China Corona Virus Outbreak

[pubert]

Wala pa ba dito nagpa vaccine sa NCR local govt na hinde HCW?

Me and my dad have availed through the Manila LGU on separate events/venues

My Dad as an A2 category: senior citizen - only requirement was the pre-registration waiver/QR code and his senior citizen card (although I was told that they allowed others to register on site)

Me as an A3 category: people with comorbidities - requirement was pre-registration waiver/QR code and document proving comorbidity (even a recent prescription for your maintenance meds will do, there's a list of valid documents, although going through the process, no one asked for the documents i brought)

My dad was vaccinated with Astrazeneca at Paraiso covered court in Sta. Mesa, the process was fairly straightforward, but my only complaint was that it was fairly crowded, they did have some social distancing, but there was space to make things better.

I had mine a few days later at EARIST school in Nagtahan, after i saw that they will be vaccinating A3 category the night before. Here social distancing was easier and ventilation was much better. They seem to be more organized here too.

The process was fairly simple:
Step 1: they get your vital signs, and fill up a small form with name and some details. (in my case, my BP was a bit high so i had to wait a bit, get another check before i was cleared)
Step 2: assessment (in our case, this was the bottleneck and I was in line for about ah hour and a half here). this is where they scan and collect the pre-registration waiver and QR code, then give and interview to check if you have been exposed or have symptoms, and what to expect after vaccination.
Step 3: the actual vaccination, this was done within a few minutes. They fill up your vaccination card with the vaccine brand, serial numbers and person who injected you - as well as the schedule for your second dose.
Step 4: observation - you are kept in an observation area for 15 mins, then you are called, informed of what side effects to look out for and then sent home.

Neither of us felt any side effects after the first dose.

My dad got astrazeneca March 29 and scheduled for a second dose for May 25
I got sinovac March 31 and scheduled for a second dose on April 28

[_Cathy_]

Sobrang efficient ng city of Manila! What a huge difference talaga kapag maayos leadership. We won't be in this such deep sh1t if we did not have that psycho as president!

Post ng cardio ng Dad ko (from TMC) I am crying kasi mixed emotions ng fear, anger, sadness, hopelessness, awa (for the families and frontliners)

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WE HAVE BREACHED THE LINE. NOW WE MUST ASK, WHO DESERVES THAT BED

As the COVID-19 surges and overwhelms the healthcare system, what are the chances of surviving or dying when hospital beds are no longer available, breathable air is running out, and the HCWs – the ones left – are beside themselves staring helplessly at life as it fades away? What choices are there to be made? What difficult conversations must we finally have?

Dr. Jose Emmanuel Martin Palo, director of the Acute and Critical Care Institute of The Medical City, writes about the hardships and the burden that his team carries and why it is about time "to have a frank conversation" with the patients as well as those in the frontlines “about what to expect when fighting the disease at its worst, and about choosing how or even when to fight."
__________________________________________________ ______________________________
The Last Line in the Sand
By Jose Emmanuel Martin Palo, MD
Director, The Medical City Acute & Critical Care Institute

Last year, already in the thick of the pandemic crisis, one of our unpublicized initiatives was “The Last Ventilator” project. A multidisciplinary group of medical leaders, acute care specialists, palliative care experts and ethicists worked on policies to guide frontline clinicians on how to assign the very last life-saving breathing equipment when there was more than one candidate. We examined the practices of other countries, statements from relevant organizations, searched our own organizational and personal values before finalizing the guidance.

We never had to activate the policy. But there were echoes of these kinds of terrible choices that still reached us: a family choosing which parent to devote resources to and attempt to save, a ventilator being disinfected for reuse after being promptly disconnected from a patient whose family had chosen to discontinue life support. Much is written about the loneliness of hospitalization and the all-too-common possibility of dying among strangers. There is less that is written about an organization or a clinician who needs to choose which person to try to save – or the consequences of those choices. It is easy to imagine what happens to the patient, but not to the family or the clinician that makes these choices.

A year in, and we are facing a surge that far outstrips our capacity to serve. The assignment of the last invasive ventilator is not even the relevant question anymore – it is the assignment of the last bed that can be used to administer oxygen. Patients with pneumonias are being turned away from many hospitals even at the emergency departments. As director of Acute and Critical Care and a practicing intensivist, my greatest fear is now true: we will fail our mission to save many of the save-able.

So, I feel, besides making the common appeal to practice the most basic of self-protections against COVID-19 disease, it is time to have a frank conversation with the patients my team serves, as well as our colleagues in the frontlines – about what to expect when fighting the disease at its worst, and perhaps, about choosing how or even when to fight.

When COVID-19 ravages a body, the first indication of serious disease is a failure of the respiratory system. Besides the administration of steroids and special drugs to try and tame inflammation, respiratory support requires increasing amounts of oxygen, then oxygen under pressure, then mechanical ventilation in various modes. Some patients are ventilated prone, some are medically paralyzed, and the worst even require oxygenation of their blood outside their body in special heart-lung machines.

Many have problems with blood pressure regulation requiring continuous infusions of adrenalin-like drugs and many have kidney failure needing dialysis. It requires a team of experts and all of the critical care armamentarium to fight it in this form. And it is really, really hard to win. Each step is more invasive than the one before, and yet deterioration is common, sudden, and too frequently fatal. The word I use to describe this disease is “traitorous.” I have been able to inquire after a few survivors, asking about how they did after their ICU stays. There aren’t many to follow-up with.

Recently, the Society of Critical Care Medicine released the results of their global registry, comprised of more than 20 000 patients with COVID-19 disease requiring some form of life-saving organ support. In it, we find that almost half of patients that require a ventilator die. And less than a third survive if requiring additional forms of support. This reflects our own early experience, but besides this, we found that less than 1 out of 6 of those above 75 makes it out of the ICU. And that no one above 80 had done so. This, in spite of the resources of the most advanced ICU in the Philippines, that is equal to any abroad. This, in spite of the unavoidable suffering that we hope is only temporary in the fight for survival. In the face of this, it is not right to continue to offer advanced care for all. The value of critical care lies in saving those who would die without advanced care, and we find here that for many of our frailest elderly it did not make a difference.

Therefore, choosing to limit invasive care in favor of comfort care and dignified palliation is a path that can be chosen. Instead of the machines and medicine to support failing organs, medicines to take away the breathlessness and pain. Instead of the hospital, home when possible. Instead of doctors, nurses and other strangers, family. This is a different kind of “hard” – and many will have a difficult time accepting such an idea. Many of us in healthcare are all too often driven by a need to do “all that can be done” even absent a valued outcome. But I suspect that patients themselves would like to have control over their choice of strategy.

So, this is a call for everyone to start having these difficult conversations, to define for ourselves what is most important to us, and the lines in the sand we do not wish to cross. To say, “I will go this far, but no further.” And to let our loved ones know. Because too many are stricken and lost without even the opportunity for clarity, and we are far from the end of this continuing tragedy.

It is very, very hard to win. For those that choose to fight, we at the EDs and ICUs will continue to do our work, to the best of our ability and for as long as we are able. But for those that choose a gentler path, the acceptance of human limits and our common mortality may not mean losing at all.

[shadow]

Me and my dad have availed through the Manila LGU on separate events/venues

My Dad as an A2 category: senior citizen - only requirement was the pre-registration waiver/QR code and his senior citizen card (although I was told that they allowed others to register on site)

Me as an A3 category: people with comorbidities - requirement was pre-registration waiver/QR code and document proving comorbidity (even a recent prescription for your maintenance meds will do, there's a list of valid documents, although going through the process, no one asked for the documents i brought)

My dad was vaccinated with Astrazeneca at Paraiso covered court in Sta. Mesa, the process was fairly straightforward, but my only complaint was that it was fairly crowded, they did have some social distancing, but there was space to make things better.

I had mine a few days later at EARIST school in Nagtahan, after i saw that they will be vaccinating A3 category the night before. Here social distancing was easier and ventilation was much better. They seem to be more organized here too.

The process was fairly simple:
Step 1: they get your vital signs, and fill up a small form with name and some details. (in my case, my BP was a bit high so i had to wait a bit, get another check before i was cleared)
Step 2: assessment (in our case, this was the bottleneck and I was in line for about ah hour and a half here). this is where they scan and collect the pre-registration waiver and QR code, then give and interview to check if you have been exposed or have symptoms, and what to expect after vaccination.
Step 3: the actual vaccination, this was done within a few minutes. They fill up your vaccination card with the vaccine brand, serial numbers and person who injected you - as well as the schedule for your second dose.
Step 4: observation - you are kept in an observation area for 15 mins, then you are called, informed of what side effects to look out for and then sent home.

Neither of us felt any side effects after the first dose.

My dad got astrazeneca March 29 and scheduled for a second dose for May 25
I got sinovac March 31 and scheduled for a second dose on April 28

What time nag open vaccination site?


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[ale828]

Wala pa ba dito nagpa vaccine sa NCR local govt na hinde HCW?


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I got a schedule for tomorrow.

If i start praising china or speaking mandarin, you know what to do. hehe

[_Cathy_]

What city? I'm thinking if I should register, sa LGU kasi Astra e I want Pfizer or Moderna. Buti pa sa private companies may moderna daw for employees

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[mokong22]

Wala pa ba dito nagpa vaccine sa NCR local govt na hinde HCW?


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Ako bro im not HCW pero na vaccine ako astra last march 30 sa lgu, pinasa lang ng wife ko sakin vaccive nya sa lgu kasi tatlong vaccine kasi naka allocate sa kanya, 2 municipality and 1 private hospital, eh 3 weeks ago na vaccine na sya sa isang lgu, so sakin na binigay yung isa, pumayag naman lgu

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[shadow]

What city? I'm thinking if I should register, sa LGU kasi Astra e I want Pfizer or Moderna. Buti pa sa private companies may moderna daw for employees

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Register. Wala naman mawawala eh kung hinde ka pumunta. I'm already registered in 3 cities. [emoji1363] bago mag react Yes, resident ako ng 3 cities.

Yan sinasabi ko magulo itong group na comorbs. Dapat kasi by appointment na lang I text nila kung sino lang naka schdule para hinde mahaba pila. Dami daw tao sa manila saka.haba ng pila inaabot yun iba ng 5 hours then daming sumisingit.

Ang bilis lang kumuha ng medical certificate, actually pwede na ako pumunta sa manila kaso natakot ako sa haba daw ng pila, I'll see next week kung ano situation pag magulo pa rin Intay ako sa isang city na mas konti population saka mas organized or kung wala sa federation na lang antayin din.

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[shadow]

Ako bro im not HCW pero na vaccine ako astra last march 30 sa lgu, pinasa lang ng wife ko sakin vaccive nya sa lgu kasi tatlong vaccine kasi naka allocate sa kanya, 2 municipality and 1 private hospital, eh 3 weeks ago na vaccine na sya sa isang lgu, so sakin na binigay yung isa, pumayag naman lgu

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Sa Province yan probably. I don't think papayagan dito sa NCR yun ipasa sa relatives.


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[mokong22]

Sa Province yan probably. I don't think papayagan dito sa NCR yun ipasa sa relatives.


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Yes province bro, hindi talaga pwede yun ipasa ang vaccine pero nakuha sa pakiusap, alam mo naman na dito satin sa pinas

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[shadow]

Yes province bro, hindi talaga pwede yun ipasa ang vaccine pero nakuha sa pakiusap, alam mo naman na dito satin sa pinas

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IMO ok lang yan basta first degree tapos HCW pa asawa mo yata. So dapat pati family ng mga HCW unahin pera hinde na sila mag worry na pag uwi eh sila magdala ng virus sa pamilya nila.


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[mokong22]

I got a schedule for tomorrow.

If i start praising china or speaking mandarin, you know what to do. hehe

Problem hindi marunong mag mandarin mga filipino chinese satin, baka pwede na fukyen chinese,

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[pubert]

What time nag open vaccination site?

I arrived 7:45am and there were already about 40 people ahead of me. The line started moving probably around 8:30am...

[shadow]

I arrive 7:45am and there were already about 40 people ahead of me. The line started moving probably around 8:30am...

Hinde mahaba pila ah. Saan ulit yan?


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[c_cube]

24.2% Ang taas!

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[shadow]

24.2% Ang taas!

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Kasi konti testing natin.


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[_Cathy_]

Register. Wala naman mawawala eh kung hinde ka pumunta. I'm already registered in 3 cities. [emoji1363] bago mag react Yes, resident ako ng 3 cities.


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Normal naman yan ginagawa ng karamihan, multiple registration tapos kung ano na lang mauna. Sana hindi ginive up ng grandparents ko property sa Manila, ang efficient kasi ng Manila LGU. Dapat kasi sa US ako pa vaccine e ngayon takot na ko mag fly ng walang vaccine. Bwiset na china virus. Naiinis tuloy ako kasi wala akong work, maganda vaccines for employees

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[pubert]

Hinde mahaba pila ah. Saan ulit yan?

mahaba pa din.. pero everyone was seated in monoblock chairs with reasonable distancing. went through step 1 and 3 fast... step 2 (yung assessment) yung bottle neck and it took me more than an hour and a half para lagpasan to. This was at the EARIST high school in Nagtahan

[BratPAQ]

24.2% Ang taas!

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The number of tested, number of positive and percentage of positive doesn't add up?


12576/33800 isn't 24.2%. Pano ba computation nyan? Does the 12576 includes some from previous days?

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[bloowolf]

Buti pa ito, 100% effective. Ito na lang kaya iturok satin? Anyway, maaaprobahan na naman Ivermectin

Russia registers 'world's first' COVID-19 vaccine for animals | Philstar.com


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[Deestone]

Is there countries that are now back to normal? Or at least close to normal (pre pandemic days) because we know that covid will stay forever.

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