COVID Update

This is how my night in the ER went:
1. COVID 72% Room Air (RA)
2. COVID 75% RA
3. EtOH fall
4. Diabetic Ketoacidosis (DKA)
5. Urosepsis
6. Urosepsis
7. Altered Mental Status (AMS)
8. COVID 86% RA
9. Afib with RVR
10. COVID 85% RA with DKA
11. AMS with DKA

1/12

12. Deep Vein Thrombosis
13. Hyperkalemia from missed dialysis
14. COVID normal oxygen
15. Non-ST-elevation myocardial infarction (NSTEMI)
16. Renal Stone
17. Bradycardia
18. COVID + NSTEMI
19. COVID normal oxygen
20. Lip laceration

2/12

There are a few other patients, but last night was a GOOD night, because there were no super sick COVID patients on BiPap or needing intubation. 3/12

Who is getting COVID?
A majority are Mexican

I've seen numerous COVID cases involving fieldworkers, who get infected then COVID spreads to their entire family. One family said, in the morning it's cold so fieldworkers huddle together which is how they believe they got the virus

I've seen people contract the virus from working at fast-food restaurants - usually a young person, who then brings it home to their family. 5/12

Even die-hard Mexican Trump supporters are realizing the pandemic is not a hoax, as members of their families are falling extremely ill to COVID19 and being hospitalized. 6/12

I'm hearing stories of Mexican families getting COVID then finding their loved ones dead in the other room, but they still do not grasp the fact that their loved one died from COVID. They don't believe COVID killed them, although the entire family had COVID. 7/12

Across Arizona, hospitals are doing their best, but the next solution is to increase ICU beds by cohorting COVID patients near each other in the ER & making ED ICUs. This is what happened in NYC when hospitals were overwhelmed. It will surely be what's next to come. 8/12

The downside to cohorting patients is that you can't have everyone in a negative pressure room, but the upside includes expansion of ICU beds, recognition of sick patients quickly, easier monitoring including vent management. An ED ICU would look something like this. 9/12

The pandemic is worse now than ever in Arizona. 120 patients are being intubated per day and nearly 100 are dying per day. As alluded to above, there are no ICU beds in Arizona. When one opens up it's quickly filled by the countless patients on the ICU bed waiting lists. 10/12

From what I gather, the plan in Arizona is to let everyone get infected with COVID then vaccinate the people who didn't get COVID. So make sure that you don't get COVID and #StayAtHome 11/12

To sum, Mexicans are 60% of the population in Yuma County, but they are making upwards of 90% of the people I admit for COVID. Intubations remain steady at 125 per day in Arizona. There are not enough ICU beds to meet demand. Please adhere to the following to stay safe /end