My experience is it seems we are losing more patients % wise here than even from beginning. We lost 4 over weekend and just called for another dying. Despite full cocktail Rx. The amount of deaths has kept our ICUs from being overloaded. Don't want to be alarmist / negative but feel I must be full disclosure.

Just a thought.

Perhaps this is a factor of better treatment early on allowing more patients to recover prior to going into ICU that were previously going into ICU and recovering there. In other words ICU is handling a higher percentage of the most desperate cases now which would likely increase the percentage of patients that are lost.

If this reasoning is sound, it could also point to a success in keeping cases out of the ICU that were previously taking up spots that can now be used for the most desperate cases.

My perception has been that our mortality from the acute COVID-19 cytokine storm has improved, but I've been seeing A LOT of post-COVID staph aureus pneumonia (MSSA and MRSA) the last several weeks that's been killing several patients. Got a guy right now whose on vanc + ceftaroline and still bacteremic with MRSA from his necrotizing pneumonia, he's probably going to end up having endocarditis. Pretty young, too.

Also a couple post-COVID aspergillosis cases which is unsettling.

Cytokines or other complications? Thrombosis issues?

Still primarily leaning heavily towards the elderly side on the deaths?

Marcus Aurelius said:

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My experience is it seems we are losing more patients % wise here than even from beginning. We lost 4 over weekend and just called for another dying. Despite full cocktail Rx. The amount of deaths has kept our ICUs from being overloaded. Don't want to be alarmist / negative but feel I must be full disclosure.

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I'm curious what you think the best approach for the country is at this point. Since you have been battling this first hand and have seen the roller-coaster of good and bad, what should we be doing as a society? Are masks and current social distancing enough or would you like to see additional closures? I think you said previously you had a kid that was starting football practice - do you think our children should be going back to school?

I truly value your opinion and appreciate everything you share on this board.

Marcus Aurelius said:

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My experience is it seems we are losing more patients % wise here than even from beginning. We lost 4 over weekend and just called for another dying. Despite full cocktail Rx. The amount of deaths has kept our ICUs from being overloaded. Don't want to be alarmist / negative but feel I must be full disclosure.

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Has the ICU admittance criteria changed at all? I believe more people in the general population currently have Covid, and drive death totals up, but that shouldn't change the % of ICU patients who die unless ICU admittance criteria is more strict due to occupancy concerns.

two steps forward...two steps back. this is very disappointing.

hardly seems worth the effort if we are going to see a lot of post-covid deaths due to complications of the virus.

Wear a mask, peeps. Vaccine(s) is likely just a few months away.

The superinfections happening in ICU or post DC? I assume in pts that were given toci + steroids. Or heaven forbid has this been in outpts that did not require inpt therapy? That would really be trouble.