2019 Novel Coronavirus Covid-19 Discussion

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#2816398 21-Nov-2021 08:19

tdgeek:

cshwone:

The assumption in the posts above about in home care seems to be that once you have been triaged at first assessment for in home that is where you stay until you recover or die.

Surely that is not the end of the story?

I know that personally if I had the virus and was at home as soon as I felt life threatened, had a bad oximeter reading etc I would be straight to the ED.

AFAIK the premise was that as most have mildish symptoms there is no point using up MIQ or beds, keep them for serious cases and other non Covid-19 needs. Vaccinations will add a huge boost to needing less beds.

Yes agree but if you read back in the thread lots of doom and gloom about people who will die at home. As @MikeB4 said, scaremongering.

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#2816404 21-Nov-2021 08:42

cshwone:

Yes agree but if you read back in the thread lots of doom and gloom about people who will die at home. As @MikeB4 said, scaremongering.

Yep. The facts are, that if the accommodation is suitable, and the medical assessment for Covid symptoms and any other medical issues is carried out, and if all that is satisfactory, they can recover at home. They get contacted daily, I believe thats by email and if no reply, by phone. The Coroner will determine the cause of death.

IMO any conclusions drawn before the Coroner's report is idle speculation, and basically inferring that no one knows how to do a medical assessment, which is ridiculous.

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#2816412 21-Nov-2021 09:08

First confirmed case in Hawke's Bay. Details at 1 pm.

Plesse igmore amd axxept applogies in adbance fir anu typos

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#2816413 21-Nov-2021 09:13

cshwone: The assumption in the posts above about in home care seems to be that once you have been triaged at first assessment for in home that is where you stay until you recover or die. Surely that is not the end of the story?

Yes, those posts are mistaken and wrong. I'd like to see more clarity around the high standard of care required in this situation. The Health Commissioner seems to be on to it.

Sup

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#2816424 21-Nov-2021 10:10

MikeB4:

cshwone:

The assumption in the posts above about in home care seems to be that once you have been triaged at first assessment for in home that is where you stay until you recover or die.

Surely that is not the end of the story?

I know that personally if I had the virus and was at home as soon as I felt life threatened, had a bad oximeter reading etc I would be straight to the ED.

It's not the full story. Apart from a very few professionals (noted on their profile) the vast majority posting here know jack about it. There is a lot of apparent scare mongering. New Zealand does not condemn people to die alone at home.

Hello, thanks for the replies.

I must not have explained the 'dying at home comment clearly'. First of all, I did state in one of my posts that we have not reached the point where that comment shifts from being a euphemism for the Govt 'in home care euphemism' to a literal state of affairs.

The primary risk with the In home care plan, is when beds are full. Which is why the emphasis on our very low capacity relative to other countries that have invested more in health. This is not made up from the ether, the DHBs themselves have been sounding warnings leading up to this current well managed outbreak. I have retired from working in the system, and I care about the system, had a lot invested in that system, (and I would say got pretty burnt out by the shortcomings of the system).

I did state in one of those posts that I do not believe we will reach this point as a given, because of our vaccine rates, so I was certainly not intending to scare monger. Thanks for checking me there. I need that sometimes, I forget how comments made loosely do not put my case in the best light.

Some of the short comings of an over the phone assessment, is that you can really only go off the patients ability to articulate symptoms, you cannot do a head to toe assessment for example, the visual cues are not possible.

Pulse Oximiters are great at giving you a cardinal sign of risperitry damage and in this context they are the most important measure.

However Covid causes in some people, multi system organ damage. Which means the person calling you may have difficulty clearly articulating symptoms beyond a general malaise "I feel crook, really bad, headache, can't move properly".

Factor in some of these people will not be educated, and or, english is a second language. Our patient who has a headache and 'can't move properly' may well have O2 Sats of 100%.

The call center staff will be very familiar with the symptom profile...Duncan Garner revealed he had difficulty moving his body with Covid.

On the face of it our patient sounds like they are experiencing normal Covid symptoms. Likely call center staff will tell the person to keep an eye on things and keep their fluids up, eat regularly, keep an eye on those 02 SATs and ring an ambulance if they deteriorate (have breathing difficulties etc).

Now lets say the same hypothetical patient walks into a GPs office. As most of us would if we felt really poorly with other forms of illness, The GP conducts a routine Neuro exam, and discovers that the 'trouble moving' is not the lack of energy malaise described with covid at all, the patient has an unsteady gait, and a raft of other signs of stroke, potentially caused by a blood clot secondary to Covid infection.

That is one example off the top of my head just to give you an idea of where I am coming from. With Multi systemic damage, symptoms can be very broad, however they can be largely teased out over a phone call since they likely have a known aetiology (we know the Patient has a confirmed diagnosis of Covid 19).

I am not trying to one up people with this post, I regret and apologize for using the throw away comment 'dying at home'....it came from a place of being cynical having worked for DHBs who called rationing things "Releasing time to care" the inference being...that if you have less stock, less basic equipment, that the DHB has done you a favor by shortening the time it takes to do a ward stock take and reorder supplies (I kid you not this is a thing, other DHB staff who use this site will verify I am talking the language of within the system, and not inventing myself as some loonie who pretends to be an ex whatever, I have been at pains to point out my specialist knowledge is not infectious diseases from my first post).

Unfortunately my contentious post/comment, has lead away from the points I was really interested in getting across.

My primary concern for the in home plan is not really a risk at all to the people who likely read these posts, they will likely be well versed at articulating needs, advocating for themselves, and most of all understanding the plan and how to respond when things go south.

Likely the people who frequent this thread, from the tone of what I have read, will be vaccinated anyway and will be highly unlikely to encounter serious issues.

My concern is the vulnerable person, especially if they live at home, by themselves, who may not have the energy to hydrate etc, attend to basic activities of daily living skills, a bed bound patient, who is more difficult to take a history from and form a full clinical picture in line with the assessment that same individual would receive from seeing a health care professional in person.

In New Zealand there is a culture among some groups across all ethnicities of not making a fuss. Not making a fuss and not bothering the nice call center people just because one new thing has changed, is a very real problem when you have one thousand people whose health care pathway is a phone call and a daily email.

Indeed we can move some people to MIQ but again, these are finite resources, which is why I fully support the Govt for an assertive aggressive vaccination target.

Anyway thanks for reading the posts and taking the time to reply :)

Just keep swimming...

cruxis

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#2816428 21-Nov-2021 10:36

quickymart:

I see Brian Tamaki had (yet another) pointless protest today. Do his supporters seriously have nothing else to do with their lives? Too much time on their hands? Do they even have jobs?

I think the long arm of the law needs to come down on his crap, seriously, the guy is getting to be a joke with protest after protest, and I see it doing little to convince anyone or change their way of thinking, outside of his hardcore band of followers.

Run a counter protest.

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tdgeek

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#2816429 21-Nov-2021 10:46

cruxis:

Run a counter protest.

Yeah, but better to leave them in the gutter, don't lower ourselves. Perhaps it may backfire, being potential super spreader events.

Dulouz

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#2816432 21-Nov-2021 11:21

Call me old fashioned but I'd prefer to die at home than in a hospital.

Amanon

Sup

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#2816434 21-Nov-2021 11:25

cruxis:

quickymart:

I see Brian Tamaki had (yet another) pointless protest today. Do his supporters seriously have nothing else to do with their lives? Too much time on their hands? Do they even have jobs?

I think the long arm of the law needs to come down on his crap, seriously, the guy is getting to be a joke with protest after protest, and I see it doing little to convince anyone or change their way of thinking, outside of his hardcore band of followers.

Run a counter protest.

I would support it, under the right within the rules conditions. I suspect a lot of people would. Watching what is happening in Europe, I am interested to see what happens with counter protests there.

There have been some events, but very few, and I forget which countries off the top of my head. If I am being honest I probably would not attend, I have lived a high risk lifestyle in terms of life and death situations at work, I am happily retired now, and I remember the Stop the Tour protests, these things can get really violent, which is the exact type of thing my Doctor tells me to avoid!

Just keep swimming...

gzt

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#2816440 21-Nov-2021 11:54

Those are all good reasons not to do something like this. There's no need for it.

Daynger

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#2816539 21-Nov-2021 12:13

quickymart:

I see Brian Tamaki had (yet another) pointless protest today. Do his supporters seriously have nothing else to do with their lives? Too much time on their hands? Do they even have jobs?

I think the long arm of the law needs to come down on his crap, seriously, the guy is getting to be a joke with protest after protest, and I see it doing little to convince anyone or change their way of thinking, outside of his hardcore band of followers.

The self proclaimed apostle is now claiming to be a sovereign citizen, so doesnt fall under NZ laws.

Surely that would make it easier to dump him off the side of a boat just outside our EEZ to fend for himself, problem solved.

Yesterdays article on Stuff contained a quote that his lawyer has told him he has the right to protest, so that will be the angle they try to defend in court.

The police should have hancuffed him on stage and dragged him to the cells so he could spend the rest of his weekend there before going before a judge on Monday but they are too soft.

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#2816542 21-Nov-2021 12:20

Daynger:

The self proclaimed apostle is now claiming to be a sovereign citizen, so doesnt fall under NZ laws.

Dump his fake church then.

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GV27

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#2816552 21-Nov-2021 13:31

Daynger:

The self proclaimed apostle is now claiming to be a sovereign citizen, so doesnt fall under NZ laws.

I know this is a serious posting area, and we're meant to put a lot of thought into our points and articulate them clearly, but please understand how difficult it is for me to now just spam this quote followed by pages of 'AHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAAHAHAHAAHAHA'.

Sovereign Citizen bullshit is amazing and Pope Tamaki and his flock are now buying into it? I cannot think of two crappier groups of people that I would gleefully wish upon each other.

Unfortunately in NZ it tends to overwhelm the Maori Sovereignty voice, which is legitimate, but this is the most comprehensive take-down of the Sov-Cit crap I have ever seen, from Canada:

https://www.canlii.org/en/ab/abqb/doc/2012/2012abqb571/2012abqb571.html

Sup

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#2816812 21-Nov-2021 23:44

GV27:

Daynger:

The self proclaimed apostle is now claiming to be a sovereign citizen, so doesnt fall under NZ laws.

I know this is a serious posting area, and we're meant to put a lot of thought into our points and articulate them clearly, but please understand how difficult it is for me to now just spam this quote followed by pages of 'AHAHAHHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAHAAHAHAHAAHAHA'.

Sovereign Citizen bullshit is amazing and Pope Tamaki and his flock are now buying into it? I cannot think of two crappier groups of people that I would gleefully wish upon each other.

Unfortunately in NZ it tends to overwhelm the Maori Sovereignty voice, which is legitimate, but this is the most comprehensive take-down of the Sov-Cit crap I have ever seen, from Canada:

https://www.canlii.org/en/ab/abqb/doc/2012/2012abqb571/2012abqb571.html

I see Grifter Brian is forming a political party. Is anyone surprised?

We already know the play book, he will incite an insurrection and claim he is not responsible. He is already framing his language in this tone.

I hope the Govt cut off his tax exemptions given he is no longer part of our society.

Coz what New Zealand needs right now is more QANON, Guns, Evangelism for cash, and Nazis.

Just keep swimming...

Oblivian

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#2816813 21-Nov-2021 23:52

Case of been there, done that

https://en.wikipedia.org/wiki/Vision_NZ

But there's a separate thread for that sort of stuff.

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