the 1980s. But at least the Air Force got to use the hammer more than once.

And what does this have to do with the ‘price of’ medical care in the US today? Let alone this topic?

Only that because of the monopoly the AMA works to its financial advantage will be a serious problem in the face of any future pandemic—bird flu or otherwise.

There won’t be enough medical support to support the society….

Regards,

Chuck(le)
[One can serve either righteousness or mammon. -- Some Wag, around 2000 years ago]

[Editor: Chuck, any hammerlock exists because the government has chosen to allow it. A hospital has its size dictated to it by the government, its prices, its policies and its costs.

The AMA itself is a dino, a majority of MD's do not belong. And most MD's are so scared of lawsuits that they treat sniffles like the Black Plague.]

The civilian ambulance service won’t be the limiting step, the limiting step will be the hospital itself. As early cases are admitted, and the epidemic is identified, critical care beds will fill quickly in community hospitals. Eventually there won’t be enough beds available to support ordinary surgical activity as postoperative beds will be taken by critically-ill influenza victims. Trauma support will go on standby at many hospitals with longer diversions. When ambulances fail to provide sufficient support, private conveyances will bring the sick to hospitals, with no coordination with other prehospital services and where the ED facilities will already be unable to accommodate them and where there will not be enough beds to accept them within the hospital. As some patients are released from critical care, stepped down or more likely expiring, there will be a triage within the hospital for critical care beds. Doctors will be forced to choose which of the sickest get the next ICU bed or ventilator. These decisions may not be accepted peacefully.

Outside the hospital, things will get more desperate. As more sick arrive, with anxious family, unmet demands for service will deteriorate into disorder. Hospital security will become a problem. Police services, already taxed by other threats of disorder and the new requirements to enforce quarantine law, may not be able to adequately respond. Other resources–likely state national guard forces–will have to be called upon to assume police and public order duties that the police can no longer handle. Entering the hospital may require passing a national guard cordon to a secure triage station. More patients will be sent directly home–increasingly by force–rather than be allowed to enter the hospital where they risk infecting other patients and hospital staff. Elective surgeries would be postponed indefinitely. As many patients as possible would be transferred home or to any available nursing facilities. Except for the direst of emergencies, the hospitals would generally have ceased to perform ordinary day-to-day services. And that is assuming the staff themselves don’t become ill, in which case things would become worse.

Whole areas where outbreaks are reported could become quarantined, not just households, but whole communities. Air travel could be suspended. Highway and rail travel could also be suspended or controlled, restricted to vital food, fuel and medical supplies, and enforced by national guard and martial law.

If travel is restricted, controls will also be necessary to ration essential but limited supplies of fuel and food. This will require an extraordinary effort of self control by all members of the community if the requirements are to be met without collapse of civil order. Money may become in short supply and there will have to be diligent efforts to prevent black marketing and smuggling at the fringe of the civil society. Mass feeding stations, a response typical of many civil disaster scenarios would present a problem as a potential locus of transmission of disease. In all likelihood, an effort to support individuals and families in place would have to replace all forms of mass-services. This will require a contingent of able-bodied persons willing to perform delivery and warden duties in local neighborhoods. An effective network utilizing all available forms of wired and wireless communication methods will be necessary to sustain these efforts.

[Editor: a good projection of the effects of a pandemic. Yesterday's events should have resulted in a triage area in the parking lot, heated, staffed and with the ability to turf patients who did not need hospital care. They way things actually work is that the triage nurses disappear from their posts for a half hour or more. See, the hospital knows that once the triage nurse sees the patient, the hospital has a responsibility. If there are a dozen ambulance crews in triage but no nurse, it's the ambulance crews' problem. If you have ever seen a crew doing CPR while waiting for a triage nurse...]

[Editor: In my experience, public health officials are far more worried about teen pregnancy, guns in the home and buying shiny new toys with Federal funds. This truly minor sequence of events shows just how unprepared we are for epidemics, never mind pandemics.]

“If I had a quibble, it would be about the decision making process which would establish the alternate sites. When does it kick in?

What exactly triggers it?” ” — Chuck Simmins

Well….

…here is where I and the ‘authorities’ differ in ‘opinion’.

The ‘trigger’ should have been last June when I sat in on a Public Health Department county-wide assembly to discuss this matter.

[Note: I was told to shut down all my recording devices and erase everything I had recorded up to that point. Otherwise, I suspect, I'd have been 'ejected'. This despite my 10+ years of work in emergency management from the (Army) installation and state—as in State ARea Command (STARC)—levels.]

The ‘trigger’ for preparation was realization—at that meeting—that most agencies were unprepared. In everything I heard after each break-out session, I heard of lot of “we should” as opposed to the more satisfying “we are prepared to” statements. Such things do not give me the proverbial ‘warm and fuzzy’ feeling that all is well planned.

As for the ‘trigger’ for the actual incident….when you hear about people in Asia dropping like flies…THAT should be the ‘trigger’ to gird up your loins.

The way I see it, from my education in microbiology—emphasis on pathogens and epidemiology—I figure it will start there, where people and birds and pigs all are crunched together; probability of .8.

However, the way the so-called ‘main stream media’ behave regarding politics, e.g., Spitzer IS a ‘Democrat’, but you won’t hear that on NBC and such, we’ll likely not pick up on such information from them until it is too late. Too much potential for ‘panic’. [Note: Indeed, a rep from a nearby television station said pretty much that during the course of the meeting.

However, I suggest that a bit of panic now by the overly sensitive is better than a whole lot of panic by just about everyone, when it's too late to do anything.]

Better keep an eye on the web for such matters.

“And, shouldn’t the hospitals be allowed to protect themselves from being flooded with patients they cannot possibly handle?” — Chuck Simmins

Yes. They should be able to protect themselves. Indeed. It will be essential. But unless the general population is educated and prepared, there’s very little chance that they could withstand the wave of people seeking aid.

That’s one reason why the need for education is so damned important.

Without the panic-mitigating preparedness, people are going to act as they are described by the Tommy Lee Jones character in MIB, i.e., badly.

And there are not enough police and national guardsmen to go around. Especially if they behave like one PD officer intimated in that meeting I attended, i.e., “We’re going to hold up with our families in a designated compound.” [Note: This is exactly the way people in responsible positions in the 14th Century behaved when the Black Death marched across Europe.] Lotta good that’ll do for hospitals and such.

So….what are you going to do?

I recommend taking up the Boy Scout motto….Be Prepared! But then again, I was one of them and still am of that mind-set.

From the perspective of a dedicated emergency service provider; (1) make sure your family has adequate supplies for one year, better two-three, as they’re talking about ‘waves’ of the disease—whatever it may be—sweeping across the land, with two-to-three month ‘social distancing’ applied to each wave, (2) be prepared to administer significant medical aid to your immediate family and neighbors [neighborhoods will be what prevails, if they can get their 'act' together], (3) get the materials to protect yourself as you perform your professional duties, (4) make sure your ‘house’ is ‘in order’ [gotta Will?] and (5) if/when it happens, make your peace with God.

Hope that helps…..

Regards,

Chuck(le)
[Everyone dies. It’s just a matter of when, how and—most importantly—why.

Until depression turns into suicide. Do you really think it’s fair to lump depression in with a runny nose or a cut finger? Any psychiatrist (or even primary care doc) would want a seriously depressed patient to go to the ER. Would that patient be triaged to the top of the list? Of course not, but at least he would be where he couldn’t hurt himself, and that’s the important thing.

Otherwise, very enlightening – and troubling – post.

[Editor: I agree to a point. I have also seen such patients leave the hospital before my paperwork is done. That is depressing.

The appearance, in this area at least, is that many docs turf their problems to the hospital. So do the police. After you have taken the "out of control" six year old in as a mental hygiene arrest, you do start to wonder. The E/D facilities for mental problems are even more limited than those for medical. I have waited an hour for an intake for a patient, and that was when they were not terribly busy.]

Ugly. (via Instapundit)…