We’re seeing more COVID patients in ICU as case numbers rise. That affects the whole hospital

Deb Massey, Southern Cross UniversityRising COVID cases in several Australian states means demand for intensive care unit (ICU) beds and specialist critical nurses will rise.

This increase in demand is on top of the typical workload ICUs might see.

And because of the nature of COVID itself and other factors, this puts pressure on the entire hospital system.

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Read more:
How are the most serious COVID-19 cases treated, and does the coronavirus cause lasting damage?

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What happens in ICU?

The ICU is where we care for the most critically unwell patients, where treatments are designed to support breathing and circulatory problems affecting the heart, blood, or blood vessels.

The most unstable and sickest ICU patients require airway support in the form ventilation to help them breathe. They also need circulatory support in the form of drugs to improve blood pressure and heart function.

Patients come to ICU as a planned admission (for example, after a complex operation), or as an emergency admission (for example, after a serious car accident).

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Read more:
ICU ventilators: what they are, how they work and why it’s hard to make more

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Patients stay for, on average, three days in ICU before recovering enough to be moved to a ward, or sadly, dying.

Because patients in ICU are unstable and critically unwell, there is usually one nurse to care for each patient. This is a highly skilled job. Most ICU nurses have extra postgraduate qualifications.

COVID changed the type of patients we see

Patients who are critically ill with COVID are often sicker than other ICU patients and may require more support for their breathing and circulation. Often, they need to stay in ICU longer than other patients.

This creates challenges for hospital systems, because beds in ICU become blocked, and planned operations may be cancelled because of the lack of ICU beds.

Once patients with COVID no longer need ventilation or circulatory support, they are transferred to the ward for additional care. They may have experienced painful procedures and have a degree of physical impairment.

They may also have witnessed a number of stressful events in the ICU, such as emergency resuscitation procedures and deaths, which may increase the risk of post-traumatic stress disorder, anxiety, and depression.

Although we don’t have definitive long-term data, patients who have been critically ill from COVID often have a long and difficult journey of recovery and will likely remain dependant on health care services for some time.

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Read more:
Younger adults can get very sick and die from COVID too. Here’s what the data tell us

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COVID changed how we nurse

ICU staff looking after COVID patients have the additional demands of working in full personal protection equipment (PPE), which can be hot and uncomfortable and very challenging to work in.

The need to use PPE correctly, and the constant concern about becoming infected or dying if there’s an infection breach, adds to nurses ongoing stress.

The International Council of Nurses’ latest analysis shows the number of nurses who have died after contracting COVID-19 globally is greater than 2,200 – more than any other health-care worker. This data are from earlier this year, so we expect those figures to have risen since then.

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Read more:
Here’s the proof we need. Many more health workers than we ever thought are catching COVID-19 on the job

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COVID challenges Australia

In Australia, there has been more time to respond to the challenges of COVID. In many states, the numbers of ventilators increased, models of care were developed for COVID-positive patients, and snap lockdowns ensured scarce ICU resources were not overwhelmed.

However, the increasing number of positive cases in New South Wales in particular, coupled with the highly infectious Delta variant, means ICUs risk reaching capacity.

At the time of writing, 109 patients were in Australian ICUs and 37 of these patients required ventilation.

Australia has 191 ICUs with 2,378 beds and the capacity to increase this by by up to 4,258 beds.
But there may not be enough specialised nurses or equipment match this bed increase.

Surge capacity also varies between ICU categories and jurisdictions, with tertiary hospitals reporting more capacity. So deteriorating patients may need to be air-lifted to major metropolitan or regional centres.

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Read more:
Does anyone know what your wishes are if you’re sick and dying from coronavirus?

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What can happen in the future?

Fortunately, public health measures have meant Australia has been spared the horrors of countries that were unable to successfully increase their ICU resources to meet demands, for example, Spain, Italy and the United Kingdom.

Yet, hospitals are still feeling the impact of a rise in critically unwell COVID patients in many ways, and will do so in the future.

Undergraduate student nursing placements, for example, have been delayed and many universities have moved their education online. So student nurses may struggle to achieve the clinical hours required to graduate. This may mean a shortfall of clinically competent and educated ICU nurses in the future.

The best we can do

So the next time you hear the latest number of COVID patients in ICU, think of what’s behind those numbers and what this means for the whole hospital system and its staff.

Protect them, yourself and others by sticking to the public health advice, including getting tested with the mildest of symptoms. Most importantly, get vaccinated. People fully vaccinated against COVID rarely end up in ICU.

Deb Massey, Associate Professor, Chair of Nursing, Faculty of Health, Southern Cross University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Christmas in Numbers

Indigenous People Forced Off Their Land

The link below is to an article that reports on the increasing numbers of indigenous people being forced of their land in Asia.

For more visit:
http://www.guardian.co.uk/world/2013/jun/02/indigenous-people-turned-off-land

USA: Protestant Numbers Declining

The number of Protestants in the USA has fallen in percentage terms, with now just 48% identifying as Protestant. The link below is to an article reporting on the latest survey.

For more visit:
http://www.foxnews.com/us/2012/10/09/protestants-no-longer-majority-in-us-study-says/

China: Quadruplets Marked with Numbers for Easier Identification

In the ‘you have to be kidding’ category, the link below is to an article about how one Chinese couple decided to make it easier to identify their kids. 

For more visit (including a picture):
http://www.inspirefusion.com/quadruplets-marked-with-numbers-to-identify-easily/

Counting the Numbers: A Hopeful Sign of Some Change

The article below is about one megachurch pastor in the United States and his questioning of marketing values in the church today. I think there are some hopeful signs in his comments, but there is no convincing evidence of a better way about to be trod.

For more see:
http://www.christianpost.com/news/churches-more-like-fast-food-restaurants-one-pastor-thinks-so-50738/

 

Nepal Church Bomber Faked Repentance

Imprisoned chief of Hindu militant group used Christianity to cover up extortion, terror.

KATHMANDU, Nepal, April 4 (CDN) — The chief of a militant Hindu extremist group sought to disguise his extortion and terror activities from behind bars by claiming he had repented of bombing a church in Nepal and showing interest in Christianity, according to investigators.

The revelation emerged when Nepal’s premier investigation agency foiled a plot to explode a series of bombs devised by Ram Prasad Mainali, former chief of the Hindu militant outfit Nepal Defence Army (NDA), in the capital city of Kathmandu. Police on March 4 arrested six cohorts of Mainali carrying powerful “socket bombs” – home-made, hand grenade-type weapons made from plumbing joints – and high-explosive powder, to be used as part of a plan to extort money from industrialists, The Himalayan Times reported.

In an interview last year, Mainali had told Compass that his interaction with Christians inside jail in Kathmandu’s Nakkhu area had led him to repent of his deeds and read the Bible (see “Bomber in Nepal Repents, Admits India Link,” Jan. 4, 2010). Mainali was arrested on Sept. 5, 2009 for exploding a bomb in a Catholic parish in Kathmandu, Our Lady of the Assumption, which killed a teenager and a newly married woman and injured more than a dozen others on May 23 of that year.

Prior to the Compass interview, Mainali had sent a handwritten letter from the prison to a monthly Christian newsmagazine in Nepal, Hamro Ashish (Our Blessing), saying he regretted having attacked Christians.

A local Christian worker who had known Mainali said the church bomber used Christianity to evade police surveillance.

“I was disheartened when I recently learned that Mainali had threatened some pastors with violent attacks, demanding protection money from them,” he told Compass on condition of anonymity.

The source said Mainali threatened him and pastors he knew by phone. He suspected that a fellow prisoner, Jeevan Rai Majhi, previously considered a convert to Christianity, had given the pastors’ phone numbers to Mainali. Majhi, formerly a notorious criminal, had allegedly accepted Christ inside the prison, and jail authorities made him the prison leader. He also led a Bible study group in the prison.

“Some prisoners who attend the Bible study in the Nakkhu Jail told me that Mainali shared the extortion money with Majhi, which aroused jealousy among other prisoners, who reported it to the jail authorities,” the source said.

Around 150 prisoners attend the Nakkhu Gospel Church inside the prison premises, though Majhi is no longer leading it. Both Mainali and Majhi were recently transferred, Mainali to the Dilli-Bazaar Jail and Majhi to the Mid-Nepal Central Jail.

Deputy Inspector General of Police and Central Investigation Bureau (CIB) Director Rajendra Singh Bhandari told The Kathmandu Post that the arrest of Mainali’s men was a “tremendous achievement” that averted “mass casualties” in the capital.

“It seems that Mainali had filled the arrestees’ minds with dreams of earning quick bucks through terror,” the daily quoted another investigation official as saying.

The Christian source said he still hoped for genuine repentance in Mainali and Majhi.

“Mainali and Majhi must have at least some knowledge of the Bible,” he said. “So I am still hopeful that they would reflect on who God is and truly repent of their ways as they spend their time in prison cells incommunicado [prohibited from speaking with any outsider].”

According to The Kathmandu Post, the CIB had been observing Mainali following complaints that he had demanded large sums of money from businessmen and others.

“He had been making phone calls and sending demand letters to them,” the daily reported on March 4.

Compass requested an interview with Mainali at the Dilli-Bazaar Jail, which officials refused.

“We have orders not to allow Mainali to meet anyone,” said one official.

Mainali had earlier told Compass that he formed the NDA with the support of Hindu nationalists in India in 2007 to re-establish the Hindu monarchy, which fell after a decade-long armed struggle by former Maoist guerrillas peaked in 2006, when all political parties joined protests against King Gyanendra.

The NDA is also believed to be responsible for bombing mosques and killing Muslims and Christians, including the Rev. John Prakash Moyalan, a Catholic priest who was principal of the Don Bosco educational institution in eastern Nepal, in June 2008. While Christians in Nepal faced persecution at the hands of the Hindu monarchy until 2006, non-state actors have been attacking them since the country began transitioning to a secular democracy.

“Several incidents of religiously incited violence directed at minority religions and their property have been recorded since the signing of the peace accord [between the interim government and the Maoists in 2006],” a local Non-Governmental Organization, Informal Sector Service Sector (INSEC), noted last year.

“Although moves have been made to promote religious tolerance and a climate of peace and cooperation, this area must continuously be monitored,” stated an INSEC report, “Commitment versus Reality,” which mentioned attacks on Christians by Mainali’s outfit.

Of the roughly 30 million people in Nepal, only .5 percent are Christian, and more than 80 percent are Hindu, according to the 2001 census. The actual number of Christians, however, is believed to be much higher.

Report from Compass Direct News
http://www.compassdirect.org

Alleged ‘Middleman’ Arrested in Malatya, Turkey Murders

Two key witnesses’ testimonies connect suspects to higher-level ‘masterminds.’

ISTANBUL, October 21 (CDN) — A court in southeast Turkey on Friday (Oct. 15) ordered the arrest of a suspected “middleman” linking the murder of three Christian men to alleged high-level masterminds.

The arrest order came after the testimonies of a former prison inmate and an incarcerated ex-gendarmerie intelligence worker at Friday’s hearing. Journalist Varol Bulent Aral – one of the suspected “middlemen” who allegedly incited five young men to stab to death Turkish Christians Necati Aydin and Ugur Yuksel and German Christian Tilmann Geske at the Zirve Publishing Co. in Malatya – was re-arrested at the hearing.  

The three Christians were bound and tortured before they were murdered on April 18, 2007, at the Christian publishing house, where they worked. Suspects Salih Guler, Cuma Ozdemir, Hamit Ceker, Abuzer Yildirim and alleged ring-leader Emre Gunaydin were caught trying to escape from the scene of the crime.

Attorneys said the last hearing of the Malatya murders was productive in tracing links between the five murderers and political masterminds whom prosecution lawyers claim are behind the slayings. A key witness, Orhan Kartal, was instrumental in proving that Aral was behind the murders, lawyers said.

“Not only this witness, but Emre also accused Aral before and then changed his statement,” said one of the prosecuting lawyers, Orhan Kemal Cengiz. “Before he retracted his statement, he gave details that couldn’t have been fabricated. So from the beginning we saw Aral was involved but couldn’t prove it.”

Kartal spent two months in prison with Aral in Adiyaman in 2008, where they were both held for crimes not related to the Zirve murders. Kartal said that while in prison together Aral detailed how he had planned the attack on the Zirve publishing house by psychologically preparing the five young murderers for the gruesome act. According to Kartal, Aral said he gave the young men the weapons they used to kill the three Christians.

In Kartal’s account, Aral also claimed that there was a higher figure behind him, retired Gen. Veli Kucuk. This year Aral completed his previous prison sentence. He is now again in prison as a key suspect in the Malatya murders.

In a previous statement, Aral had complained that retired Gen. Kucuk had threatened him about testifying. Gen. Kucuk has been arrested in connection with Ergenekon, a loose collection of ultra-nationalist generals, businessmen, mafia and journalists who planned to destabilize the government. Evidence in Malatya hearings over the past three years suggests that the murders were instigated by Ergenekon.

Aral has also been implicated in the Ergenekon case, the hearings of which are underway.

Prosecutors believe the Malatya murders are directly linked with a military operation called the Cage Plan within the scope of Ergenekon activities. A document entitled “Cage Plan,” found on a retired general’s computer, described assassinations that targeted the country’s small Christian communities. The document referred to the Malatya murders as a “successful operation.”

A second witness, Erhan Ozen, also in prison for other offenses, worked for the clandestine Gendarmerie Intelligence Organization (JITEM). He said that as early as 2004, JITEM personnel were planning the Malatya murders and the assassination of Armenian editor Hrant Dink.

Ozen said that after a meeting, some co-workers talked about how they were organizing an operation against the three Christians in Malatya in an effort to portray the state as ineffectual. He also testified that the rector of the local university and JITEM were monitoring the activities of the three Christian men.

“He was convincing because he gave many details that were coherent and that confirm each other, so his testimony seems to me authentic,” attorney Cengiz said. “But of course, we will see.”

In April the Malatya court added the Cage Plan indictment to its case file.

Prosecuting lawyer Erdogan Dogan told Compass that this is clear evidence linking the Malatya murders to the Cage Plan. For almost a year, prosecution lawyers have tried to make the case that the two court cases should be merged.

“We had progress in the case,” Dogan said of the two testimonies on Friday. “They might decide to join the two cases in the next court hearing.”

Judges had found the phone numbers of ultranationalist lawyer Kemal Kerincsiz and Sevgi Erenerol, spokesperson for the Turkish Orthodox Church – a Turkish nationalist denomination –in Aral’s personal phone book. Both figures are accused of playing leading roles in Ergenekon and spearheaded prosecution of Christians Hakan Tastan and Turan Topal for speaking to people about their faith.

This week various media released autopsy pictures and images of police videos showing the five suspects as they walk through the blood-stained Zirve office explaining how they committed the crime.

Lawyers said they did not know who leaked these to the press, but they didn’t think the images would affect the case.

“These will, however, show the country how the young men were incited and murdered the men, full of racism and hatred,” said Dogan. “This will be obvious and should be noted. The state needs to urgently address the fact that these youngsters, or anyone, can become so filled with racism and hatred.”

He said that acceptance and tolerance of other people’s thoughts and beliefs is fundamental, and that the state should teach these values to its people.  

The next hearing of the Malatya murders case is on Dec. 3.

Report from Compass Direct News

Christians Accused of ‘Blasphemy’ Slain in Pakistan

Two leaders shot outside courtroom after handwriting report threatened to exonerate them.

FAISALABAD, Pakistan, July 19 (CDN) — Today suspected Islamic extremists outside a courthouse here shot dead two Christians accused of “blaspheming” Muhammad, the prophet of Islam.

The gunmen shot the Rev. Rashid Emmanuel, 32, and his 30-year-old brother Sajid Emmanuel, days after handwriting experts on Wednesday (July 14) notified police that signatures on papers denigrating Muhammad did not match those of the accused. Expected to be exonerated soon, the two leaders of United Ministries Pakistan were being led in handcuffs back to jail under police custody when they were shot at 2:17 p.m., Christians present said.

Rizwan Paul, president of advocacy group Life for All, said five armed, masked men opened fire on the two Christians amid crowds outside Faisalabad District and Sessions Court.

“Five armed, masked men attacked and opened fire on the two accused,” Paul said. “Sajid died on the spot,” while Rashid Emmanuel died later.

Rai Naveed Zafar Bhatti of the Christian Lawyers’ Foundation (CLF) and Atif Jamil Pagaan, coordinator of Harmony Foundation, said an unknown assailant shot Sajid Emmanuel in the heart, killing him instantly, and also shot Rashid Emmanuel in the chest. Pagaan said Sub-Inspector Zafar Hussein was also shot trying to protect the suspects and was in critical condition at Allied Hospital in Faisalabad.   

CLF President Khalid Gill said the bodies of the two Christians bore cuts and other signs of having been tortured, including marks on their faces, while the brothers were in police custody.

As news of the murders reached the slain brothers’ neighborhood of Dawood Nagar, Waris Pura, Faisalabad, Christians came out of their homes to vent their anger, Pagaan said. Police fired teargas cannons at Christian protestors, who in turn threw stones.

“The situation is very tense,” Gill said. “Police have arrested eight people for damaging property and burning tires.”

Paul of Life for All said tensions remained high.

“The situation in Faisalabad has deteriorated,” Paul said. “Indiscriminate shootings between Christians and Muslims have ensued. The situation has become very volatile, and local police have initiated a curfew.”

The courthouse shooters escaped, and Punjab’s inspector general has reportedly suspended the superintendent of police and his deputy superintendent for their failure to provide security to the slain brothers.

 

Lynch Mob Mentality

The report by handwriting experts to Civil Lines police station in Faisalabad presented a major setback to the case filed against Emmanuel and his younger brother under Section 295-C of Pakistan’s widely condemned blasphemy laws.

Muslims staged large demonstrations in the past week calling for the death penalty for the brothers, who were arrested when Rashid Emmanuel agreed to meet a mysterious caller at a train station but was instead surrounded by police carrying photocopied papers that denigrated Muhammad – supposedly signed by the pastor and his brother and bearing their telephone numbers.

The Muslim who allegedly placed the anonymous call to the pastor, Muhammad Khurram Shehzad, was the same man who filed blasphemy charges against Emmanuel and his brother and was already present at the Civil Lines police station when the pastor and an unnamed Christian arrived in handcuffs, said Pagaan of Harmony Foundation. Civil Lines police station is located in Dawood Nagar, Waris Pura, in Faisalabad.

Pagaan said that on July 1 Rashid Emmanuel received an anonymous phone call from a man requesting to see him, but the pastor declined as he was due to lead a prayer service in Railways Colony, Faisalabad. After the service, Emmanuel received a call at about 8 p.m. from the same man, who this time described himself as a respectable school teacher.

Pagaan said that Emmanuel agreed to meet him at the train station, accompanied by the unnamed Christian. As they reached the station, Civil Lines police surrounded them, showed them photocopies of a three-page document and arrested them for blaspheming Muhammad.

Sources told Compass that police released the young, unnamed Christian after a couple hours, and on July 4 officers arrested Emmanuel’s younger brother, a graduate student of business.

On July 10 and 11 hundreds of enraged Muslims paraded to the predominantly Christian colony of Dawood Nagar calling for the immediate death of the two Christian brothers. Some chanted, “Hang the blasphemers to death immediately,” sources said, adding that the mob hurled obscenities at Christ, Christians and Christianity.

Islamic extremists led the protests, and most participants were teenagers who pelted the main gate of the Waris Pura Catholic Church with stones, bricks and shards of glass and pounded the gate with bamboo clubs.

Some 500 protestors gathered on July 10, while on July 11 more than 1,600 demonstrated, according to Joseph Francis, head of Centre for Legal Aid Assistance and Settlement. Fearful Christians locked their homes, while others fled the area, as the demonstrators had threatened a repeat of the violence wreaked on Korian and Gojra towns in July and August 2009.

Nazim Gill, a resident of Waris Pura, told Compass that Muslims burned tires and chanted slogans against Christians last week, and that on Friday (July 16) announcements blared from mosque loudspeakers calling on Muslims “burn the houses of Christians.”

Khalid Gill contacted authorities to request help, and police forbid anyone to do any damage.

Saying “continuous gunshots have been heard for the past five hours now,” Kashif Mazhar of Life for All today said that Punjab Chief Minister Mian Shahbaz Sharif had ordered the provincial inspector general to restore law and order and arrest the murderers of the Christian brothers.

 

Other Victims

Khurram Shehzad had filed the blasphemy case on July 1 under Section 295-C of Pakistan’s blasphemy laws, which are commonly abused to settle personal scores.

Section 295-C states that “whoever by words, either spoken or written, or by visible representation, or by imputation, innuendo, or insinuation, directly or indirectly, defiles the sacred name of the Holy Prophet Muhammad (PBUH) shall be punishable with death, or imprisonment for life, and shall be liable to fine.”

Section 295-A of the blasphemy laws prohibits injuring or defiling places of worship and “acts intended to outrage religious feelings of any class of citizens.” Section 295-B makes willful desecration of the Quran or a use of its extract in a derogatory manner punishable with life imprisonment.

Khalid Gill said Khurram Shehzad, a merchant of Rail Bazar, Faisalabad, filed the charge after his servant told him that the two Christians had put up blasphemous posters at a truck station.

The Emmanuel brothers had been running United Ministries Pakistan for the last two years in Dawood Nagar, area Christians said.

The last known Christian to die as a result of a false blasphemy charge was Robert Danish on Sept. 15, 2009. The 22-year-old Christian was allegedly tortured to death while in custody in Sialkot on a charge of blaspheming the Quran. Local authorities claimed he committed suicide.

Area Christians suspect police killed Danish, nicknamed “Fanish” or “Falish” by friends, by torturing him to death after the mother of his Muslim girlfriend contrived a charge against him of desecrating Islam’s scripture. The allegation led to calls from mosque loudspeakers to punish Christians, prompting an Islamic mob to attack a church building in Jathikai village on Sept. 11 and the beating of several of the 30 families forced to flee their homes. Jathikai was Danish’s native village.

Three prison officials were reportedly suspended after Danish died in custody.

In other recent blasphemy cases, on July 5 a Christian family from Model Town, Lahore, fled their home after Yousaf Masih, his wife Bashrian Bibi and their son-in-law Zahid Masih were accused of blaspheming the Quran. Some 2,000 Muslims protested and tried to burn their house, Christian sources aid.

Police have filed a case against them due to pressure from Muslim mobs, but local sources say the allegations grew out of personal enmity.

Faisalabad was the site of the suicidal protest of Bishop John Joseph. The late Roman Catholic bishop of Faisalabad took his own life in May 6, 1998 to protest the injustice of Pakistan’s blasphemy laws.

Report from Compass Direct News

Uzbekistan: arrests in one of the biggest churches

On May 16, 2010 law-enforcement agents of the Republic of Uzbekistan carried out a raid on one of the biggest churches in the country – Tashkent City Church of Christ, reports Christian Telegraph.

During the morning service at 11.00 AM several police officers and agents of the national security service came to the church. Part of them began filming the service, including people’s faces and church offices.

After the end of the service, police officers stopped people, took their passport information and wrote down the names of all children and car identification numbers. During the morning service there were about 500 people, not counting kids.

During several hours police officers and agents of the national security service searched through the church building. They confiscated six computers, a scanner and books, written permissions from parents, who allowed their kids to come to church, and other documents. Police officers also opened up donation boxes.

At about 01.00 PM the raid organizers called representatives of different city services to the church building – sanitary and epidemiological service, fire inspection and tax inspection that in obligatory procedure “found” violations.

Searching and all forms of examinations continued through the whole day. As the result, the second service that had to begin at 04.00 PM was cancelled. The church office was closed and sealed; the panelboard was cut of current.

Soon eight people, ministers and members of the church among them, were taken to Mirso-Ulugbeksk local office of the internal affairs of the city of Tashkent. The assistant pastor Arthur Avanesian was also arrested. Two church members were arrested for filming of what was happening on their mobile phones.

Christians were in custody through the night and were denied to meet with their relatives. On Monday their cases will be submitted to the court for the decision on the merits. As relatives say, they might be under strong pressure to give convenient confessionary statements.

Tashkent City Church of Christ is considered religious organization, which was officially registered in August of 1999. During the time of its existence, the church has never had any admonitions, it led its activity according to the law and had different examinations by state services. The last examination was held by the Department of Justice of the city of Tashkent just two months ago.

All actions by the authority give all reasons to believe that the raid was carried out in order to find reasons to close the church.

Report from the Christian Telegraph