🐼🕊Dr. Natalia 🌻🪬
@SolNataMD
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MD, PhD, MLS in Healthcare Law • ICU doc • immigrant • anti-disinformation • medical ethics • health equity • Views r own
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Hospital trick: patients admitted with covid in 10-12 days become post-covid & no longer counted as hospitalized covid patients. ICU is full of post-covid patients that are here for 30, 40, 50 & more days. Not counted in the official stats.
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In the ICU I am at now, 6 nurses resigned just today. The ones that are still coming to work care for 3-4 patients 🤦🏻♀️
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My rain of covid patients today. Only 1 is vaxxed & on high flow O2 texting. The rest, unvaxxed, - intubated, laying on their bellies, on dialysis, sedated & paralyzed. I'm sweating in a plastic PPE like took a shower in scrubs & having new face wounds.
#Tired
#GetVaccinated
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Being the one who intubated & treated hundreds of covid patients during the past 2 yrs, its hard to watch how easy ppl take off the most important level of defense! N95 is what protected me before vaccines, w limited PPE, in poorly ventilated places. I am NOT ready to take it off
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They say the pandemic is over. They ask why I am still wearing a mask.
Two weeks ago, I worked with a doc, who then called out sick. Tested + for covid. Kept extending his off time. I just learned the doc was placed on life support. Lean, healthy, young.
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1/Last night broke me. I've never imagined I would see such lack of care from politicians for people they represent, for people they supposed to advocate for. Covid should've never been about politics. It's about life & death. People are still dying! Nobody cares!
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For the first time in 2 years, I've worked ICU shift with zero covid patients. It feels very unusual to have a sign out without highlighted diagnosis of covid & to have rounds without needing to put on PPE. I don't think we are done, but its a nice to have a covid-free break.
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When did it become normal not to value lives of people with underlying conditions or elderly?
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Two more painful discussions with covid patients families. One - with mom, another - with wife. Both patients r dying. Both women r in tears. They ask about transplant, ecmo, meds that can keep patients alive. I know a shot that could have prevented all this but it is too late...
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It takes only one person to have covid at the workplace and not knowingly be maskless. Then the surgery gets canceled because the whole surgical team has covid just like the plane gets canceled because the whole crew has covid. This is happening.
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My 6 yo God-son got vaccinated today❤! While being monitored post-shot, he delivered a speech how important it was to get vaccinated. One of the adult pharmacy customers said he could no longer be scared if the kid was not. And the customer got his shot.
#KidsRock
#GetVaccinated
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A vaccinated elderly woman in n-95 mask held her adult son's hand, touched his face, told him what she'll cook when he comes back home. Then she looked at all scary devices her unvaccinated son was connected to & there was so much sorrow in her eyes. Broke my heart to pieces.
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By the end of the 4th day of maskless training with me being the only one in N95, several people started sneezing or coughing. They say its FL cold weather or allergies. But this is the same weather as 4 days ago & there was no allergies on day 1, 2 or 3.
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Don't get bullied by maskless people that surround you into unmasking! Keep wearing your mask! 😷 We are not done with the pandemic! 😷
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Feels like I am the last person wearing a mask in Florida.
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Guys! When I write about frontlines, I don't do it to push for empathy towards me or HCWs. All i want is for you to understand YOU HAVE NO HEALTHCARE NOW in this country. Its not about feeling sorry for us. Its about all of you having NO ACCESS TO CARE NOW.
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Covid is a household disease. Sometimes your patient dies and you have nobody to notify because all other members of the family are either intubated or also died. 🤦🏻♀️
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A friend got exposed to covid in the office. My friend's colleague who is normally maskless suddenly put on a mask. My friend inquired about this sudden masking. The colleague said that tested covid+ & admin said to mask up, come to work & not to tell anybody. Thats where we are!
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Covid-19 exhausted my soul. Emptied it. Completely wiped out the joy of medicine. It continues its attempts to break me. Every single day.
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Intensivist sign out for the night: 56 ICU patients on the list, ER is full of critically ill patients awaiting for ICU beds, floors have about 50 patients on BIPAP at 100% O2 awaiting for ICU beds. Hospital census is going up fast.
❗There is only 1 ICU doctor in the hospital❗
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Rumors about vaccine side effects matter until people become patients. Then patients & families are ready to accept any drug with any side effects just to be alive. Unfortunately we don't have drugs that do miracles in ICU. Covid miracles happen before ICU gets involved.
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I know how it feels when you are the only person in the room wearing a mask & the other 30+ maskless people look at you like something wrong with you. I also know how I feel when I learn that after the meeting several people tested positive & I didn't.
#CovidIsNotOver
#WearAMask
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Just got an email from one of the hospitals I work at. In summary, we are short of everything; think twice before ordering a test, doing a blood draw, or doing a procedure; don't order things you may survive without. We have no tubes for blood samples, test or procedure kits.
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For 2 years, we watched videos explaining covid spread when we talk, cough, & just breath. As we still have >2.5K ppl dying every day, & hospitalized & ICU numbers r not down to pre-Omicron level, its shocking to watch how comfortable ppl are to dine together indoors.
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Visibly congested people, coughing and sneezing are flying maskless all over the country.
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Unbelievable how all women in this country and all doctors are being held hostage by 6 people poisoned by their political agenda. And no rescue is coming.
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Great beginning of the shift that starts with the info we ran out of high flow oxygen devices.
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It only takes ONE time to have covid & end up with debilitating endless LONG covid.
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Went to two grocery stores. There was only one mask & it was mine. This ship has sailed. No studies about clotting/psychiatric/neurological complications can convince people to wear masks.
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1/ Last night - a lot of cardiac arrests. Ppl stay home & do self-medicating until their heart stops. Many are coming from outside, but also from the floors & ICU patients are arresting. ICU is full. ER has 6 intubated pts awaiting for beds.
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Natural immunity seems to be working just fine. A patient in 60s - 1st covid 4 months ago, treated in ICU, survived, now 2nd covid, again in ICU, heading towards intubation.
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11/Last night broke me. I had no moment to sit down x12 hrs. Several crashing patients, tons of procedures. Nurses & RTs were running around not having time to eat or drink x12 hrs. Some brought water & food for the shift & it remained untouched. Never ending Spring 2020 😭
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With this tsunami of positive cases - assume everybody you interact with is covid positive!
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Remember: You can never make the same mistake twice because the second time it's not a mistake, it's a choice.
After the first surge when we were mistakenly unprepared, every other surge is a choice. Not wearing a mask, not vaccinating is a choice to continue the pandemic.
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6/Where are the politicians? Come to bedside or go donate blood. During legislative session each state house & senate & staffers go donate blood, go volunteer in the hospital. Instead you are doing shitty laws to gain power, control, wealth.
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In the middle of this ICU disaster with tons of covid patients, death, codes, lines, chest tubes, my two interns just fell in love ❤.
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We are at the point when stories of people dying from covid aren't enough. Stories of frontline workers being completely burned out aren't enough. Stories of people being disabled from long covid aren't enough. How do we continue?
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Patients shouldn't be asking healthcare workers to wear a mask. Masks should be a norm in healthcare settings. If a patient asks you to put a mask on, put it on. The answer - it's up to us to decide whether to wear a mask or not - is unacceptable. Maskless healthcare is NOT care.
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New consult: patient found unresponsive, took an unknown amount of ivermectin. A spouse won't disclose in what form & how much.
Just don't blame hospitals for shit you take!
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People who had a mild covid once seem a lot more accepting of getting next rounds of covid. But one mild covid is not a guarantee that your next one will be mild too. A patient in 20s had a mild 1st covid, didn't vaccinate, got severe 2nd, on life support, awaiting transplant.
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ICU doctors r leaving their full-time jobs. Burnout from workload & admins abuse & being put in unsafe situations is unbearable. Feeling like scapegoats of the failed system, 2 former colleagues reached out today to learn about my life after leaving my job. This happens weekly.
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7/Where are the medical organizations? Should be screaming at every media outlet abt the deep crisis we r in. Its not enough to write a statement & be happy about own performance. The disinfo doctor is being confirmed for state surgeon general position, no society speaks abt it.
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9/Honestly, we are 2 years into the pandemic. Politicians f*cked the response in this country. We reached this point that its scary to be in need of healthcare because no matter if for covid or not for covid you'll get a very deficient healthcare.
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8/Where are the reporters? One thing they do is they ask of what is the name of the hospital. Because they want a hot screaming story. IT'S EVERY HOSPITAL! Or most of them. No names. But all these are true facts. Lived by us. Every. Single. Shift.
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2/We have no capacity to care for the sick either from covid or from other things. We do the best we can. But we just cannot care for the amount of sickness with the resources we have. Everything is either deficient or delayed or short or takes time to be found or outdated.
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10/You can believe in whatever you want to believe (vaccines/no vaccines/ivermectin) but no party can save you from dying if you don't get care you need when you need it. If we run around the hospital to find an amp w sugar water it means you may die even from low blood sugar.
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Every friend who recently came back from Europe, got covid 2-3 days after arrival. 5 times vaccinated people. Positive tests for 11-13 days. Every friend who took paxlovid for 5 days got rebound. I know its anecdotal. I just wish our tools worked better.
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Sudden surge of covid in DC. All people around the President are testing positive for covid. Nobody wears masks on most meetings or press conferences. Remember what happened when 1 dem senator had a stroke? Like we can afford any of these ppl to get sick or get long covid.
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A resident comes to a covid patient room. A nurse offers an N95. Resident: Studies showed a surgical mask is just as good as N95.
And goes into the pt room in a surgical mask. What are we teaching residents? They learn disinfo before learning to critically assess garbage studies.
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Florida canceled covid. In the hotel I am in during 5 minutes, I was approached twice as a hotel worker because only hotel workers wear masks.
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An immune compromised friend who lost 2 family members to covid felt unsafe on the plane after boarding as there were maskless people next to him who were visibly congested, coughing & sneezing. My friend left the plane. Maskless freedom comes with freedom to hurt vulnerable.
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5/ Blood supply is low. Some covid patients are bleeding profusely. Last night brain bleed, bowel bleed, hemorrhagic shock from stomach bleed. Blood donation bus came this am to the hospital entrance to collect blood from dead-tired healthcare workers.
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Got some sarcastic msgs saying that covid seems to be gone since I don't tweet abt it. If this needs an explanation, then this: My family comes from Ukraine, Belarus & Russia. I have family in all 3 countries. Now all 3 are in war. In war with each other. Unthinkable.
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A family member of my patient: I didn't realize how bad it was until I came to ICU. Nobody realizes what you guys are seeing & dealing with. If I was you I would have quit a long time ago & started doing nails just to see happy faces all the time, not all this sadness & death.
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3/Deficient of staff, or supply, or drugs, or blood, or lab tests. Ran out of amps with sugar (D50). Why check blood glucose if cannot replace it? Ran out of sterile flashes. Instead of 10 cc they use 3 cc flashes. One hospital has no central lines, the other - midlines.
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Just intubated a reclassified post-covid patient who is no longer covid (hospitalized early Jan) but is a new vent.
A nurse said: The hospital reports a drop in hospitalized covid patients, but patients are going nowhere. Some stay for months.
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Death is not the only covid outcome & survival is not the only goal.
As time goes by, survivors of the initial waves are coming back. Permanent disability, chronic lung failure requiring oxygen, lung scarring, & needing a 🫁 transplant.
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Spending the last couple of days with 30 doctors. All share their suffering from burnout & moral injury. Everyone of them is looking to either go part time or quit medicine completely. The healthcare system acts like doctors are easy to replace. Until there will be no doctors.
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4/Ran out of lab technicians & lab tests. Sent blood for a lab test to be done ASAP, didn't get results for hours. How much time does it take to get a result ASAP? Some lab results never come back. Blood may never be processed, or may be lost. Or nobody is there to do the test.
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An important result of anti-doctor & anti-hospital disinformation of the last 2 years is that people are now scared to come to hospitals. People self-treat symptoms until they are nearly dead & families finally bring them. Every patient I admitted this week stayed home too long.
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An emotional moment today watching nearly ZERO masks in the Ft. Lauderdale airport & being almost the only one masked.
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I know nobody cares anymore & FL is full of cars from all over the country, but today we have 6,790 new covid-19 cases (the most since March 2) & 71 new deaths.
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Just read in a patient's chart in another doctor's note "patient is non-compliant, undocumented and uninsured".
Dear colleagues, I hope you realize that by writing this, you demonstrate your bias, xenophobia, and bad intent.
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Discussing with a new ICU patient a plan of care. The patient is with airway problems & risk of airway closure. Refused all testing & imaging. Said - "I understand you want to do these studies, but tonight I will do my own research". 😳🤯
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This is from a friend written just few hours ago and, of course, this is from one of Florida's ICUs
#GetVaccinatedNow
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Hospital reality: nurses who were called "heroes" just 2 years ago now are bullied by hospital admins bc of low patient satisfaction scores. Apparently, these overworked, understaffed & underpaid "heroes" are told they lack kindness & compassion & it affects patient experience.
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Just started my shift in the ICU where I work per diem just few shifts a month. Yes, this ICU seems to have less covid patients than 1 month ago. But EVERY unvaccinated covid patient I took care of in this ICU a month ago DIED.
#GetVaccinated
#Depressing
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Still no news about the CDC director. Tested positive on the 21st of October, then pax1, then rebound last Sunday, maybe pax2 (who knows). We are at the 2 weeks mark today.
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Masks should have never left healthcare settings😷. Stupid people are making stupid rules. Now patients, visitors, patients family members, & other healthcare workers walk around congested 🤧 coughing & sneezing. Trying not to get sick at work requires an effort 🤦🏻♀️.
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Three years ago today I isolated my first ICU patient with suspected covid. The nurses looked at me with fear & skepticism confirming I was sure of isolation. I was because the patient had severe 🫁 disease similar to what was described by ICU colleagues from China & Italy.
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Nearly 100% vaccinated medical residents are taking care of nearly 100% unvaccinated covid patients. Does it seem fair?
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South Florida. Walgreens. Came for my vaccine appointment. There is a line to get vaccines. All slots are taken. Every person in line is getting COVID-19 booster. Some also get other vaccines (RSV, shingles, flu).
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One friend, who is immunocompromized, just found out he has zero antibody after 3 shots. The other friend with normal immunity also found out he has zero antibody after 3 shots. Did we really need to relax indoor masking? The cases are going down but immunity is waning too.
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Another dude with his always wrong advice 👇🏻. Do the opposite if you want to stay safe!
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7/ We do the best we can with resources we have. But its shitcare & deathcare.
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When I write about vaccines, I get attacked by all kinds of antivaxx/qanon trolls & this is expected. When I write about masks in healthcare, I get attacked by other doctors & this is shocking. I wouldn't choose you as my doctor because you can harm me.
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Working in covid ICU is so damn hard. You come to work after few days off & many of patients w covid (even young & relatively healthy) you cared for DIED during these days. You vividly remember fear in their eyes & their last words before intubating them. Their forever last words
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A non-medical friend (3d ago): how do I get telemed consult? Need antibiotics for sore throat & fever x5d
Me: did u test for covid?
Him: no, I thought I had strep
Me: do covid test
Him: but I am vaxxed & boosted
Me: it doesn't prevent covid
Him (today): checked, positive
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Went to my pharmacy to get my prescription med. A pharmacist said he is the only one working & other staff is out w covid. He is to answer the phone, to serve the line, to fill prescriptions, to give vaccines. If he gets infected - u get it. Make sure you have enough of your meds
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Few wks ago, a friend (also, a HCW) tested + for covid. Later confessed - exposed themselves on purpose to catch covid to be able to dine indoors x 90 days. 🤦🏻♀️🤦🏻♀️🤦🏻♀️
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From a friend: Admitted 9 covid patients during my shift. All are unvaccinated except one who is the only one with mild symptoms. The vaccinated patient is a prisoner & chose to get vaccinated due to high risk of exposure in the facility.
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A former colleague, also an ICU doc, just resigned. Completely burned out. Admins acted ugly trying to make the doc feel guilty for leaving during already bad staff shortages. Hostility is really not the way to keep docs from leaving, but healthcare admins think it is.
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New covid patient 50 yo, no health issues. Patient's son, a hospital worker w a chin mask, cried watching his parent thru the glass ICU doors. I asked the son if he was vaccinated. He looked away. He wasn't. His parent wasn't either. I screamed: " Why?" No answer.
#GetVaccinated
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@dremilyportermd
Adults are playing political games & failing to protect kids & to raise kids by an example. Adult world is a terrible example right now
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Recruiter just called & asked if I can help in Arkansas. And if I know anybody else who can help because the hospital needs at least 6 intensivists now 👀👀👀 we are back to emergency licenses, covid units, outdated machinery, suboptimal staffing ratios.
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Why exactly don't we have this in the US? So much cheaper and easier than Urgent Care & ER visits.
👇🏻
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No professional would debate anything with an uneducated incompetence. Just because one floods the information space with blatant disinformation, doesn't prove this person has experience & expertise to be debated by one of the top world scientists like
@PeterHotez
Peter, if you claim what RFKjr is saying is “misinformation” I am offering you $100,000.00 to the charity of your choice if you’re willing to debate him on my show with no time limit.
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Staff shortages are so bad. Experienced staff shortages are even worse. Patients get sicker, treatments get more complex. We can't take care of complex patients without properly trained nurses. But there are no nurses. Not trained, not untrained.
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There should not be holiday events scheduled at this point especially the ones that require public unmasking (eating, drinking, singing, etc).
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ICU is a complex machinery, pumps, vents, lots of infusions, tubings, catheters that should not be mixed up. It cannot be operated by untrained personnel. It also doesn't function on its own. ICU beds mean all these tools operated by well trained staff not just a bed to sleep on.
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I repeat once again you have no healthcare now. Nothing is available. No elective procedures, no elective surgeries. Until your problem becomes an emergency, you have no healthcare. Once it is an emergency, we do bandaid care or CPR or palliation. How do we get out of this?
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I rarely watch TV, but when I do I am always amazed to see how selective the news coverage is. First, covid disappeared from the news, then the war in Ukraine. Media makers decide what they want people to know.
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6/ A day doc shared that in the other hospital where he worked last week he was escorted to his car by security twice due to threats by angry family members.
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News about Europe being on the way to another surge freezes my heart & soul. It will come to us too. Effing again 😱.
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Today witnessed 270 doctors discuss a statement that natural immunity against any virus may be equal or even superior to vaccine-induced immunity. Shockingly, 30% of these doctors agreed with the statement despite the mentions of polio & other deadly/disabling viral diseases🤦🏻♀️.
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4/ More importantly, we ran out of people. Nurses & RTs keep resigning. Some of the ones that s stay tell me they r just out of orientation, still learning & ask to explain. They lost experienced nurses who used to share & pass their experience. But they do the best they can.
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This is an amazing 🧵 on short & long term effects of covid even in mild cases. Different organs & systems can get affected & permanently damaged. Vascular & neurological effects are terrifying bc maybe permanently disabling. I continue to wear n95 always to avoid this.
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A fully vaccinated ×3 previously healthy friend had a mild nearly asymptomatic covid several months ago & is still with headaches, fatigue, dizziness, near-syncopal episodes & now undergoing full neuro & cardiac work up.
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