COVID Diary

4/3 Team Defense 2

My colleague Mike Rayo followed up Team Defense is about Help basketball metaphor with his own from volleyball. He writes: “Sports give us plenty of guidance about teamwork, which we need right now! We need to think of ourselves as #TeamUSA, and we’re all suiting up. One important lesson comes from volleyball: You never call […]

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3/31 Team Defense 1

Team Defense is based on a system of help In the March 30, 2020 webinar on Resilience Engineering and Covid-19 pandemic, a colleague asked how should society make the trade-off between the consequences of massive economic disruption versus the aggressive actions needed to turnaround virus transmission, reduce hospital overload, and minimize fatalities. As is always

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3/28 beyond-surge capacity

Adapting when faced with a beyond-surge capacity incident is essential for effective disaster response.  Studies of sudden-onset, no-notice disaster show that emergency departments and hospitals engage in a massive ad hoc effort to generate adequate resources. They have to mobilize and reconfigure response capacity despite overload, uncertainty, and time pressure. The hospital’s ability to adapt

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3/20 Decompensation

Another three-way conversation recorded From a colleague with family in Madrid: “I think it is very good that Ohio moved very swiftly; this was not the case in Madrid and the consequences are apparent. It is also shocking how fast everything happened… almost no issue by the beginning of the spring break, but major issues

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3/19 Reciprocity

I think there is a basic confusion between stopping the current outbreak and what is the long term, endemic, state of the virus, interventions, and risks associated with the virus.  We are in ‘stop the outbreak’ urgency while coping with the outbreak’s consequences for at risk groups. Some of the confusion is due to multiple

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3/18 shortages

Another 3 way conversation recorded Protective gear shortages: Ohio Governor’s briefing says insufficient protective equipment (PPE) in state and actions to “conserve” supplies. A colleague just got a story from a nursing friend: all the nurses received their ONE paper bag last night with their PPE in it which they were instructed to “reuse” for

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3/14 Getting slammed

Looking at the  Italian doctors interview about his ICU getting slammed and trying not to be overwhelmed by the surge.   A lot of the stuff we talk about in general is evident in his experiences.  It also parallels our study of a mass casualty response – the clinicians adapt to somehow make up a

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