1xbet
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
1xbet-1xir.com
betforward
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
betforward.com.co
yasbetir1.xyz
winbet-bet.com
1kickbet1.com
1xbet-ir1.xyz
hattrickbet1.com
4shart.com
manotobet.net
hazaratir.com
takbetir2.xyz
1betcart.com
betforwardperir.xyz
betforward-shart.com
betforward.com.co
betforward.help
betfa.cam
2betboro.com
1xbete.org
1xbett.bet
romabet.cam
megapari.cam
mahbet.cam
1xbetgiris.cam
betwiner.org
betwiner.org
1xbetgiris.cam
1xbet
1xbet
alvinbet.site
alvinbet.bet
alvinbet.help
alvinbet.site
alvinbet.bet
alvinbet.help
1xbet giris
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
1xbetgiris.cam
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
pinbahis.com.co
betwinner
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
betwiner.org
1xbet
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
1xbete.org
betforward
betforward
betforward
betforward
betforward
betforward
betforward
betforward
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
betforward
betforward
betforward
betforward
betforward
betforward
betforward
betforward
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
yasbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1xbet
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
1betcart.com
betcart
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی
بهترین سایت شرط بندی ایرانی

Global Statistics

All countries
695,781,740
Confirmed
Updated on September 26, 2023 9:04 pm
All countries
627,110,498
Recovered
Updated on September 26, 2023 9:04 pm
All countries
6,919,573
Deaths
Updated on September 26, 2023 9:04 pm

Global Statistics

All countries
695,781,740
Confirmed
Updated on September 26, 2023 9:04 pm
All countries
627,110,498
Recovered
Updated on September 26, 2023 9:04 pm
All countries
6,919,573
Deaths
Updated on September 26, 2023 9:04 pm

Do You Want to Die in an I.C.U.? Pandemic Makes Question All Too Real

City of Cape Town urges people to leave Kataza the baboon alone

Kataza the baboon. Facebook / Baboon Matters The City of Cape Town has asked the public not to feed a baboon that has relocated to Tokai. The baboon, known as Kataza or SK11, is slowly being integrated into the Tokai troop. Video footage, however, shows humans feeding Kataza. The City of Cape Town has requested that Kataza…

Rassie: There are various benefits for SA rugby to go north

As SA Rugby moves to determine which franchises will go to Europe in future, Rassie Erasmus has noted several potential benefits for the local game should that route be followed.The national director of rugby believes the high world rankings of Wales, Ireland and Scotland mean PRO Rugby is competitive and that fans will eventually identify…

A Once-in-a-Century Climate ‘Anomaly’ Might Have Made World War I Even Deadlier

(John Finney Photography/Moment/Getty Images) An abnormally bad season of weather may have had a significant impact on the death toll from both World War I and the 1918 Spanish flu pandemic, according to new research, with many more lives being lost due to torrential rain and plummeting temperatures. Through a detailed analysis of an ice…

PICS | Truck driver killed in Pinetown after truck ploughs into several cars

A vehicle that was hit in the accident. A truck driver was killed in a horrific sequence of events following an initial crash in Pinetown. While trying to move the truck after the accident, it appeared to lose control. He died after falling out of the truck which ploughed into several cars and a wall.A truck driver…

42 people in court for R56m police vehicle branding scam

Forty-two people have been implicated in a police car branding scam. Forty-two people have been arrested for their alleged involvement in a police vehicle branding scam. They face a range of charges including corruption, fraud, money laundering, theft and perjury.Of these, 22 are serving police members.Forty-two people are set to appear in the Pretoria Magistrate's Court on…

a third to two-thirds of adults haven’t drafted advance directives, the documents that outline which medical treatments they would accept or refuse and designate a decision maker to act on their behalf if they’re incapacitated.

“People think, I’ll deal with it in the future,” Mr. Banach said. But for thousands of older adults, the future may have arrived.

To date, there’s no clear evidence that older people are more apt to contract the new coronavirus, said Dr. Douglas White, a critical care specialist and the director of the Program on Ethics and Decision Making at the University of Pittsburgh School of Medicine.

“What we do know is that older individuals are more likely to experience very severe disease if they do become infected,” he said. “The data are sobering.”

That’s partly because most older adults have chronic conditions — heart or lung disease, diabetes, high blood pressure — known to intensify the virus’s effects. And they have less physiologic reserve — “less ability to rebound from an overwhelming illness,” Dr. White explained.

When seniors and their families engage in what’s called advance-care planning, they often focus on the D.N.R. question — whether patients would want to be resuscitated after cardiac arrest.

But because Covid-19 is a respiratory disease, the more pressing question will likely be whether a hospitalized patient who’s seriously ill will accept intubation and ventilation.

That initially involves a tube inserted down the throat, connected to a ventilator that pushes air into the lungs. When a patient has spent two weeks on a vent, doctors commonly perform a tracheostomy, creating a surgical opening in the windpipe that replaces the swallowed tube.

Long before the virus erupted, among people over 66 who spent 14 days in an I.C.U. on a ventilator, 40 percent died within a year of discharge. Now, “those numbers are too rosy for Covid,” Dr. White said, citing findings from Italy and Britain, where more than half of older patients on prolonged ventilation died.

A just-published JAMA article looked at coronavirus patients admitted to Northwell Health hospitals in and around New York City. Excluding those still hospitalized after the monthlong study, the mortality rate among patients over age 65 exceeded 26 percent, and almost all patients over 65 who needed mechanical ventilation during that period died.

That data can prompt frank exchanges. “If a patient is elderly and has significant medical issues, I’ll explain that a large proportion of people who become ill with Covid-19 and need a ventilator unfortunately will not survive,” said Dr. Kosha Thakore, the director of palliative care at Newton-Wellesley Hospital in Massachusetts.

Moreover, longevity is not the only priority, and sometimes not the primary one, for older people considering medical options. What will life look like if they do survive?

“After elderly people have been on a ventilator, they’ve often already developed physical debilitation, difficulty swallowing, bedsores,” Dr. Thakore explained. They frequently cycle in and out of hospitals with complications. Their deficits can be physical or cognitive or both, and are often permanent.

Even pre-Covid, after 14 days on a ventilator in an I.C.U., only about one in five older discharged patients went home. “The others end up in nursing homes,” Mr. Banach said. “Some may later go home, and some will die in the nursing home.”

Though older adults with Covid-19 may not require hospitalization or ventilation, the decisions they face if they do highlight the importance of reviewing advance directives.

A new study in JAMA Internal Medicine questioned 180 patients over age 60 with serious illnesses; most said they would trade a year of life if that meant they could avoid dying in an I.C.U. on life support.

But that kind of aggressive care is exactly what they might receive. “If you don’t let the system know your wishes, the system takes over,” Mr. Banach pointed out. Family members can feel lingering trauma if they’re forced to make life-or-death decisions for loved ones who never discussed what they wanted.

“Many older patients we’ve encountered with Covid-19 have opted not to undergo ventilation and an I.C.U.,” Dr. White said. “No one should impose that on a patient, though if there’s true scarcity, that may arise. But patients might choose it for themselves.”

If older people have paperwork stashed in a drawer or safe, now is the time to unearth it and see if their instructions still reflect their values. If so, scan the document and send it to family members and doctors, Mr. Banach advised.

But for those who never got around to drawing up advance directives, appointing a decision maker — and telling that person what’s acceptable and what’s not — is ultimately more crucial. In emergencies, doctors probably won’t flip through documents to learn patients’ wishes; they’ll ask family or friends.

Mr. Banach’s counsel: “Take out your phone and do a video selfie: ‘This is who I am. This is the date. This is what I want.’ Send it to your friends and relatives. That’s enough.”

Many hospitals and health systems have developed workarounds when documents require signatures or witnesses; some are also doing palliative-care visits via telemedicine.

Dr. Gregg VandeKieft, a palliative care specialist with Providence Health on the West Coast, recently spent half an hour on Zoom talking with a patient’s sons about her end-of-life care. Dr. VandeKieft and a nurse were in Olympia, Wash.; one son was in Alaska and two elsewhere in Washington. “It felt not all that different than if we’d been in the same room,” Dr. VandeKieft said.

The coronavirus pandemic may spur more such conversations. In Los Angeles recently, Brie Loskota and her husband contacted close family friends, a couple in their 70s, asking about their well-being, offering to FaceTime, and then inquired: “If you got sick, is there anything we should know?”

The older couple, one of whom has a neurodegenerative disease and has already experienced mechanical ventilation, responded that they both wanted to avoid hospitalization and to die at home.

“It was a relief to be told,” said Ms. Loskota. “It’s not less heartbreaking, but it lets us make a decision with them in mind. It led my husband and me to talk about it for ourselves.” They’re in their 40s and have not yet drafted advance directives.

  • Updated April 11, 2020

    • When will this end?

      This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.

    • How can I help?

      The Times Neediest Cases Fund has started a special campaign to help those who have been affected, which accepts donations here. Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)

    • What should I do if I feel sick?

      If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.

    • Should I wear a mask?

      The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.

    • How do I get tested?

      If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.

    • How does coronavirus spread?

      It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.

    • Is there a vaccine yet?

      No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.

    • What makes this outbreak so different?

      Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.

    • What if somebody in my family gets sick?

      If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.

    • Should I stock up on groceries?

      Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.

    • Can I go to the park?

      Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.

    • Should I pull my money from the markets?

      That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.

    • What should I do with my 401(k)?

      Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”


Read More

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Hot Topics

City of Cape Town urges people to leave Kataza the baboon alone

Kataza the baboon. Facebook / Baboon Matters The City of Cape Town has asked the public not to feed a baboon that has relocated to Tokai. The baboon, known as Kataza or SK11, is slowly being integrated into the Tokai troop. Video footage, however, shows humans feeding Kataza. The City of Cape Town has requested that Kataza…

Rassie: There are various benefits for SA rugby to go north

As SA Rugby moves to determine which franchises will go to Europe in future, Rassie Erasmus has noted several potential benefits for the local game should that route be followed.The national director of rugby believes the high world rankings of Wales, Ireland and Scotland mean PRO Rugby is competitive and that fans will eventually identify…

A Once-in-a-Century Climate ‘Anomaly’ Might Have Made World War I Even Deadlier

(John Finney Photography/Moment/Getty Images) An abnormally bad season of weather may have had a significant impact on the death toll from both World War I and the 1918 Spanish flu pandemic, according to new research, with many more lives being lost due to torrential rain and plummeting temperatures. Through a detailed analysis of an ice…

Related Articles

City of Cape Town urges people to leave Kataza the baboon alone

Kataza the baboon. Facebook / Baboon Matters The City of Cape Town has asked the public not to feed a baboon that has relocated to Tokai. The baboon, known as Kataza or SK11, is slowly being integrated into the Tokai troop. Video footage, however, shows humans feeding Kataza. The City of Cape Town has requested that Kataza…

Rassie: There are various benefits for SA rugby to go north

As SA Rugby moves to determine which franchises will go to Europe in future, Rassie Erasmus has noted several potential benefits for the local game should that route be followed.The national director of rugby believes the high world rankings of Wales, Ireland and Scotland mean PRO Rugby is competitive and that fans will eventually identify…

A Once-in-a-Century Climate ‘Anomaly’ Might Have Made World War I Even Deadlier

(John Finney Photography/Moment/Getty Images) An abnormally bad season of weather may have had a significant impact on the death toll from both World War I and the 1918 Spanish flu pandemic, according to new research, with many more lives being lost due to torrential rain and plummeting temperatures. Through a detailed analysis of an ice…