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Pacific Northwest yetti

Expedition Medic
Did I miss what all of this is for? Are you working on some event?

Sent from my Pixel 5 using Tapatalk


Thank you, good call out. This is in regards to the 2020 season, and my contract deployment to Egegik, my second season there. As the site Safety manager and Remote Medic. I also, went back and added the location and date to the previous posts.

After contract last year, I was just so fried after 6 months straight of C19 work. And frankly, just did not have much of an interest in revisiting it. Once i got home the plan was to get the dog, load up the truck and camper and spend a month, checked out in the 4 corners area. with Courdel going MIA ( we now know( think) taken from our property) that did not happen. It took me a little longer to reset than normal.

Cheers
 

Pacific Northwest yetti

Expedition Medic
This was *for the 2020 Season May-August, in Egegik Alaska*

Lets talk PPE, Procedures for a + patient. And a few numbers, stats and C19,

Covid 19, a SARS strain. Spread from droplets from an Index patient. these droplets need a large viral load so spread.

These droplets cant move on their own, and would then need moved into the mucus membrane of another person. Eyes, Mouth,Ears, hands, etc
Being transported by one person touching an infected surface and then their own food, mouth, face, etc

Simply put, everyone has something and you dont want it, and if cant guarantee its ben clean, don't touch it, or put it on or around your mouth, especially if its wet.

Masks, so the N95 only filters to 0.3 microns, that's large enough too see, infact not to far from .3 mechanical pencil lead size. OSHA requires everyone whom wears one in business, to sign the OSHA Appendix D, which states that the mask will only protect from particles large enough to see, not smoke, etc and much be changed and kept clean.

We know virus are way smaller than that, nanometer size, needs a microscope to see.

One of the largest misconceptions about masks is that they are to filter C19, which has never been the intention. Not even from the CDC. The WHO unfortunately released a press article in which the word filter was used, and it all went up in smoke.

Since C19 is spread by droplets, the masks are only a splash shield, that's it. To prevent someone who may not know they have it from spreading it. Strange droplets from talking yelling ,sneezing, Laughing, etc from touching you or a surface.

Originally it was thought 10 percent, but some studies have shown as high as 30%. The Alaska Program is one of the best to look at, as everyone was required to be tested regardless of symptoms. Our Alaska numbers showings us its a little under 10%

The company brought 3000 employees into the state. Every person has to get tested multiple times,

Out of these 3,000 employees, 297 tested +, of those 297 +;s 280ish were asymptomatic, they had no symptoms, the remaining 17 showed symptoms.

I had 300 people on site, I am proud to say, my location had the smallest number in the entire company, and Bristol Bay. With 5 +'s on site, and something like 15 close contacts. ( those who tested -, but could of gotten it from the index patients) Index patient is the +.

The requirements are that if you have an index patient, ( a +) they will remain in isolation for 10 +1 days, from their sample. Its a rolling day, as the date of sample is not counted, 10 full days. This can be voided, if someone is showing symptoms and now " bumps" until its 10+1 days after the last symptom. You cant really test out of it, but can take a test every 24hrs for 4 days and they may* allow you out early.

A close contact, being defined as someone who has 1, Shared a bathroom, 2, Contacts of intimacy, or 3, longer than 15 mins, under 6 feet with out a mask.

The close contacts have to wait 15 days ( +1) from the date they were last exposed to the index patient. You can see, how it can get confusing.

One a pt has tested +, and they have been placed into Isolation contact tracing begins, and then notification to the state, and CDC.

Now the cohort group associated with the +, may have their time extended or to all be tested again. many variables,
But the index patients and then close contacts, are moved into strict Isolation, and the entire building must be disinfected or sterilized if possible.

To do this, would require boots, tyvec suit w/hood, mask, and face shield. Two layers of gloves, and taped wrist cuffs, field teams dubbed this the marshmallow suit. Then every surface in the room and building would be sprayed at a minimum 4 times with an alcohol solution of about 75%. I preferred Alcohol, as its non corrosive and safer for general coating everything. Walls, door knobs,clothes, beds, handles, floors etc The bunkhouses would usually take about 4 gallons, a level.
The index pt sheets, were bagged, sealed, sprayed, and then left for a week, followed by a max heat double wash and dry cycle.

For alcohol to kill germs, is must permeate the cell, or RNA walls, and as it evaporates it bursts them. SO its not spray and wipe, its spray and walk away with a fine mist.

We have to trace, everywhere that person has been for the last 15 days, and weigh that with the precautions they took. Of course everyone,, swears they have always masked up....

Lucky for us, its easy to track employees as we provided all their travel data. And it can be tracked to an unsecured area, IE) Airport, somewhere where you can't control the disinfection of the premises. We were able to trace all our primary index patients, to Airports, and a specific airline. That's primary, many other locations had it spread between members inside camp.



C19, has an incubation period of anywhere between 1-15 days. This means you could have C19, and take a test on day5, it shows negative. Your viral load is high enough on day 6, you could test +.





Team, after disinfection of upper Meshik
106907589_744151883061451_4572824293755296041_n.jpg

The girls always wanted poses, humor helps with the serious stuff and allows some relaxation.
107265299_3260479854008486_359386824325424144_n.jpg

107801299_832135807310211_1814302589420007957_n.jpg
Marshmallow time
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The suits would be removed using hazmat aseptic technique and placed in Bio bags, and burnt. Pretty much cut and roll them off and inside out.
IMG_20200618_1323239.jpg

Shields were disinfected between uses
IMG_20200618_1323291.jpgIMG_20200618_1323481.jpg

Team, full
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It takes about 20mins to suit up
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Pacific Northwest yetti

Expedition Medic
This was *for the 2020 Season May-August, in Egegik Alaska*


The other 3 team members, were part of a team designated by the plant manager, and myself whom we trusted to do a great job, and keep a cool head.

I was the constant, the other 3 members ( they were asked, none declined) were worried about others finding out they were part of the team, so it was all done double blind, to keep their identity secret. Only myself and the plant manager know the identities, and everyone looks like a marshmallow.

Cohort group notified, a + was in their group, everyone goes to quarters until further notice.

The + and index folks, are collected ( where everyone else in still in their rooms) and taken to Isolation.

Team goes into rooms of Index patients, the cohort group is moved to a rec room, all leave doors open

Team leaves index patient dorm rooms, and starts process for entire building. Once done, they go to the Infirmary, and close the doors to the bunk rooms when cleaned

cohort group goes back to their bunk house.

team decons, and then released to return to their normal work activity.
 
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Pacific Northwest yetti

Expedition Medic
This was *for the 2020 Season May-August, in Egegik Alaska*

Part of the cannery, known as " Retort" these are where the cans are places in those rolling racks and then into the large red tubes, which are massive steam pressure cookers.

You will also notice the plastic hanging from the ceiling, part of the requirements for C19 and food processing. Barriers between all work locations, where folks stand along the line
IMG_20200703_1132028.jpg

thats a lot o cans
IMG_20200703_1132070.jpg



Our carpenter retired this year, and his new replacement has quite the sense of humor. Matt, will be missed. He was 86, and could outwork anyone on site. He was like a White Ninja Santa. The joke was no one ever saw him move, but his jobs were always completed fast and efficient. Each move dialed in for ultimate efficiency.

Matt was a true master craftsman, for example we added a door in the galley. One way traffic only, another of the governor's requirements. He walked over, with his hand in the "hang loose" form middle fingers folded pinky and thumb out. He " walked" it across the area and left. I caught up with him later and he was in his shop building the frame, i thought it looked kind of crooked but did not say anything. About an hour later, he used a chainsaw to cut a hole in the wall, and the door fit perfect......



The "new" guy was very excited about the safety board he made. He has been working under Matt for probably 5 years, and was an accomplished carpenter himself. Jugo made custom shelves for the infirmary an did an excellent job.

IMG_20200703_1135066.jpg

Not your Typical humor, as you can imagine there is a specific type of personality out here.
IMG_20200703_1135397.jpgIMG_20200703_1135573.jpgIMG_20200703_1136018.jpg
 
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ITTOG

Well-known member
Sounds like your gig is at at cannery. You mentioned they flew in 3,000 people. Where are the people from? I am assuming outside the state for some or most?

I am no expert but it seems some of the precautions are in excess of CDC guidelines. Is that correct? Also, who came up with the policies/procedures you are following? In the end it doesn't matter, just curious.

Most importantly, sorry to hear about your dog.
 

jgaz

Adventurer
This was *for the 2020 Season May-August, in Egegik Alaska*

Lets talk PPE, Procedures for a + patient. And a few numbers, stats and C19,

Covid 19, a SARS strain. Spread from droplets from an Index patient. these droplets need a large viral load so spread.

These droplets cant move on their own, and would then need moved into the mucus membrane of another person. Eyes, Mouth,Ears, hands, etc
Being transported by one person touching an infected surface and then their own food, mouth, face, etc

Simply put, everyone has something and you dont want it, and if cant guarantee its ben clean, don't touch it, or put it on or around your mouth, especially if its wet.

Masks, so the N95 only filters to 0.3 microns, that's large enough too see, infact not to far from .3 mechanical pencil lead size. OSHA requires everyone whom wears one in business, to sign the OSHA Appendix D, which states that the mask will only protect from particles large enough to see, not smoke, etc and much be changed and kept clean.

We know virus are way smaller than that, nanometer size, needs a microscope to see.

One of the largest misconceptions about masks is that they are to filter C19, which has never been the intention. Not even from the CDC. The WHO unfortunately released a press article in which the word filter was used, and it all went up in smoke.

Since C19 is spread by droplets, the masks are only a splash shield, that's it. To prevent someone who may not know they have it from spreading it. Strange droplets from talking yelling ,sneezing, Laughing, etc from touching you or a surface.

Originally it was thought 10 percent, but some studies have shown as high as 30%. The Alaska Program is one of the best to look at, as everyone was required to be tested regardless of symptoms. Our Alaska numbers showings us its a little under 10%

The company brought 3000 employees into the state. Every person has to get tested multiple times,

Out of these 3,000 employees, 297 tested +, of those 297 +;s 280ish were asymptomatic, they had no symptoms, the remaining 17 showed symptoms.

I had 300 people on site, I am proud to say, my location had the smallest number in the entire company, and Bristol Bay. With 5 +'s on site, and something like 15 close contacts. ( those who tested -, but could of gotten it from the index patients) Index patient is the +.

The requirements are that if you have an index patient, ( a +) they will remain in isolation for 10 +1 days, from their sample. Its a rolling day, as the date of sample is not counted, 10 full days. This can be voided, if someone is showing symptoms and now " bumps" until its 10+1 days after the last symptom. You cant really test out of it, but can take a test every 24hrs for 4 days and they may* allow you out early.

A close contact, being defined as someone who has 1, Shared a bathroom, 2, Contacts of intimacy, or 3, longer than 15 mins, under 6 feet with out a mask.

The close contacts have to wait 15 days ( +1) from the date they were last exposed to the index patient. You can see, how it can get confusing.

One a pt has tested +, and they have been placed into Isolation contact tracing begins, and then notification to the state, and CDC.

Now the cohort group associated with the +, may have their time extended or to all be tested again. many variables,
But the index patients and then close contacts, are moved into strict Isolation, and the entire building must be disinfected or sterilized if possible.

To do this, would require boots, tyvec suit w/hood, mask, and face shield. Two layers of gloves, and taped wrist cuffs, field teams dubbed this the marshmallow suit. Then every surface in the room and building would be sprayed at a minimum 4 times with an alcohol solution of about 75%. I preferred Alcohol, as its non corrosive and safer for general coating everything. Walls, door knobs,clothes, beds, handles, floors etc The bunkhouses would usually take about 4 gallons, a level.
The index pt sheets, were bagged, sealed, sprayed, and then left for a week, followed by a max heat double wash and dry cycle.

For alcohol to kill germs, is must permeate the cell, or RNA walls, and as it evaporates it bursts them. SO its not spray and wipe, its spray and walk away with a fine mist.

We have to trace, everywhere that person has been for the last 15 days, and weigh that with the precautions they took. Of course everyone,, swears they have always masked up....

Lucky for us, its easy to track employees as we provided all their travel data. And it can be tracked to an unsecured area, IE) Airport, somewhere where you can't control the disinfection of the premises. We were able to trace all our primary index patients, to Airports, and a specific airline. That's primary, many other locations had it spread between members inside camp.



C19, has an incubation period of anywhere between 1-15 days. This means you could have C19, and take a test on day5, it shows negative. Your viral load is high enough on day 6, you could test +.





Team, after disinfection of upper Meshik
View attachment 635863

The girls always wanted poses, humor helps with the serious stuff and allows some relaxation.
View attachment 635864

View attachment 635865
Marshmallow time
View attachment 635866

The suits would be removed using hazmat aseptic technique and placed in Bio bags, and burnt. Pretty much cut and roll them off and inside out.
View attachment 635867

Shields were disinfected between uses
View attachment 635868View attachment 635869

Team, full
View attachment 635870

It takes about 20mins to suit up
View attachment 635871
Excellent write up! I forward these to my wife (retired RN).
She found your procedures to be very informative if you had to care for a C19 patient at home due to lack of hospital beds.
She has always been a hope for the best but prepare for the worst person.
 

Pacific Northwest yetti

Expedition Medic
Sounds like your gig is at at cannery. You mentioned they flew in 3,000 people. Where are the people from? I am assuming outside the state for some or most?

I am no expert but it seems some of the precautions are in excess of CDC guidelines. Is that correct? Also, who came up with the policies/procedures you are following? In the end it doesn't matter, just curious.

Most importantly, sorry to hear about your dog.
This was *for the 2020 Season May-August, in Egegik Alaska*




Yes, that one was for a Seattle based Seafods company. At a Cannery in Egegik Alaska, a small town off of Bristol Bay.

The company brought in 3k employees, about 2670 were Eastern European processors. Russian, Ukrainian, Bulgarian, Serbian. Roe techs are from Japana few from Mexico,

Truth be told, we cant get enough domestics to work processing. , The rest were US citizen's.


Unfortunately not in excess of the CDC guidelines, in line with them. This is coming from CDC, State of Alaska, Dept of Homeland Security, Alaska Governors health mandate 17. Which would change sometimes daily, for example, 2 days prior to starting they changed a requirement for the hanging barriers. Its not like we can just go to a homedepot to get plastic, everything has to be barged in, or flown in. There are no stores in Egegik, its a town of 35. Anchorage is a 2 hour flight away.

They required plans to be submitted, but set strict guidelines. Like all the testing, intra and interstate travel guidelines. As the plans are changing for the 2021 season, I can tell you with certainty they are all being changed again right now.

This industry was the first to really get after it, w/ full staffing. When i was setting up the programs with Chevron, and Honeywell the weeks prior to this they were still at half and staggered staff. This was all early 2020, started the planning in March- April. Supplies were loaded on the barge in March. With Boots on the ground in May. Work Visa's are tricky as well on a normal year, last year was tough.





Courdel, that has been extremely tough. About that same time, a few other older farm dogs disappeared the same morning. All pretty similar stories as mine. Sherriff says its a animal rights group, " rescuing" retired farm and LGD dogs. We are on a small place, 20acres with the house in the middle and pastures all around us. They believe they were baited, and probably took some planning, like giving them treats for a week or so to gain trust. ....I know it sounds crazy.....I wish it was a tail.
Thank you.
 
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ITTOG

Well-known member
Sounds like a cool operation and a lot of work to get everything staged and ready. Yeah I didn't figure there were any stores there after looking at the location on google maps. What was the area like? I assume there were mountains in the distance? What about the weather?

So sad about the dog. It seems more and more protection groups are now turning into terrorist groups. Just doesn't make sense that they take it so far. I know Courdel is not replaceable but hopefully you can find another best friend to help with the coping.
 

Pacific Northwest yetti

Expedition Medic
Excellent write up! I forward these to my wife (retired RN).
She found your procedures to be very informative if you had to care for a C19 patient at home due to lack of hospital beds.
She has always been a hope for the best but prepare for the worst person.


This was *for the 2020 Season May-August, in Egegik Alaska*

Thanks,

Remote Medicine really is a different world. An actual life fight would be 2-3 hours away, IF Anchorage will let it go, they usually wont agree to loose their bird for 4-6 hours. Anchorage is a level II ( when fully staffed, currently a level III) trauma center, they ship most their patients to Harborview in Seattle once stable. Dillingham, has a life flight fixed wing bird, but it requires 3 of the hospital staff to use.

I can usually get a PT out, but they must be stable and be able to sit up. We do have a Helo w/ Floats on retainer. If weather is good and stable the helo can usually get there in an hour. If weather is bad, ill have my PT for a few days. Sometimes we can put them on a tender and send them up river, to Dillingham IF* its high tide and their hold is empty. The town clinic has a monitor and 12 lead, they let me use.

Egegik has a clinic, that is staffed for a few weeks a year by a health aid. My infirmary is better stocked and equipped than it, but we do have a good relationship with them when staffed. And we don't have imaging, or labs. But a decent stock of Antibiotic's, Medications. Id love to get an Istat, 12lead, and pocked ultrasound, but no luck yet.



Dillingham has a hospital, Knackaknack Hospital. With i believe 16 beds, a 1hr flight away. And no reliable imaging, with rotating staff from Anchorage as per BBHC agreement's. For example, they did an x ray, and missed a C3-5 Fracture......

And they actually had their doors padlocked shut this season, and would not let people in........ I was able to get a patient w. Staph in, but had to threaten. And that if my PT lost their eye, I would personally pursue as well as the company, and PT family and asked for her licensure number, before that she refused to patch me through to their doc.... the charge w/ the EMTLA act.... Once I was allowed to talk to their Doc on staff, who was great all worked well.

( note, Egegik does not keep birds on site, so charters have to get there, and then to the place chartered too. *
Any of my serious patents were moved to harbor view. The Amputations, Anchorage will set simple fractures though. And do some Ortho surgeries,

Most the towns, villages and medical folks in Bristol bay signed a petition to shut the commercial fishery down. As they have limited medical resources, and fairly so ( BBHC is tribal owned) they don't have many + experiences with " white people bringing diseases to us" a quite from one of the local papers.

Egegik, has a remarkable history with the Spanish flu.....as in it never saw it...

 
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Pacific Northwest yetti

Expedition Medic
Sounds like a cool operation and a lot of work to get everything staged and ready. Yeah I didn't figure there were any stores there after looking at the location on google maps. What was the area like? I assume there were mountains in the distance? What about the weather?

So sad about the dog. It seems more and more protection groups are now turning into terrorist groups. Just doesn't make sense that they take it so far. I know Courdel is not replaceable but hopefully you can find another best friend to help with the coping.


It is honestly kind of hard to fathom, just the scope of things out there. Logistics can be pretty hard, Our office manager, she is like magic the way she can get stuff there.

Its pretty, green when we are there. Arctic desert, Tundra for sure. Lots of water, wet. Surrounded by Volcanoes on the distance. It can be quite rainy, usually always a breeze and 60-70. for the summer, and light 24hrs of the day.

The Icicle canary, now Ocean Beauty Icicle- and the entire town.
{BBB899C9-807B-4A04-BAC9-8B70F9F59F0C}.jpg

An overview of the Location, My office/exam room/bedroom ( its actually a great set up) is in the center left of the picture, where the office and bunkhouse T.
egegik-cannery-overview.jpg

Volcano- Im not sure which one. Katmai Natl park is to the north east of us. This is looking North
IMG_20190809_1614156.jpg


IMG_20190810_1131337.jpg



I was actually kind of loosing my mind, not knowing. He had been with me all over the US, and for all of my 20's.



A few weeks ago, my vet called me and asked if I would adopt and or foster a female Great Pyrenees that had been dumped. She had been in the same spot next to a gravel road for 6 weeks, and they had her for two weeks.


Meet Mishka

FB_IMG_1609729390439.jpg

FB_IMG_1609795910285.jpg


Mishka is Russian slang for Bear, And Ukrainian for Mouse. - So its something along the lines of Mouse Bear, or Bear cub.

Im not a fan of dogs on furniture, but she's had a hard 3 years. And now stays off the couch and recliners, and sometimes uses her 4 inch think, memory foam dog bed.

IMG_20210102_0950149.jpg

IMG_20210103_1125086.jpg

Sadly, even though they are all taken from my phone the other images it says are too large.

Shes a large part of the reason I got back to writing on here, back to doing almost daily dog ventures.
 

Pacific Northwest yetti

Expedition Medic
This was *for the 2020 Season May-August, in Egegik Alaska*

With the exception of C19,

Medically it was a tame year. All the normal stuff you would expect to see, coughs, colds, runny noses, Ortho stuff, etc

I was lucky, to have a PA join the staff for a month this year. He was great at helping me w/ differential diagnosis.

We had a few large issues,

1 individual who had MRSA in their nose, and was unreactive to my antibiotics, Day 2 was feeling eye pressure. This person was sent by boat ( No birds would come in, it was storming) to a facility in Dillingham. And was there for a week before returning.

1Pt who did not turn off the propane and tried to unscrew the hose. She was lucky and only got 1-2nd degree frostbite.

1Pt who was got their leg trapped under a 2kib bag of ice and the hull of a tender.......... Also ok, was extremely lucky and had nothing broken.


This individual whom I was called for " someone passed out on the line, and is shivering uncontrollably" " we think its hypothermia" This was in the cold storage building. Pt was only Serbian speaking, was indeed cold. However upon further investigation, it was found that he had quit eating three days ago, cause eating made him sick/throw up and had abdominal pain w/ rebound tenderness. Had just been living off of tea... His body and Organs were shutting down, and was also hypothermic.

That took one IV's wide open, NSx1Liter, heated. Blankets, was unable to swallow, so a NG tube, made from a nasal canula and chicken stock and OJ directly into stomach. That got helped to stabilize, so he was no longer shivering and could talk. It was important to stabilize, so we could move him to Anchorage. This is when the office manager and staff work miracles, to get someone out in about 2 hours. This also means, travel permits have to be filled out, C19 documentation, pick up and drop off at the airport. The Helo was a huge help


Unfortunately abdominal pain, well there is a lot of stuff crammed in that location and w/o blood work and imaging its almost impossible to tell.

The town cat, doing cat things..
20200724_104918.jpg

Fluids and warmth


IMG_20200709_1255016.jpg

We have Lift off
IMG_20200709_1437490.jpg


IMG_20200709_1439078.jpg


IMG_20200709_1440024.jpg
 
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Pacific Northwest yetti

Expedition Medic
Probably, I will end up adding these as sticker and shirt format to the store.
674669df702c26f044a12bb5d27b9ba2.jpg





1fbfcc1f6bb4d142913347a83a9765b9.jpg


Sent from my magical BlackBerry pocket tool, somewhere remote. Happy Tails & Safe Travels
 
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