coronavirus discussion

[Hondaracer]

Wearing masks isn’t a law so there’s nothing to ticket

You’re not gonna round up those people and try to give them bylaw infractions for social distancing. Most of the cops weren’t even wearing masks

[twitchyzero]

1st wave looks like a kid's wading pool

[whitev70r]

^ just wait ~ 10 days!

[Hondaracer]

Originally Posted by westopher

Not to mention the elevated workplace risk on their unit.
I don't think those of you that are saying "the hospitals aren't at their limits" understand how small the number is compared to the population is required to hit capacity. Here are some numbers.
https://thetyee.ca/News/2020/04/02/C...pitals-Mapped/

I completely agree and no one wants them to be setting up field hospitals in tents

However, this is month 9 of covid, why haven’t they been building capacity into the system all this time? There’s almost never a mention of that when it should be in both the short and long term planning at all levels.

[westopher]

I'm sure they have been. That infographic is old, but even if they tripled it, its clear the numbers aren't going to be equipped to handle thousands of cases a day. You can't build a hospital in 9 months, never mind 20 of them.

[spoon.ek9]

I can kind of answer that question. Every hospital has finite resources. Even with ~9 months, there's almost no way capacity could have been increased with the low levels of funding available. The best we could do with almost no warning was to reallocate whatever we could into makeshift operations to deal with this crisis. I don't know if anyone has ever noticed how long it takes for any sort of meaningful change to happen in a hospital but it's borderline ridiculous. We're talking 5-10 years for most things to even get started.

A new building was approved to increase our capacity back in 2016. The plan involved tearing down one section of the hospital to add a new tower that would give us ~200 new beds. Four years later, guess what? Literally nothing has begun. Now, to be clear, I'm not blaming anyone in particular. All I'm saying is that it even with well thought out plans, allocating the resources and actually starting the work takes a butt load of time. This current situation was clearly not well planned for so we're all making due with what we already have.

[Hondaracer]

Well instead of putting resources into expanding the immigration program and all these other trivial ventures Turd could have been streamlining funding to create that capacity?

Like I know we ain’t China but China built those field hospitals at the beginning of covid in a few days, how can we not be pumping funds into building even portable hospitals which could carry the burden of an overflow? Do we not have the ability to staff them?

[spoon.ek9]

110% we wouldn't have enough staff. Even on a normal basis, most departments that I'm aware of are operating short handed to some capacity.

Also, added to that is what happens when people get sick and cannot work for lengthy periods of time. We're very used to having another person's shift responsibilities divided and added to our day because there's literally no one who can/will come in to cover the shift.

[westopher]

Originally Posted by Hondaracer

Well instead of putting resources into expanding the immigration program and all these other trivial ventures Turd could have been streamlining funding to create that capacity?

Like I know we ain’t China but China built those field hospitals at the beginning of covid in a few days, how can we not be pumping funds into building even portable hospitals which could carry the burden of an overflow? Do we not have the ability to staff them?

Well, you may not remember, but there was plans during the first wave to turn the VCC into an urgent care centre. My wife was worried that she would be pulled off of maternity to work it, based on her previous experience, but the need didn't come to that. Yes its a possibility. No, it's not a good situation to be in. The Canadian government has literally allocated billions since the pandemic started for healthcare. LPNs go to school for 2 years, RNs go to school for 4 years. Doctors go to school for 8-10 years. See the issue?

[Hondaracer]

Well you could always pay to have people relocate for temporary stints etc. But yes

[westopher]

Originally Posted by Hondaracer

Well you could always pay to have people relocate for temporary stints etc. But yes

But where would they come from? Florida was offering RNs $5000 a week for nurses to travel there in the thick of their outbreaks this summer and they still couldn't fill the spots. Everywhere is so stretched. Thats why mitigation needs to be in place, because once shit hits the fan, there isn't the equipment or the people in the world with the ability to take care of it, no matter how much money is thrown at it.

[spoon.ek9]

Again, it's an issue of man power. If multiple hospitals are already running short, where are these people coming from? There's also a limit to how much OT one person can do before they're completely burnt out. Being burnt out in healthcare is like the pinnacle of dangerous work situations for the employee, their department and the patient of course.

This month and next I'm already working 3-4 scheduled OT shifts. I've already had to decline approximately 6-8 other shifts (probably more). I want to help more but I'm trying to moderate it. If I can help it, I'd rather not be at the hospital for 17 hours per day. Guaranteed there's going to be sick calls I'll be asked to cover which I may or may not want to accept.

There's also union rules in place to prevent burn out for those that aren't aware. You're no longer allowed to work more than 7 days in a row without a day off in between.

[EvoFire]

Originally Posted by Hondaracer

Well you could always pay to have people relocate for temporary stints etc. But yes

I get a sense from you that you don't understand how this works. Admittedly I don't know the details and ins and outs of things, but capacity isn't added with a snap of a finger.

Whatever China did to build two new hospitals won't fly here, ever. Those make shift hospitals that China built for original SARS and for Covid aren't in use regularly. I'm pretty sure I read the two hospitals built for Covid are now abandoned.

Part of the problem right now is just getting hands on deck. The healthcare system is stretched thin as is, and then you start taking resources away to dedicate to Covid, which is going to screw everything else up.

I know a friend who works at RCH. He said the amount of bureaucracy and stupidity is staggering at the management levels. On top of the government tiptoeing around the issues, nothing gets done.

[Ludepower]

I trust Dr. Bonnie judgment than some of you armchair doctors.

If they lock us down so be it. We only have ourselves to blame and knew the second wave was coming.

[Obsideon]

I'm just so upset that I'm doing all that I can to mitigate the issue but the few that are fucking around are dragging everyone else down with them.
Like Westopher, I'm also in the restaurant industry and most of us are NOT going to survive another lockdown...

[threezero]

China don’t have unions to protect their worker.
China don’t need to go thru any bureaucracy when CCP needs to get things done
China don’t have all of their population question every fine detail on how their tax dollar are spent.
China does not have vocal portion of population questioning every move the government makes
China don’t have Worksafe or any version of that that isn’t just a fake front.
China doesnt have overtime laws or laws to protect construction worker from working until their arms falls off.
China is okay putting patients in the equivalent of hospital made out of metal container
China has a massive workforce that can be ready and working immediately largely due to many of the above points

China has done a lot of thing during this pandemic that just isn’t possible for anyone else.
Not a good or even a fair comparison for Canada

[Hondaracer]

All those problems are solved with money in Canada. And money is pretty much free right now so if there was a will, there would be a way.

There are more than enough trades and skilled workers that if you really had to you could convert places like river view or retrofit unused wings of existing hospitals very quickly for use in the treatment of covid

However, as mentioned above you don’t want to just build capacity and not care how people are respecting the virus.

Capacity will be built into the system going forward but it seems crazy that it isn’t being done proactively 9 months into this (maybe it is, but I haven’t heard or seen anything that would lead me to believe it’s being done to scale)

If you can build a 50 story high rise in 7 months, you can built a “decent” hospital to take care of covid overflow in a very short period of time, yes, even in Canada.

[threezero]

Originally Posted by Hondaracer

All those problems are solved with money in Canada. And money is pretty much free right now so if there was a will, there would be a way.

There are more than enough trades and skilled workers that if you really had to you could convert places like river view or retrofit unused wings of existing hospitals very quickly for use in the treatment of covid

However, as mentioned above you don’t want to just build capacity and not care how people are respecting the virus.

Capacity will be built into the system going forward but it seems crazy that it isn’t being done proactively 9 months into this (maybe it is, but I haven’t heard or seen anything that would lead me to believe it’s being done to scale)

If you can build a 50 story high rise in 7 months, you can built a “decent” hospital to take care of covid overflow in a very short period of time, yes, even in Canada.

Private project get done a lot faster than any government project, there is less hoop to jump through and lot less people they need to answer to.

Anybody that has work with a government entity on any project will be able to attest to the amount of bullshit you have to sift thru.

The system that ensure us of our of citizen right, fairness and relative transparency also has another side.

Our system was suppose to be setup so that money is not the be all end of of all solution/options.

In a place like China without these mechanism, you are right those problem were literally solve with money.
If it was that simple, we would not be discussing lockdown, mask wearing and still begging people to social distance almost a year into the pandemic.
If we can't even get the population to agree on simple task. Good luck having a speedy discussion on how the government plan to build the propose hospital. Where it would be located and the contract details etc.

Case in point the pipeline. How much money has been thrown at it? China would have build 100 pipeline spanning the whole continent at this point.

[Hondaracer]

Pipelines are irrelevant in this discussion.

The govt. already has a list of approved contractors who can submit bids and joint bids. I’m not talking about building another saint Paul’s. I’m talking about building a tilt up building or the like with the infrastructure to care for people. As mentioned previously however it’s probably easier to convert somthing like the convention Center into a temporary hospital than it is to build somthing for the points you laid out.

However, you’re describing the conditions which infrastructure projects are under during normal conditions. Covid is anything but normal. I’m sure your average citizen couldn’t have a problem awarding a joint contract to a Byrd/Kewit to build a temporary hospital. They’ve awarded billions in contracts to these companies in the past and will do so going forward.

Frankly I don’t think it will be needed in the end but in emergency situations anything is possible.

[SkinnyPupp]

Originally Posted by Hondaracer

Pipelines are irrelevant in this discussion.

The govt. already has a list of approved contractors who can submit bids and joint bids. I’m not talking about building another saint Paul’s. I’m talking about building a tilt up building or the like with the infrastructure to care for people. As mentioned previously however it’s probably easier to convert somthing like the convention Center into a temporary hospital than it is to build somthing for the points you laid out.

However, you’re describing the conditions which infrastructure projects are under during normal conditions. Covid is anything but normal. I’m sure your average citizen couldn’t have a problem awarding a joint contract to a Byrd/Kewit to build a temporary hospital. They’ve awarded billions in contracts to these companies in the past and will do so going forward.

Frankly I don’t think it will be needed in the end but in emergency situations anything is possible.

They can turn BC Place into a hospital if they have to

But where are the healthcare workers going to come from? Alberta? And what happens when they get hit hard? They take from Manitoba? And so on

We have to prevent a huge backlog from happening. Not because 90% of Corona patients die, but because a lot can if care is not provided, and it's insanely contagious

Feels weird explaining things we learned in January

[Hondaracer]

Bring them from regions where there are almost no cases? Northern BC, Kootneys, etc.?

Even interior health could likely lend a large portion of its workforce, at least temporarily



Graphic doesnt seem to be loading but here is the link:

http://www.bccdc.ca/Health-Info-Site...s_20201029.png

Many of these health regions in BC have had double digit numbers total since the beginning.

[Jmac]

Originally Posted by EvoFire

I get a sense from you that you don't understand how this works. Admittedly I don't know the details and ins and outs of things, but capacity isn't added with a snap of a finger.

Whatever China did to build two new hospitals won't fly here, ever. Those make shift hospitals that China built for original SARS and for Covid aren't in use regularly. I'm pretty sure I read the two hospitals built for Covid are now abandoned.

Part of the problem right now is just getting hands on deck. The healthcare system is stretched thin as is, and then you start taking resources away to dedicate to Covid, which is going to screw everything else up.

I know a friend who works at RCH. He said the amount of bureaucracy and stupidity is staggering at the management levels. On top of the government tiptoeing around the issues, nothing gets done.

Hospital standards make everything infinitely more complicated. CSA Z317 spans dozens of books and references dozens more. Building code is a drop in the bucket.

So let's say you want to take an area that is currently used for non-clinical use and use it for patient rooms. First, you need services there (medical gases, nurse call systems, etc.) that probably aren't there. Those need to be installed to building code plus their applicable CSA standards. Do you have the required spaces for patient care in the area like clean and soiled utility rooms? Clean and soiled linen rooms? Clean supply rooms? Nursing stations?

Then there's the HVAC requirements, which are typically significantly more for patient care areas than they are for non-clinical spaces. Now you need double-to-triple the airflow and additional filtration. Can the air handling unit provide additional airflow while simultaneously overcoming additional levels of filtration? Can the air handling unit's filtration system even be upgraded? Can the air handling unit handle higher levels of outside air and maintain heating/cooling on peak days without freezing up/losing control? Can the secondary heating/cooling sources downstream (e.g. reheat coils, radiant panels, radiators, etc.) handle the additional airflow? Pressure relationships are likely to require significant adjustments. Is the duct work sized to handle the new requirements? Then you may have equipment that can't be used in patient care areas that is acceptable in non-clinical areas like fan coil units that may be relied on for heating/cooling under normal circumstances, so how do you heat/cool the space now?

[underscore]

Those regions have fuck all for population though. Even if you force them to go, you're not going to be able to get many people.

[Hondaracer]

Under normal conditions sure. However under normal conditions we also stick people in hallways and lobbies for hours if not days as well. So if it means your in a makeshift concrete hospital or you’re dieing at home, I’m sure the latter is preferred

Again I’m just brainstorming and I don’t think it will happen/be needed.

I will say however that in the event something like this was required and the reason why it couldn’t be done is the bureaucratic hoops the process would get hung up in, that’s fucked.

[westopher]

They aren't flush with staff in places that don't have massive influxes of Covid cases. You are talking about bringing in staff from place that already have widely known GP and nurse shortages often because highly educated people
A) don't really want to live there
B) they don't have opportunity for job growth
A place that has 30 nurses can't send you 300. There are finite resources. Places don't just have thousands of healthcare workers waiting in the wings. Canada can throw 100 trillion dollars at people, but if they don't exist they cant take the job. Remember how angry people get at the prospect of immigrants coming in an takin r job.