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About gangzoom

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  1. Last couple of months with sun the PowerWall is starting to show it's real potential. Essentially since the mid April our house is almost using no grid electricity!! This is my electricity bill for last 30 days. Despite having less than ideal SE/SW solar PV, there are days when we are generating more electricity than we can use. Yesterday at 5pm the PowerWall was at 100%, the EV at 90%, eletric water heater was off because the water was hot and we still ended up exporting 4kWh to the grid!! I estimate half of our reduction in electricity usage is due to not doing so many miles in the car, currently 350 mile a month down from over 1000 miles a month. Some of that is because am doing more miles on the pedal bike, around 200 miles a month, but still it's pretty impressive performance by the PowerWall. If this level sun keeps up our electricity bill for 6 months+ of the year will be crazy low. Our standing charge for electricity is currently triple the cost of our actual electricity usage!
  2. Done more miles on these two than the car since end of Feb. The Trek is nearly 10 years old but still rides like a dream.
  3. Well since its the weekend there isnt much else to do in a situation like this..... I wouldn't be doing my job though without pointing out this isn't the offical coping strategy as outlined by the Intensive care society:).
  4. If you are young (under 40) you will most likely be fine, but it's a numbers game once the infection starts. The more people that get it, the higher the chance someone will get seriously ill:(. Age is a really important risk factor, 70% of our consultant staff (average age 40) who have been in contact with patients has now had it/symptoms, but only 20% of junior doctors have had symptoms (average age under 25). We are actively keeping older staff away from infected zones, it's a case of risk management for most hospitals now, not infection control! Good luck in your work setting, but having clear/flexible leadership is vital at this time. We are changing protocol/practices twice a day sometimes in response to new information/clinical situation, and we certainly aren't waiting on any official guidance if we think action needs to be taken. Look after your staff, your selves and your 'clients' first. Do what you think feels right on the ground, those giving press conferences in government have little idea what's actually needed on the front line, they all still have have half an eye on the next election.
  5. To be honest outside if ITU the so called 'PPE' is next to useless. I have my own eye protection (cycling glasses), and the surgical mask is OK. But the plastic half apron is a joke, and gloves are not any replacement for hand washing. If you do end up with a prisoner with COVID I suspect it'll spread like wild fire just like in hospital regardless of PPE. This virus at times must be airborne not just droplets, we have gone from a few patients infected last week to 20+ now infected, that's despite all staff wearing PPE. If someone is actively coughing than you are in a proper @*!# storm. The PPE we have really is useless at that point, as some coughing is in effect producing an aerosol of virus every few seconds. The only way to stop the spread is proper filter mask, total body protection (including shoes), negative pressure rooms. All of which we lack, even ITU is now running low - Government advice on 'reusing' long sleeve gowns is an utter joke, viral contamination is more likely to occur when taking the gowns off than when wearing them!! For contact with confirmed patients reducing your viral load exposure is vital. So if you have 2 people on a 14 day shift, rather than someone doing 7 days on than off, alternate one day each is much better. In short the best protection is try and make sure no one catches the virus, which is why social distancing/isolation is so important. It's also why once it hit a care/nursing home sadly its game over for half the residents. No amount of non ITU level PPE will protect staff/patients once the virus gets a foot hold :(. Though new case numbers are steady this virus is going to be causing chaos for a while yet. Out ITU is even now running out of dialysis fluid!! We all need to support each other/colleagues through this :).
  6. Looking fowards to 5pm today, apart from Easter Sunday been working/oncall every day since the 3rd. It's been the most stressful stint at work I've ever done. Not necessarily the busiest interms of actual patient numbers, but I've never seen plans/demand change so quickly. Yesterday went from feeling 'relaxed' after seeing COVID+ patient numbers continue to fall, to near full out panic when ITU called and told us they were running out of fluids for their dialysis machines and if we could help. We have gone from having 3 COVID+ patients in the department to now having 2 wards full. I've lost count of the number of COVID+ patients I've seen, wearing PPE is now second nature, I've also lost count of patients who have sadly passed away, can someone make this virus go away now please??? :(. Anyways, 12hrs to go, than having a bottle of wine, may be two :). Bizzarly I've not come down with this virus, three out of 4 colleagues whom have been working with me during the same time period have now tested positive. So either 2 of us are super good/lucky at PPE, or we are the 10-20% of asymptomatic super spreader!!!
  7. 6 kids are now without a mum, and all because they were simply doing their job of looking after people. One of our ITU nurses is now ventilated on ITU .Beyond the figures this is the true cost of this pandemic, can you imagine the fear/anxiety of our nursing staff today!!!Once this is all over the idiot politicians and so called health 'experts' advising the government have alot to answer for. Even now our trust is refusing to give nursing staff full selved gowns because NHS England says it's not needed........All to save 50p per gown, and also to make the politicians look like they have delivered on PPE.Am off to work in a hour, and half considering going by theaters and just grabbing a whole load of long sleeve gowns for our nurses........But as the captain of the Theodore Roosevelt has found out, as ever the importance of image to politicians/those in power is far higher than the actual health of people on front line .
  8. 50% of nursing staff are already in self isolation on some wards, the GMC is anticipating medical students will be used widely for health care delivery by the time we are done with this!! I actually worry quite a bit about the mental health of staff in the coming weeks. Am use to seeing people die in front of me, talking to relatives and dying patients, but even after 15 years+ of doing this, dealing with death isn't 'natural'. Currently we are working on building up reliesence of our staff so they can be prepared for what's coming. But how a group of 18 year old kids, and volunteers who may have never seen any one die is going to deal with potentially seeing multiple death on their first day on the wards is anyone guess. Hopefully things woudlnt be as bad as predicted!
  9. Data from China shows viral load in GI/faeces is fairly low (though only based on a case series from 8 patients), most patients who are COVID+ don't seem to have much detectable viral load from GI tract. The virus is also very unstable once the Ph goes much above 8 to below 6, am not sure what the Ph of sewage is, but I doubt an RNA based virus can survive long. Your chance of catching it from a colleague is probably higher.
  10. I was one of the consultants on call two weeks ago when we first started getting the first confirmed COVID cases in. Since than I've see half a dozen patients whom have now been confirmed with COVID. This week we've been trying to get some mental support in place for staff whom are going to be seeing some horrific scenes in the coming weeks :(. COVID19 case are now going up 30% every day in our hospital, average age of patients with COVID on ITU is only 65 and mortally rate is 50%!! We still have capacity at the moment, but am not looking forwards to been on call next weekend. We are projecting 'peak' demand will hit in 10 days, how long it stays at 'peak' levels no one knows. Only thing I enjoy about work at present is the commute in on the pedal bike, even at Christmas time the main road into town is never this quite!!
  11. Personally I wouldnt wait on any kind of NHS wide policy before taking action to protect your self, your patients, and your staff. The few things we know about this virus so far is quite scary: 1. In a young, not disease burden population the mortality rates is around 2% (Wuhan), but in an older, more co morbid population (Italy) that figure is near 10%. 2. Only 40% of patients initially present with a cough/fever, a large number of patients are 'asymptomatic', how long they stay asymptomatic for is not known, nor the impact of been exposed to increasing viral loads. 3. Social distancing works, so far antibiotics, steroids, antiviral don't. In effect we have no proven medical treatment for this condition. Colleagues in London tell me the hospitals there are already starting to creak, and wouldnt last long if patient numbers keep on going up. Stay safe, stay clean, and we will all get through this. Though the coming months will be hard for everyone.
  12. It's not the media saying we need to turn car factories into ventilator factories, it's our current health minister. Pretty much all of Europe is now in lockdown, with every country now shutting their boarder. Spanish police is using drones to enforce public cufies. This isn't SciFi or hype, it's coming to the UK very soon.
  13. The more remote you are the less likely your see/be in contact with a case. The reasons why politicians, footballers, and Chelsea/Kensington in London have current highest numbers is because these people tend to have more social contact globally than others, and people in Chelsea/Kensington will have a larger golable social circle compared to the rest of the UK population. Here in the UK we are almost exactly matching Italian figures but 2 weeks behind. What's going in Italy will hit us around end of March. The only silver lining is kids don't seem to be effected virtually no deaths recorded. There are some life changing times coming to us all sadly :(.
  14. When this is all over, that will be one of the biggest mysteries for someone to solve :).
  15. I was the most senior medic physically in a reasonable sized hospital when H1N1 (swine flu) reached its peak, I remember to this day the conversation I had with the senior ITU doctor at the time as I sent a 37 year old patient up to ITU with respiratory failure (ARDS) needing ventilation. His exact word were 'That is our last ITU bed, including ventilating in theatres, don't call me for the next one you get, you can try Newcastle (150 miles away) but I doubt they have space, good luck'. That was at 3am, I don't quite know how we made to 9am without another case of ARDS that night. Covid19 is looking roughly 10 times worse demand on ITU/critical care. Here in the UK we are currently almost exactly 2 weeks behind Italy, this is a quote from two Italian Professors involved with the current crisis..... In layman terms, what they are talking about is essentially saying if you are old, have a medical problem already and get Covid19 and come to hospital you will not be given life saving treatment as available resource should be reserved for those who may have better chance for surviving.......... Bare in mind we are not in a Sci-Fi film, and Italy has a BETTER health care system, more ITU beds than the UK, and this statement has been published in the Lancet - one of the best medical journals around. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30627-9/fulltext As I say, here in the UK we are 2 week behind Italy. Managing H1N1, SARAS, Ebola was is like having a 2 week holiday in a 5 star Caribbean resort compared to Covid19. There is a @*!# shower coming, and there is nothing anyone can do about it .





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