Friday, March 13, 2020

A Report From An Italian Doctor - and it is NOT about toilet paper

From World Economic Forum

 

'Every ventilator becomes like gold' - doctors give emotional warnings from Italy's Coronavirus outbreak

Last updated 10 March 2020.
  • Italian doctors are taking to social media to share what it's like to work at hospitals battling coronavirus.
  • One doctor warned against complacency in a country where more than 7,000 people have been infected by COVID-19.
  • The whole of Italy is now under quarantine measures to curb the spread of the virus.
As COVID-19, or the coronavirus, spreads across Europe, responses are mixed. While World Health Organization (WHO) guidance underscores the seriousness of the situation and some employers encourage people to work from home, for many people life simply continues as normal. 

But one doctor who is at the heart of the outbreak in Bergamo, northern Italy, has taken to social media to issue an emotional warning on the reality that could await elsewhere if complacency wins.
At the time of writing, the whole of Italy is under quarantine measures as it battles to contain an epidemic that has infected more than 7,000 people and killed at least 463 in the country. According to the WHO, one-fifth of people infected need hospital treatment - and this could be enough to overwhelm healthcare systems if the epidemic spreads.



coronavirus spread chart
The flattened curve shows how a reduced rate of coronavirus infection could reduce the strain on hospitals
Image: Ester Kim, Carl T. Bergstrom

Dr Daniele Macchini, an Intensive Care Unit physician in Bergamo, a city near Milan, shared his experience of working in a hospital where exhausted staff battle to save patients. His Facebook post was picked up in an Italian newspaper and translated on Twitter by Dr Silvia Stringhini, an epidemiologist and researcher based at the Geneva University's Institute of Global Health. 
Below is the text of the translation, which you can also read in the thread above. As context, 80% of people with coronavirus experience mild symptoms, but an acute form of the illness can lead to life-threatening pneumonia. The elderly are particularly vulnerable.
Dr Daniele Macchini's post, translated by Dr Silvia Stringhini
"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.
"I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.
"I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly 'emptied', elective activities were interrupted, intensive care were freed up to create as many beds as possible.
"All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.
"I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.
"The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.
"The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia. 
"Now, explain to me which flu virus causes such a rapid drama. [post continues comparing Covid19 to flu, link here]. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is 'temporarily' put in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.
"Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.
"Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.
"Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.
"The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask, 'What can I do for you now?'
"Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.
"There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols. 
"Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.
"We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy.
"I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?"


AND ONE MORE THING FROM SNOPES:
https://www.snopes.com/fact-check/trump-fire-pandemic-team/

AND ANOTHER THING (if you saw the mess of a news conference this afternoon: https://www.joemygod.com/2020/03/google-trump-just-lied-about-us-building-a-site/

Wednesday, March 11, 2020

Waters of the Desert

Hubby and I went for a two day vacation down state to Truth or Consequences, New Mexico. (you can google that if you want to know why and when the town took its name from the old TV game show)

Truth or Consequences other claim to fame is its hot springs. There are several "resorts" or places that one can go to to take a good hot soak in hot, steamy mineral waters. Other than that, the town is a rather typical New Mexico town. A bit run down, a bit artsy, a bit touristy, a bit historic, a bit economically depressed.

The Hot Spring business seems to be the main economy. Lots of locals are employed and there are a few restaurants that probably depend on the hot spring tourists. The town is, like so many in New Mexico, "out there" so most people have a substantial drive to get there.

We went to Blackstone Hot Springs where we met up with some friends we knew from Connecticut who had moved to Las Cruces about a year ago. They are only about an hour and a half from T or C.

The rooms at Blackstone are all themed after old TV shows like Golden Girls, Superman, Twilight Zone, Star Trek, Jetsons and others.

Leon and I stayed in the Studio because it was the only dog-friendly room (and of course Benni came along). Our friends had the Wonder Woman room (see photos below).



Each room has its own soaking tub which is filled with hot spring water on demand and drained when you are finished. Seems like such an extravagant waste of water, but I'm assuming the supply is endless.
The resort supplies plenty of towels and bathrobes.

Wonder Woman's Tub

And the grounds as well as the rooms are beautifully done. The sun and shade does not make for good photos, but these are a few shots that are not too bad.

The pergola and deck and other wood work is really nicely done.

And the privacy walls are pretty creative and unique.

Less than three hours from where we live they rarely get a snowflake and there are PALM TREES. Nice change of climate and greenery.

There are also "communal" or private outdoor pools which can be rented by the hour. They will have fresh towels ready and the pool filled when your hour starts and the pool will begin draining when your time is up.

It was a nice get-away and we all had a relaxing stay. We would definitely come back again.

Sunday, March 1, 2020

Rambling Thoughts and Loose Ends

I don't post here very often anymore. Perhaps it's because I don't have a lot to say about anything...at least nothing that anyone would find interesting.

Sure, I could post photos of every loaf of bread I bake or the the King Cake and jambalaya from Tuesday's dinner or the stuffed peppers and stuffed eggplant that I made two weeks ago or pics of Benni, the Dog doing dog things.

Our Mardi Gras was not as Elegant at Russ' and MP's
A View of Cochiti Lake
We took a day trip to Los Alamos (it's only 17 miles from Cochiti if you're a crow, but it's 68 miles (1 hour, 15 minutes) via Santa Fe or 110 miles (2 hour,s 20 minutes via Jemez Springs). The old route via an unimproved and slightly scary Dome Road, was 36 miles but took about 1 hour and 30  minutes).

In other words you can't get there from here (easily).

We stopped at the nearby Valles Caldera - the remnant of an ancient volcano. At over 11,000 feet it has it's own climate.



Moisture on the windshield caused the effect





In Los Alamos Smith's (Kroger's) Supermarket is on steroids. Competing with WalMart, but classier. It has a Pub with Beer on Tap if you aren't interested in shopping with the hubby.

And a whole section for clothing
Back in Santa Fe, near the Frank Ortiz Dog Park is a plaque commemorating those Japanese Americans who were interred in a camp there during World War II. Not many people know that Japanese-Americans were transported to this Santa Fe location and imprisoned for being of Japanese ancestry out of the fear and bigotry that grew out of the attack on Pearl Harbor.


Italian class was going well, so long as we were focused on conversation...I did live in Rome for nine months when I was a Junior in college, a lifetime ago, so started this class with a little knowledge...but when we started to conjugate verbs I got so confused.

I can use the same verbs in various tenses in conversation, but when asked to just conjugate them out of context...that is an exercise in frustration. I'll have one more class next week and then I'll be on my own...unless there will be another "more advanced" class.

Had my annual physical recently and as usual it involved some referrals for updated bloodwork (my bad cholesterol is good and my good cholesterol isn't so good and my triglycerides are high which is status quo for me).

Also got a referral for a ultrasound of my bladder and prostrate (because I mentioned frequent bathroom trips at night).

One of the "nice things about getting older" is I am getting to visit the various medical facilities and clinics in Santa Fe!

Well, the "prep" involved drinking 32 ounces of water 1 hour before the test, which I did. I drove into town and walked into the testing facility unable to hold it any longer. I told the receptionist that I HAD to use the restroom.
"OK," she said, "but just go a little."
"Impossible," I said.

When I was done she gave me two more glasses of water and by the time I was called in for the ultrasound I was at the bursting point again.

Thankfully the "full bladder" test was over within minutes; After a a restroom break I got the "empty bladder" exam. (all the tests came back OK).

But what I got in the mail this week was enlightening. A bill/statement.

Amount charged $ 389.00
Adjustment           $ 342.30
Insurance Paid    $   26.17
Patient Balance     $   20.53

So this is with a Medicare Advantage Plan. The "adjustment" is what the plan has brokered with the provider to just deduct from the bill. So does the provider just eat the $342 or is the charge just an arbitrary, inflated number to make it look like I'm getting a bargain?

If the charge is legit, the service provider is losing a lot of money. People with no insurance presumably pay the full price...and they are subsidizing Medicare/Medicare Advantage.

And just an added level of complexity, there are maybe 10 different Medicare "Supplement" plans offered by each private insurance company that come with a monthly premium that is NOT cheap.

Just saying..."Medicare for All" may not be what it promises to be.

Thursday, February 13, 2020

Laura Pausini e Gilberto Gil - Seamisai / Sei que me amavas

I absolutely LOVE this song. I have Italian ancestry but I think I have a Brazilian soul. Laura Pausini is nice but Gilberto Gil has such a sensual, sexy, enticing voice, he gets right into my romantic groove. I'm including the lyrics and translation as I am studying Italian....The video also has the Portuguese lyrics which have beautiful sound.
Give it a minute to load...it takes some patience....




Seamisai
Laura Pausini 
Songwriters: Alfredo Rapetti / Gil Gilberto / Giuseppe Carella
Seamisai lyrics © Warner Chappell Music, Inc

Non dire no                                        Don't say no  
Che ti conosco e lo so cosa pensi      I know you and I know what you think             
Non dirmi no                                      Don't tell me no
È già da un po'                                   It's already been a some time
Che non ti sento parlare d'amore      That I haven't heard you talk about love or
Usare il tempo al futuro per noi        Using the future tense for us 
 
E non serve ripetere ancora               And there is no use in repeating again
che tu mi vuoi                                      that you love me
Perché ora non c'è quel tuo sorriso    Because now your smile for me
al mattino per me                                 in the morning has gone   
Perché non mi dai più niente di te       Because you give me nothing of yourself now

Se ami sai quando tutto finisce             If you love, you know when it all ends 
Se ami sai come un brivido triste         If you love you know like a sad shudder
Come in un film dalle scene già viste   Like a movie one's already seen   
Che se ne va, oh no                               That fades away, oh no 

 
Sai sempre quando una storia              You always know when a story
si è chiusa                                              has ended
E non si può più inventare una scusa    And one can no longer invent an excuse
Se ami prendi le mie mani                      If you love take my hands
Perché prima di domani finirà               Because before tomorrow it will end 
E non si può                                            And you can't 
chiudere gli occhi e far finta di niente    close your eyes and pretend there is nothing  
Come fai tu quando resti con me            Like you do when you lie by my side


E non trovi il coraggio di dirmi              And you don't have the courage 
                                                                 to tell me
"che cosa c'è"                                          "what's going on"

Sarà dentro di me come                           Inside me it will be
una notte d'inverno perché                       like a winter night because 
Sarà da oggi in poi senza di te                 It will be from now on I'm without you
 
Se ami sai quando tutto finisce                 If you love, you know when it all ends
Se ami sai come un brivido triste             If you love, you know like a sad shudder 
Come in un film dalle scene già viste       Like a movie one's already seen
Che se ne va, oh no                                   That fades away, oh no

Sai bene quando inizia il dolore                You really know when the pain begins
E arriva la fine più una storia d'amore      It comes at the very end of a love story 
Se ami prendi le mie mani                          If you love, take my hands
Perché prima di domani                             Because before tomorrow
Te ne andrai                                                You will go away

Non sarai                                                    You will not be
Qui con me                                                  Here with me

If you love you know

Versions: #1#2#3#4
Don’t say “no”, as I know you and I know
what you think
don’t tell me “no”.
It’s been some time now that I haven’t heard you
talking of love
using the future tense for us
and there’s no use in repeating to me again that you love me
because now that smile of yours in the mornings
has disappeared
because you don’t give me anything of yourself anymore.
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You always know when a story has concluded
and it’s not possible to make up more excuses
if you love, take my hands
as before tomorrow arrives
it’ll be over.
And it’s not possible
to close your eyes and pretend nothing happens
as you try and do when you’re by my side
and you don’t have the courage to tell me what’s going on
inside me it’ll be like a winter
night because
from now on I’ll be without you
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You know very well when the pain sets on
and the end of a love story has arrived
but if you love, take my hands
as before tomorrow arrives
you’ll leave, you won’t be
here with me
https://lyricstranslate.com
English translation
A A

If you love you know

Versions: #1#2#3#4
Don’t say “no”, as I know you and I know
what you think
don’t tell me “no”.
It’s been some time now that I haven’t heard you
talking of love
using the future tense for us
and there’s no use in repeating to me again that you love me
because now that smile of yours in the mornings
has disappeared
because you don’t give me anything of yourself anymore.
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You always know when a story has concluded
and it’s not possible to make up more excuses
if you love, take my hands
as before tomorrow arrives
it’ll be over.
And it’s not possible
to close your eyes and pretend nothing happens
as you try and do when you’re by my side
and you don’t have the courage to tell me what’s going on
inside me it’ll be like a winter
night because
from now on I’ll be without you
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You know very well when the pain sets on
and the end of a love story has arrived
but if you love, take my hands
as before tomorrow arrives
you’ll leave, you won’t be
here with me
https://lyricstranslate.com
English translation
A A

If you love you know

Versions: #1#2#3#4
Don’t say “no”, as I know you and I know
what you think
don’t tell me “no”.
It’s been some time now that I haven’t heard you
talking of love
using the future tense for us
and there’s no use in repeating to me again that you love me
because now that smile of yours in the mornings
has disappeared
because you don’t give me anything of yourself anymore.
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You always know when a story has concluded
and it’s not possible to make up more excuses
if you love, take my hands
as before tomorrow arrives
it’ll be over.
And it’s not possible
to close your eyes and pretend nothing happens
as you try and do when you’re by my side
and you don’t have the courage to tell me what’s going on
inside me it’ll be like a winter
night because
from now on I’ll be without you
If you love you know when everything is over
if you love you know, like a sad shudder
like a film whose scenes you’ve seen before
and that it’s going away now, oh no!
You know very well when the pain sets on
and the end of a love story has arrived
but if you love, take my hands
as before tomorrow arrives
you’ll leave, you won’t be
here with me
https://lyricstranslate.com

Give Us Our Daily Bread

One thing about not being able to sleep past 2 AM is that I get to make dough.

Rather than lay in bed and contemplate the ceiling or try to rub my sore back (Am I too old to be shoveling snow?) I finally got up, got dressed and went to my office - the kitchen.

Leon had mentioned cinnamon rolls...actually a co-worker of his was asking, so I woke up thinking about cinnamon rolls.

One not so good thing about not having a "recipe" is that when something comes out exceptionally well, you have no way of replicating it exactly.

My cinnamon rolls this morning were quite exceptional. I think I used a teaspoon of yeast in 1/2 cup water and 1/3 cup sugar; let that set for a few minutes, added a teaspoon of salt and a cup of gently warmed milk (2%) a half stick to 2/3 stick of butter, softened and enough flour (?) to make a soft dough. Beat it up, kneaded it gently and let it rise for an hour.

Then I formed the rolls by making a "rope" about 6-8 inches long, dipped each in melted butter and dredged them in cinnamon sugar, formed a spiral and placed them on a baking sheet and into a 375 degree oven for 20+ minutes.

After they cooled just a bit I frosted them with a thick confectioner sugar/water/orange extract mix.

Exceptional!



Then it was on to the bread. Actually I started the bread dough while the cinnamon rolls were rising.

I will say I am getting better every time I make bread. This morning I used 3 1/2 large coffee mugs of water, 2 teaspoons of yeast, a little sugar, salt and I mixed in a cup of whole wheat pastry flour with the King Arthur all purpose.

Those bread snobs who weigh everything: the water, the yeast, the flour. And they calculate the percentages of water to flour to yeast and salt. I have a kitchen scale but I think I would break it if I weighed my ingredients.

Besides, I've watched old Italian women on YouTube make bread in a large trough which probably holds twenty-five pounds of flour.

I think they take turns making bread for the entire neighborhood in one huge wood-fired oven that is prepared ahead and heated to probably over 900 degrees. It holds maybe 30 or more loaves of bread.

I don't have a wood-fired oven, but I heat mine to 475 degrees and place a large roasting pan with about 1/2 inch of water on the bottom of the oven and allow that to heat to steam point.

I brush my loaves with water and sprinkle on sesame seeds (cuz I like the flavor they impart) before taking them to the oven. The bread is done in 20 to 25 minutes.

Exceptional! If I do say so.

Insomnia bread. I beats tossing and turning.





Wednesday, February 12, 2020

Yesterday's Snow Will Be Tomorrow's Mud

How many times have I mentioned that one reason we moved to New Mexico was to get away from the snow in New England. Yesterday it found us.

We got hammered in our little village,but of course there was no snow at all in most of Albuquerque and friends in Santa Fe said they only had about an inch, most of which was gone by noon. 

Our share was 6 to 8 inches and will be around for a while. 

Then will come the MUD. I don't mind hiking with the dog in snow, but MUD here is another thing altogether. It's more like concrete, or should I say, more in keeping with the locale, adobe.  

Another day for that, but for now we're enjoying the white stuff.









For more pics see Benni's Blog

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