Are All Systems Go? 

Daily thoughts & numbers on the COVID-19 pandemic from a M.D. working in the front lines at the Emergency Department in a hospital in Stockholm, Sweden. 

‘All systems go’ is a phrase that originated in the 1960s aerospace industry, indicating preparedness to launch. It’s used in colloquial language as an statement for: everything is ready. * *

By now the COVID-19 pandemic is a global phenomenon with the health care of some places having seen and survived the peak while others are preparing for it. Stockholm falls into the latter.

Right now our healthcare system, like that of other countries, is undergoing significant mobilization of resources preparing for the worst crisis in health care seen in modern times, the bulk of which, we think, is yet to come.

From inventory of personal and equipment to recruiting large number of medical students as health care workers and building a COVID-19 hospital in the matter of days at Älvsjö in Stockholm with help from the military. * *

People are told to change their social behaviour and huge amounts of capital is being invested to help out medical organizations.

At the end of the day, most agree that none of it will be enough – but that we must do as much as we can to prepare for the accelerating spread of SARS-CoV-2.

‘Are All Systems Go?’ then becomes a daily question for the clinician, a check-in to make sure everything is in place and working as well as possible. But it also becomes an extremely dynamic question as resources and systems have changed and will change drastically over time, both with the sheer numbers of infected increasing (both patients and healthcare workers), and also due to the fact of new personal recruitments and the constant ongoing mobilisation of new resources.

On a personal level it’s not just a daily question, but a great question to ask before each shift in the emergency room or at the emergency ward:

• What protective gear do we still have left and are they at hand where they need to be?
• What are the latest routines when it comes to the testing and management of COVID-19?
• What is plan B and C and D… when plan A fails and the system becomes swamped?

Asking ‘Are All Systems Go’? and checking your resources at each work shift was a common practice among experienced emergency, surgeon, and intensive care physicians even before COVID-19, however it’s never been more important than right now under this ongoing pandemic.

COVID-19 Numbers Sweden 2020-03-25 *

• 42 deaths nationally
  • 21 of them in Stockholm
• 2 510 confirmed cases nationally
  
  (Number of COVID-19 cases over time in Sweden, updates during mornings so todays numbers are not yet complete until the next day).
• Intensive care: *
  • 158 patients
  • 8,9 days from symptoms to ICU
  • 23 % women
    
    Total number of recorded of COVID-19 patients needing ICU care each week. From Week 10 it seems to more than double each week, 5 →  24  → 127 → (202 this week up until now, however since it’s only wednesday this weeks numbers are yet incomplete)

COVID-19 Numbers Globally (updated yesterday 2020-03-24 at 22:53 CET) *

• 16 362 confirmed deaths
• 375 498 confirmed cases
• 195 countries , areas or territories with cases

New Resources Added to ※ CTSOP 

• COVID-19 main page created, with brief info on the virus and also links to the pages listed below
  • A-Z Resources COVID-19 page created, a subpage with useful links/resources that I will add to continuously over time
  • A-Z Studies COVID-19 page created, subpage with studies published in medical journals that I will add to continuously over time

COVID-19 Image: Flatten The Curve * *

Picture above is what every health care system and political system on earth is trying to achieve right now with social guidelines and mobilization of resources.

All systems go.