#encountering worst of humanity everyday but desperately trying to believe in the goodness of it and through it in the goodness of self

[themthistles]

not even joking i would kill for some kind of beyond evil sequel focusing on jihwa. it doesn't even have to be a full time drama. a mini-series, a movie, anything is fine i just need it

[yandere-ac]

Hey buddy, do you know a channel named Etce? It's a guy that makes gameplays of Animal Crossing, and his favorite is Maple. It's so funny how he sounds low-key like a yandere for her, with made me imagine what it would be if we, the darlings were villagers, and maybe the yandere villagers played the role of humans trying desperately to cage us in their islands lol (like Audie being human and trying to take you with her) sorry, it's just so shitpost idea I hoped it made you laugh a bit tho :D

Yandere Human Audie x Villager Reader x Yandere Human Raymond

Rescue me

Another day in hell. That’s pretty much how life was for you nowadays. Each day you wished it would be your last and everyday just got worse and worse. Even if you wanted it all to end, you couldn’t. But let’s start from the beginning shall we? Your name is Y/N. You are a F/A villager who, unbeknownst to you, was a REALLY popular villager. People had online groups talking about just how badly they wanted you, people drew tons of art of you, some really cute, other a bit...questionable. Some people were even selling you for millions of bells. Of course, it all started small. So when a moderately big group of people on the internet started to talk about how cute you were and how they wanted you, you didn’t put much thought into it. You were very flattered at their compliments and left it at that.

However, once it came out that you would be signing up for the nook inc island getaway package, all hell broke loose. It was the day before the move when you decided that, why not check out the little fan group you had. As much as you hated to admit it, you did get a small boost in confidence from all the nice people who seemingly liked you. And right now you were pretty nervous about the whole move. So you quickly typed in your name into your phone and searched up. Your eyes widened at what you saw once you hit search.

947 619 results in 0,8921 seconds. What the hell?! Why did your name have so many results?! This...this had to be some weird coincidence, I mean, maybe you just shared a name with a popular actor who just blew up. Yeah that’s probably it. But all rational thought left you head once you saw that the little group was now the top result, and the little group wasn’t so little anymore. No, quite the opposite. It had gone from maybe about 5000 people to around 230 000 people. Each and every one of them, praising you, talking about how much they loved you. Some of them even wrote out detailed descriptions of what they would do with you if they found you, things that made your face flush scarlet red, why in the world would someone write that?! What reason did they have?! You felt disgust and discomfort flow throughout your body. Now feeling even worse than how you felt before! Should you even move?! What if you encountered one of these weirdos?!

Yet, you still went. You couldn’t exactly cancel your flight now could you? You’ve already sold your home and you couldn’t buy it back. You just hoped that you didn’t get paired up with a crazy person. And still, it would seem like luck wasn’t on your side.

Knock knock knock

Oh god.

“Y/N! Good morning my sweetheart!” And so, it began. You turned to look at the human in front of you, trying to push down your instincts to whimper and tremble. You had found it easier when she believed you weren’t horrified of her. Last time you shook in her presence she came very close to you and asked what was wrong. When you told her she was scaring you she simply picked you up and carried you to her house. There she spent the next 3 hours spooning and cuddling you, whispering various things in your ears all while you quivered in her arms, terrified of what she would do. Who was this woman? Why it was the island representative, Audie. The girl had long orange hair that went down to her waist and blonde bangs. On her head rested a pair of white sunglasses with purple glass, she never really used them for sun protection so you guessed it was for the aesthetic. She had yellow eyeshadow and winged eyeliner, bringing out her intense blue eyes. Eyes that would strike fear and dread throughout your entire body once they made contact with yours. She was wearing the same tropical muumuu that she always wore. Audie was looking at you with a big smile on her face. You would be lying if you didn’t say that she was a very beautiful girl. But all that beauty was overshadowed by a possessive and clingy nature. She was crazy, she saw you as hers and would make sure you belonged to her and her only. She seemed normal enough when you, her and a third islander moved to the island together. A little strange but still very bubbly and happy to be around you. You probably should’ve realised that she was one of your fans sooner than you did.

She would get annoyed when you hung out with the other resident, Kevin, a yellow bird. Soon you started to see her hitting him with a net, telling him to get out of the island along with other horrible things. And you realised that the more you tried to comfort and hang out with him the more Audie would hit him. You didn’t know what to do. You would report this behaviour to Isabelle but she told you that there was nothing she could do since Audie was the island rep. She was untouchable, and so, you could only helplessly stand back as Kevin was being harassed. You knew if you tried to intervene, Audie might do something more drastic. The whole situation was bad and apparently even Tom Nook has privately told Kevin that it might be for the best if he moved out.

All of the abuse led to Kevin finally moving out. You felt bad for the poor guy. But you were even more scared of Audie. What was truly scary was the fact that Audie had acted nothing but sweet around you. Giving you cute outfits and accessories and furniture. In a way it scared you more than if she would be hitting you as well. Because she was honestly terrifying when she acted nice around you. She would be unaware of how strongly she came off while near you. As a result she would usually be oblivious to your fear of her, which would result in very little personal space and a lot of touching. Not anything inappropriate, no, touching your shoulder, twiddling with your hair, stroking your arm, even giving big hugs that would shake you to your core. She was so much bigger than you, so to have her overpower you like that, you felt completely helpless in her strong grip. She could do anything and you would be powerless to stop it. And that’s why she was so much scarier when nice. She would practically drown you in affection that you did not want. Yet she either didn’t care or didn’t notice.

Going back to present day however. Audie was now walking towards you and you could feel yourself Yelp as she grabbed your hand and kissed you on the cheek. “H-Hello sweetheart...” you didn’t want to call her that, it’s literally that you couldn’t NOT say that. She changed your catchphrase to “Honey” and your nickname for her to “sweetheart”. So you had no choice but to call her that. You could feel your hands start to shake slightly and you tried to make it stop, but that only made you tense up in your whole body as trying to calm your nerves only made them worse. Audie was quick to notice this. “Oh? Why Y/N, your shaking. Is something wrong?” What do you say what do you say? “N-No I’m fine! I uh...I’m just a little cold that’s all...” you probably should have said something else as once she heard this, Audies eyes lit up and instantly you knew you weren’t gonna like this. “Awe you poor thing. Here let me help you!” And so, she lifted you up in her arms and carried you to your bed, where she proceeded to spoon you. At this point you figured you might as well not hold back, as long as she thought you were just cold and not afraid. And so, your whole body started to tremble. No matter how many times she did this, it would never be any less scary. “Oh my. Your shaking very bad. You must be absolutely freezing! Looks like we’ll be here for a while.” Shit.

But this sort of suffocating intimacy was not even the worst part of Audie. As island representative, she was the only one who could build and terraform the island. And she used that for bad things. The first thing she did when she found out she could move houses was to move yours next to her. After that, she completely surrounded both of your houses with a fence. Audie could exit the “yard” anytime, all she needed to do was pick up a part of the fence and put it down. But you, you were stuck. You could not get out and could only watch the island from inside your little “enclosure”. She also started to decide what you should wear. Sometimes she would give you cute clothing, things that you actually enjoyed wearing and felt comfortable with. Other times...other times she would give you skimpy outfits that barely covered you and made you feel very uncomfortable. At times like that you felt grateful no one else could see you. It was only you and Audie. But that didn’t exactly make you feel good. Anytime you wore them, Audie would squeal and blush and inspect you. She would walk circles around you, like a wolf circling a terrified bunny. Just waiting to pounce on it and sink it’s teeth into the poor critter. Luckily, Audie has never done anything...like that to you. She at least respected you enough to not force you to do anything. And that was at least a comfort for you. It was one of the very few comfort you had.

However, you weren’t ALWAYS trapped. Sometimes, Audie would hold a strange sort of...event? It’s very weird. She would open the fence and let you wonder around but shortly after you could see people arriving through the airport and drop off hundreds of Nook mile tickets. It would be insane to see how much they would give Audie. And at first you didn’t know why, you were aware of the fact that some people sold their villagers, but from what you knew, Audie didn’t do that. It was only later that you realised why they were here. They were here for you. They would pay up to 200 nmt just so they could get an hour of talking with you. You thought that was really weird, but to be honest, you didn’t mind it at all. It was the only time you could walk around the island and you could even talk to other people. Those other people being the paying humans of course. But it was nice, you enjoyed talking to some of them. You didn’t particularly like the humans that would only gush about you, telling you how much they loved you, and only asking you about stuff over and over again. It was just tiresome and very annoying. But every now and again there would be the humans that would talk to you like a normal person. Those were your favourites. Out of everyone, three humans stood out to you.

The first one was a girl. She was pretty short, maybe a few inches taller than you. She had light brown skin with freckles and blond hair. Her eyes were big and said hair was tied up in two pigtails. She was wearing a beige layered tank dress that looked very cute. Her name was Coco. She used to see you all the time. She was a frequent costumer, but then one day she just...stopped coming. Maybe she ran out of tickets, maybe she just lost interest, or maybe she found or bought her own Y/N. Yeah, that was a concept that made you really freaked out. The fact that there was apparently a bunch of copies of you out there. It happens to everyone who buys the nook inc getaway package. Either way, it didn’t matter. She stopped showing up, and you never saw her again.

The second one was a tall chubby man with yellow curly hair and a brown moustache. His skin tone was a bright shade of yellow. His eyes were kinda narrow but you could still see his very prominent blue eyes. He was always wearing a red ringmasters coat, always wearing it with such pride, you thought it was very cute. His name was Chops. Chops was always very nice to you. He would treat you well and act like a gentleman, sometimes it would come off as a bit weird but you knew his intentions were good. But after one visit where he asked if you would ever like to see his island, you never saw him again. And you were really excited as well...you thought that you could get away from this place but...apparently not. You didn’t believe that he just stopped going here like Audie said. By now you were smart enough to know that Audie wouldn’t let ANYTHING like that fly. You see, she kept a close eye anytime someone was there to visit. It was all part of the deal. They would get to come and hang out with you just as long as she was there with you. She would of course stand back a little, giving you and the customer some space. But never the less, she would be there, watching.

And the third person was a tall skinny guy named Raymond. Out of all three, Raymond was probably your favourite. He was around the same age as you, maybe a year or two older. He was very pale, you got the impression that he wasn’t exactly the type of person to tan. He would wear a grey waistcoat with a blue tie. His hair was blond and very neatly kept, he was very adamant about being precise. He wasn’t a neat freak per say. But he wanted things to stay orderly. But one of the most captivating things about him was his eyes. He had heterochromia, his right eye was brown and his left eye was green. On top of his eyes were a pair of glasses. And although he himself had said that he didn’t like his eyes, you thought they were beautiful. And anytime you would say that, you could see his face heat up as he muttered a thank you. You really liked Raymond, and you got the feeling he liked you as well. You liked him a lot more than Audie and you hoped she didn’t figure that out. Because once that happened, Raymond would probably get thrown out and not be allowed to see you.

Luckily, you don’t think she suspected anything. She seemed to trust Raymond since she left you two alone when he was over for no extra charge. It was amazing really, you don’t know how he did it but he apparently got her to trust him. And you were grateful for that. Because you and Raymonds conversations were usually the most genuine out of all your interactions.

“Hey Raymond? Could I ask you something?” You asked the guy sitting next to you. The two of you were sitting under a cherry tree near by the beach. He looked at you with a smirk. “Of course you can! You can tell me anything my dear Y/N.” As he said this, you could feel a smile form on your lips. He was always so sincere with you. “Okay so...how many tickets have you spent visiting me? A lot right? Why wouldn’t you just save up those tickets to buy or go for a villager hunt to find a copy of me? Wouldn’t that be easier than spending so much just to get an hour of speaking time with me?” This so something that had bugged you for a while. You didn’t understand this man. Why would he spend so much just to talk to you? Raymond let out a deep chuckle at this, pushing up his glasses on the bridge of his nose slightly before looking at you.

“It’s because, my dear Y/N. I don’t want a “copy of you”. I want to hang out with the real you, you who are living on this island. You mean a lot to me, and to see you not remember me...well it wouldn’t feel right...” he said. You could feel tears prickle your eyes. Did he really mean that? Did he care so much about you? “Woah woah what’s wrong?! Was it something I sa-“ before he could finish that sentence, he could feel two small arms wrap around his waist. You were now crying into his chest, with him awkwardly trying to comfort you by patting your back. “Hey now, don’t cry. It’s okay-“ “No no it’s not! You don’t understand!” But as you said this, Raymond pulled you out from his chest, grabbing your shoulders as he stroked one of your cheeks with his hand. “But I wanna understand! Please Y/N! If there’s something going on, I want to know so I can help! Just...please...tell me what’s going on? I care about you Y/N...” as he said that you could feel your heart skip a beat. Should you....

And so, you told Raymond about the whole thing. You told him about Audie, about Kevin, about the strict rules. About everything. You tried to keep your breath steady but it was hard as all your emotions spilled out. Once you were done it was easy to see the disgust that lingered on Raymond’s face. You didn’t blame him. It wasn’t exactly the lightest thing to process. But after a few minutes of silence, Raymond grabbed your shoulder and looked at you with a serious yet sad look. “Y/N I-.....I’m so sorry....I didn’t know how bad Audie was and I-....I’ve been supporting her...I’ve been paying her nmt just so I could see you. I’ve been giving her the satisfaction and encouraged by directly contributing to-“ before he could continue you grabbed his hands. Raymond looked down at you and got the message. Right now there were more important things to dissolve rather than blaming someone. “Okay okay...you’re right. Well what can I do? Do you need anything?” He asked you. You didn’t know. Should you...yes. “Take me away from here.” You said short and simply. “What?” Raymond responded, making sure what he heard was real and not something he imagined. “Take me away from this hellhole! I don’t wanna live here! To Audie, I’m just some toy for her enjoyment. I don’t want to live here! I don’t want to live here! I don’t-“ Raymond quickly pulled you in for another hug. Both to comfort you, and to silence you. He didn’t want Audie to hear... “Okay okay. Shhh, it’s okay. I’m here Y/N....” Raymond got quiet for a few seconds, almost like he’s considering something. “Come to my island. You’ll be safe there and I’m sure my residents would love you.” He told you, gently stroking your cheek. “Thank you Raymond. Thank you so much!” “Of course Y/N. I promise you. I WILL get you out of here...”

And so, the two of you started planning. Planning on what to do, planning on how you’d do it. There was barely any time left for Raymond’s visits so he agreed to come back the next day. You and Audie waved goodbye to him as he entered the airplane and left the island. Audie grabbed your hand as she looked down at you. “Did you guys have fun? What did you guys talk about?” She was acting and talking very sweetly but you knew what that question meant. It wasn’t “I’m interested in what you discussed” it was “I’m paranoid and need to know what you were doing without me.” But by now you were used to these questions and knew how to get around them. “Oh you know, just life in general. He talked a little about how his island is going and I talked about my life. I told him about the delicious peach pie you made last week.” Any and all suspicion that Audie had melted away once you aged her a compliment. You knew that if you ever wanted to change the subject or get away with something, you needed to sprinkle in a compliment. And just like always, Audie let all of her guard down. “Aww! That’s so sweet of you! I love you so much!!!” And just like most times, she wrapped you up in a big hug. You tried to steady your breathing as you responded to her. “I love you to...” and you stayed like that for a couple of minutes before Audie released you. “Well I just wanted to say, this was the last visit! I’ve got so many Nook mile tickets now that I don’t even need any more! So you don’t have to interact with these weirdos anymore! And guess what? The first thing I’m gonna do is fix up our home. Maybe I can convince good old Tom Nook to give us that big Villa so we can live in the same house! Imagine it, we could hare the bed, I could hold you every night. We would eat breakfast, lunch and dinner together! I could spend my mornings and nights with you! Oh just thinking about it is making me all giddy!”

As she said this, you could feel your whole body tense up. Your eyes went wide and you felt all the air escape your lungs. You wanted to cry, to scream, to yell out for help. But only meekly whimpers came out of your throat. “Oh darling, you’re so happy you can hardly breathe! Well don’t you worry dear. There’ll be plenty of celebration time later!” “N-N-NONONO! H-Hold up i-why...why can’t we celebrate a little tonight? W-why don’t I...sleep at your house tonight? I-I mean if we’re gonna sleep together, we might as well start getting more accustomed to it...” as you said this, you could see Audies face turn into a shade of dark red. It seemed the two of you had very different ideas of what you would be doing once you shared a bed. Of course, nothing happened later that night, just you asleep in Audies arms. Her grip on you was very strong. To get out, you had to slither your way away from her, it took about 30 minutes to do this as any time you made a slight movement, Audie started groaning and moving. You had to be careful, if she woke up it was game over. Once you were free of her grip, you carefully searched the whole room for her phone, making sure not to step on any creaking floor boards in the process. After about 3 minutes, you found it lying on the nightstand next to Audie. So carefully, you approached it and picked it up from the table. Now walking out of the room, preparing to rummage through it. You entered all messaging apps and looked through them all to find Raymond. Finally you found a conversation between Audie and Raymond on an app called “Discord”. You wasted no time, quickly typing in a message for him. You just hoped he would be awake at this time...

“Raymond? Is this you? It’s Y/N. I’ve taken Audies phone. She’s planning on stopping the visits and she’s gonna limit my freedom even further. Please I need your help.” As you sent this you felt even more panic rush over you. The reality of the situation hasn’t quite settled in yet but now? Now you truly realised what could happen if Raymond didn’t help you. Your hands started to shake and your eyes filled with tears, it was getting harder and harder to breathe quietly. You needed to get out of the house before Audie heard you! But just as you opened the door you could feel the phone vibrate. It was Raymond! Before you opened the text, you quickly went out of the house, making sure to carefully close the door. After that you ran towards the big fence, it was higher than your entire body. But you couldn’t stay here. Looking around you saw a tree stump with a sharp golden axe lodged into it. Should you? You have no other choice! So you ran towards the axe, picking it up with struggle. And then, with all your might, all the pent up fear and anger, you struck the fence with force. After maybe two swings you had broken up a small part that you could fit through. And so, you ran, you ran to the beach near dodo airlines. Picking up the phone to look at the new message.

“Y/N?”

“Okay calm down, we’ll figure this out...I made a promise to help you and I’ll be damned if I don’t keep that promise.”

“What if I double the amount of nmt to see you? Would that work?”

You thought about it. But no. Audie wouldn’t care. “No, that’s not gonna work, Audie probably has ten thousands of tickets by now...” And after about 20 seconds you got a reply. “I’ve got it! Why don’t you go to the dodo airport, open the gates and tell me the dodo code!” This....this could actually work! You wiped your tears away and quickly replied. “Yes! I’ll go do it right now!” And with that, you quickly ran into the dodo airlines. You asked Orville to open the gates and that you wanted visitors, and after a quick weird look he complied, telling you the dodo code. He was probably not used to villagers wanting to go but it wasn’t exactly any rules against it. You pulled out your phone to text Raymond, he had left a message to you. “Alright! Let me go to the airport!” You smiled to yourself as you read this. Is this it? Are you really gonna escape? You texted him back. “The dodo code is B2GT7.” And now you just had to wait. You sat down on one of the stools in the airport, twiddling your thumbs as you waited. But then. Something awful happened.

“WHAT ARE YOU DOING HERE!?” You quickly turned around in shock to see the person you wanted to see the least. It was Audie, standing in the doorway. Her hair was disheveled and she looked this close to snapping. Your whole body started to shake more violently then it had ever done. “A-A-Audie?! I-I-I ca-an exp-plain!” You couldn’t keep your voice steady as you hastily backed up against Orvilles desk. Orville was looking at the both of you, very concerned but mostly scared. “YOU’RE NOT SUPPOSED TO BE OUT HERE!!! ESPECIALLY AT THE DODO AIRLINES! WERE YOU GONNA FLY AWAY AND LEAVE ME!!!!” Audie was now approaching you at a rapid pace. It didn’t take long before she was towering above you. “I really thought I could trust you Y/N! But it seems I’ve been giving you to much freedom. Until we get the shared house, you’re gonna be locked inside my house!” As she said this, she grabbed a hold of your arm and started dragging you

away, you were punching and trying to pry off her hand but it wouldn’t budge. Once you were outside of the airport Audie continued. “Maybe I’ll have to put the new basement to use. Yeah, until we get the shared house, you’ll be chained up in my basement. I can’t trust you on the main floors, they have windows and I wouldn’t want you to escape again!” Once you heard this, adrenaline kicked in to the max. You used all your strength to kick Audie in the shin. She instantly released you to grab her leg. Letting out strings of grunts and curse words. You tried to run back to the airport again but Audie tripped you and grabbed your legs. Now dragging you back to the house. You tried to grab onto anything, digging your nails into the ground. But nothing slowed her down, she was determined to take you with her. So you cried out for help. Hoping that someone, ANYONE would hear.

And just then you could hear footsteps approaching and Audie letting out a grunt. Suddenly, her grip on your feet released and you could hear a big thud. Turning around, looking back, you could see Raymond. He was leaning over Audie, two hands pressed against her throat. He was strangling her! You quickly ran up to him and tried to pry him off. “Raymond no! Stop! Please stop!” He looked at you, hate in his eyes, yet none of that hate directed at you. You gave him a pleading look. And so, Raymond stood up. Taking his hands off her throat. Audie immediately started to cough, desperately trying to get air back into her lungs after it being forced out. Raymond wasted no time however. Grabbing your hand and running off to the airport. He slammed his hands onto the desk that’s Orville say by. “TAKE US AWAY FROM HERE! NOW!!!”

The flight home was very quiet. Neither of you wanted to bring up what happened before you left. Raymond felt ashamed over himself. He decided to try to break the silence. “Listen I-“ “you tried to kill her...” He didn’t know how to respond in a way that wouldn’t make him sound like a psycho. “...yeah...I did...I’m...im sorry Y/N. I tried to stop myself, but right then, that moment. When I saw how horrified you looked...I guess the adrenaline took over...a-and I know that’s not a valuable excuse! I know that! What I did was inexcusable! But...I don’t know, I guess I just lost control...” as he said this, you leaned your head against his shoulder. “I don’t care what happens to Audie. I care about what COULD have happened to you. What if she got loose and attacked you?! What if someone saw it and called reinforcement!? Do you really think I’m worth going to jail for!?” You turned around to look at him as you said this. There were tears flowing through your eyes. Raymond cupped your cheeks with his hands, using his thumbs to wipe away your tears. He looked into your eyes and leaned closer, kissing your forehead. “You’re worth dying for Y/N...”

After maybe 2 minutes of flying you finally arrived at Raymonds island. Salamacis. You always liked that name and this would be the first time you ever visited Salamacis. The island was still very bright. It appeared to be around 5pm at the island when you arrived, and as the plane flew closer to the ground you could see the decor of Salamacis. It was beautiful, the entire island was decorated in a very classical manner. The ground was covered with stone paths except for the flower gardens full of white and black flowers. There were full of zen gardens everywhere, In fact the whole place screamed of “Zen”. It was very nice. You could also see the occasional islander running around. Some of them saw the plane and waived, some of them even ran after the plane. And sure enough, as you and Raymond walked out of the airplane, A small group of villagers had gathered around you. They all looked curiously at you. Your grip on Raymond’s hand tightened, but Raymond stroked it gently with his thumb, trying to calm you down. He let go as he walked toward them all, with you following behind him. “Everyone! This is my friend Y/N! She’s going to be living here from now on! I want you all to treat her with respect and kindness. As she is a new addition to the family.” Everyone was quiet for a few seconds before a small rabbit ran up to you. She was black with a few white spots here and there and had a black tuff of hair on her head right between her ears. She was wearing a black box skirt uniform and a black beret. “Hello! I’m Mari! Welcome to Salamacis! You’re Y/N huh? We’ve heard so much about you! If you want we can give you an island tour!” “Yeah! Let’s give them a tour!” “Follow us!” They all said as they ran away, you felt much easier as you ran after them. But you stopped midway and ran to Raymond. “Thank you Raymond. Thank you for everything.” And with that, you gave him a quick pick on the cheek and ran after the others. You got a feeling that you were gonna enjoy it here. Meanwhile, Raymond was standing by the airport wide eyed and blushing like crazy.

“So we don’t actually have an open plot for you to live in...so you’re gonna have to sleep in my house.” Raymond said as he led you up the stairs to the bedroom. “I know that it sucks that you just got out of the Audie situation and now still have to share house with someone, but don’t worry! I’m gonna sleep downstairs on the couch!” As he said this, you two arrived in the main bedroom. Just the mere sight of it made you let out a small “woah” to which Raymond laughed slightly. He thought your amazement was adorable. The room had a king sized bed in the middle, with a big fluffy rug under it. You went up to it and sat on the bed. The blanket was made with a soft material and the mattress was so comfortable that you practically fell into it once you sat down on it. You immediately laid down, basking in the comfortable material as you stretched. “So, again, if you need anything, and I mean ANYTHING, feel free to come down and ask. Alright? Goodnight Y/N.” And so, as you got down under the blanket, Raymond turned to walk down the stairs. “A-Actually Raymond? There is one thing I wanted to ask...” as you said this, Raymond made a total 180 and looked at you. “Yeah?” “Would you...would you sleep with me tonight?” Once you asked this, Raymond’s eyes went wide, it looked like there was about a thousand thoughts going through his head. “Y-yeah! Of course!” And so, he walked up to you. Lifting up the blanket and laid next to you. You crawled up to him, embracing him. And he did the same, he was wearing a silk rope with some imperial print. It felt very comfortable. You rubbed your face against him, feeling yourself drift off to sleep. “Goodnight Raymond....I love you...” and just like that. You were out like a candle. Raymond felt his heart beat faster. You...loved him?

“...hhhehheh....hehehe, oh Y/N...” Raymond laughed quietly to himself. He had you, he finally had you! After months of searching! After thousands of Nook mile tickets! At first, he just wanted one of you. But when he found out that you were the original you! That made him interested in you specifically. And that interest only grew and grew until it became a monster-like obsession. He wanted you, he needed you. He was gonna do everything it took to get you. When he attacked Audie, he went in full intention to murder her. Such a disgusting individual! How dare she treat you like nothing but a mere pet! Raymond felt ashamed for what he did, not because he regretted it, but because he did it in front of you. You should never have had to see that side of him. But not to worry, you would never ever HAVE to see him like that again! Now that you lived here with him there was nothing that could come between you and him! He was gonna treat you so much better than Audie did. You would be allowed to walk around freely! Talk to anyone you wanted! Dress in any way you wished! If he found you at the Ables sisters and you wanted the 1 000 000 bell crown? He would buy it! No questions asked! He would even let YOU decide where to place your house once you got it! ...but there’s no rush. If he could have you like this, next to him, for a few more weeks...maybe that wouldn’t be such a bad thing...he knew that he would eventually have to let you move out into your own home. After all, he just said that he wouldn’t be like Audie. But maybe a little bit more time with you wouldn’t hurt. You wouldn’t mind! The proof was right in his arms. He didn’t even suggest that he slept next to you, yet you still asked for it! And you said you loved him! Oh you were gonna be so happy here! He was gonna make sure of that. He’s your friend. Your saviour. The one who’ll always be there. The one who’ll always have time for you.

The one who rescued you.

/ / / / / / / / / / / / / / / / / / / / / /

Oh was this a shitpost idea? How about I turn it into a 6 0 0 0 W O R D F I C ? No but for real. This is probably one of my favorite ones. It was such an interesting idea and like...I got so much inspiration. Also sorry to the anon that wanted a wholesome happy ending. It’s more of a bittersweet ending. But if you feel bad for Y/N, I don’t think Raymond is gonna do anything since Y/N is pretty much in love with him. There. Happy ending! So yeah...more Raymond :D wooo! Hope y’all are hungry because I am serving some food! This time featuring friends as the villagers beck didn’t want to come up with villagers myself!

[taeyongdoyoung]

summary: the forest is your only escape from the everyday troubles with your family until you find danger lurking behind the trees. or rather, danger finds you. your fateful encounter with the vampire ravn leaves you wishing for a different life. you strike an unexpected deal with the stranger that will soon turn into something more…

pairing: vampire!ravn x reader

side characters: leedo and seoho

genre: vampire!au, angst, romance, humour

warnings: kidnapping, cleithrophobia, manipulation, lies, human trashnaming, blood mentions, stabbing, swearing (like twice)

word count: 2.5k

author’s note: @mariuscheng i deeply apologize, you’ll see why *mwah*

part one 🌙 part two 🌙 part three 🌙 part four 🌙 part five 🌙 part six  🌙 part seven 🌙 part eight 🌙 part nine 🌙 part ten 🌙 part twelve 🌙epilogue

Minutes turned into hours and hours into days. You began to lose track of time. You had no idea how long you’d spent in this terrifying place where Leedo had taken you to. You just wanted to go back home. Not where your parents were, no. That had never felt like home. You wanted to be back in Ravn’s castle, in the safety of his arms. He was the one…well, not person, but rather being who had treasured you and cared for you like nobody else. 

And no matter how hard you tried to convince Leedo that you would never change your mind and love him the way he wanted you to, he just refused to let you go. Which only frustrated you further. You felt like a bird in a cage and that feeling was the worst in the world. You needed to think of a way to escape. But how? These metal bars were so hard. And Leedo never let you out of sight. True, he never physically harmed you or forced you to do anything. 

But the mere fact he had kidnapped you, taken you away from the place you called home was enough of a red flag to change your friendly feelings for him into something that resembled distrust and annoyance. Since you couldn’t find a way to escape, your only hope was that Ravn wouldn’t give up on you. Maybe he would come for you. 

As more days passed by, you realized you were on your own. Harbouring hopes was foolish and would do you no good. You could either die or make peace with your current situation. Or…you could try something else entirely. Something wicked and a bit cruel, but it could work, nonetheless. And since you weren’t in the mood for dying and you weren’t one to give up so easily, you decided to go for it.

“I changed my mind,” you told Leedo one day, the lie coming out easily. “I’m willing to give you a chance. I can try…to love you like you need me to.”

Leedo eyed you suspiciously. He doubted the sincerity of your words. And for a good reason.

“Do you expect me to let you go, then? Just like that?”

Actually, it wouldn’t be such a bad idea. But of course not. You weren’t that stupid.

“Someday, you will,” you responded, attempting to sound absolutely convinced by the validity of your statement. “Give it time.”

A desperate wish for it to be true appeared in Leedo’s stare. Good. Let him dream.

“Really? You’re willing to try?”

“I am if you are,” you lied once more. What’s another one? You’ve come so far…

“What about the vampire you claim you care about?” Leedo reminded you, which briefly troubled you. But you had to play your cards right if you wanted out of here. You had to deceive Leedo successfully in order to go back to the one you truly loved.

“Well, you were right about him. He’s just a cold-skinned bloodsucker. You could be so much better for me,” the words sent pangs of guilt down your spine as you pronounced them. You didn’t mean any of it, of course. But you had to try your best to convince Leedo you did. If you couldn’t escape on your own, you could manipulate him into letting you go. You only hoped that you were good enough an actress to make this work.

“I’m glad you’re finally beginning to see the error of your ways. We could be so good together, you and I.”

You resisted the urge to vomit. He was delusional. But you had to play along.

“Sure, we could. Now, tell me,” you murmured in what you were wishing sounded like a seductive voice, “What does a girl like me have to do to get some fresh air and a bit of sun around here?”

Leedo laughed. He obviously wasn’t as dumb as you’d hoped he’d turn out to be.

“Not yet. But we’ll get there, I promise. I’ve been very patient with you. What’s a couple more weeks?”

Weeks? If you had to spend another night in this godforsaken place, you would die. You had to get out of here soon or you would lose your mind.

“Right,” you attempted not to sound too crestfallen about it. “Well, until then, we could get to know each other better.”

Leedo smiled.

“What do you want to know?”

🌙🌙🌙

Ravn’s POV

As soon as I found Seoho, I told him everything that had happened and begged him to help me find her. I couldn’t live without her and I had no intention of letting her go. He listened to my pleas calmly, without saying a word. When I was finally done, he spoke:

“Of course, I will help you,” Seoho started. “Even though I don’t trust humans…”

“I’m sensing there’s a big but coming.”

“But I’m afraid we might be too late.”

“Too late?” I whispered, immediately panicking. “Is she dead? Did the werewolf do something to her?”

Seoho shook his head in a composed manner.

“That’s not what I meant. Too late as in…she might have betrayed your secret. You could be in danger, Ravn. You don’t want what almost happened to Xion to happen to you, do you?”

“Y/N’s not like that, I swear. She would never do this to me.”

“Alright, then. Do you have something of hers so that I could cast a locating spell?”

I nodded and handed him one of the books I’d gifted her a while ago. She would read from it every night before sleep. I figured it was her most prized possession.

“Shakespeare, huh?” Seoho chuckled. “Okay, just…go sit in the other room, don’t distract me and I’ll call you when I’m ready.”

I agreed, even though it was impossible for me to sit and stay calm in this current predicament. I was losing my mind. I had to find her soon. What if she was hurt? What if…I never got the chance to see her again? The chance to…tell her everything she meant to me…Tell her…

“She’s near the river in that forest of yours. In some sort of…prison cave,” Seoho informed me a while later.

I wasted no time and stormed out of the room without even bothering to thank my best friend. He’d understand, I told myself. But before I could make it outside of his house, Seoho had teleported next to me and grabbed my hand.

“Where do you think you’re going, lad?” he scolded me. “I’m coming with you.”

“I can’t ask you to…risk exposure. I know how much your secret means to you.”

Seoho obviously disagreed with me.

“You’re not asking. I’ll come on my own free will. You’re my best friend, Ravn. If you care about that foolish human, I feel it is my duty to help you out.”

“Seoho, you really don’t have to…”

“No time for arguing,” he shut me up. “And besides, me teleporting us there would be much faster than your vampire speed.”

I laughed wholeheartedly at his sensible observation.

“Lead the way, powerful wizard.”

Before I could blink, we were standing near the river. Closeby, there was indeed a cave that I had never seen before. I had heard rumours of its existence but never laid eyes upon it. So strange…I rushed ahead, eager to save Y/N from whatever torments that…dog had put her through. But before I could do so, Seoho stopped me once again.

“What now?” I complained because of his apparent eagerness to slow me down.

“Before we go in there, there’s something you should now.”

“Just say it already, the tension is killing me,” I groaned.

“Ravn. You’re already dead,” Seoho reminded me.

“Not helping, Seoho,” I sighed.

“Okay, okay, sorry. Y/N must be nearby so I…heard a fraction of her memories. She had just told that werewolf something very disturbing about you. I’m not sure I can even say it, it’s too vile.”

“Just go ahead,” I rolled my eyes. What could possibly be worse than losing her?

“She said and I quote here, so please, don’t get mad at the messenger ‘He’s just a cold-skinned bloodsucker. You could be so much better for me.’ Listen, man, it’s highly possible that her and the werewolf have been working against you. I told you that humans can’t be trusted!”

I shook my head, refusing to believe him.

“No, that can’t be true. Are you sure you heard it correctly? It must have been the wind or…”

Seoho, however, was determined that she had, in fact said that.

“I’m telling you, it’s best we get out of here. It could be a trap. We don’t know what we’re walking into, Ravn! Humans are such wicked creatures, it’s not safe.”

“No, no,” I repeated helplessly. “I can’t just leave her here. I love her, okay? And even if she doesn’t love me back, even if she did say these things about me, I still can’t let anything happen to her.”

Seoho scoffed in disbelief.

“It’s your funeral, mate.”

I shrugged.

“Like you said earlier. I’m already dead.”

I hurried towards the entrance of the cave.

“Then I’d rather die by your side than just stand outside like a coward!” Seoho yelled right behind me.

“If you’re scared for your life, you don’t have to come in. I won’t blame you, I’ll understand,” I reassured my friend.

“I’m not scared for my life. It’s you I’m worried about,” Seoho replied.

“While I’m sincerely touched,” I squeezed his arm. “I am perfectly capable of taking care of myself.”

“Not against a werewolf, you’re not. Dumbass,” he added that last part affectionately.

“Well, two dumb brains are always better than one,” I joked and the two of us went inside.

🌙🌙🌙

Reader’s POV

This shit wasn’t working. You were being so nice and pliable to Leedo and he still hadn’t let you go! Ugh, men! You wanted out so badly but you couldn’t risk being too forthright about it or it would ruin all the careful planning, all the progress you’d been making so far. Just a few more days, you kept telling myself. Just a few more and he’d believe you. You had to be strong enough to continue with the lies, with the whole acting scheme. They would be successful. Or you didn’t know what you’d do with yourself. You missed everything so badly. You missed holding Ravn’s hand. You missed reading books in his big…library. You missed making flower crowns for him. You even missed him drinking your blood. To think that the one time you’d found a home for yourself…only to have it taken away from you so cruelly. It was really unfair. You had never before been in a situation where you had to deceive someone on purpose. You had never wished ill upon anyone. So, for whatever crimes you were being punished, you couldn’t help but get frustrated by the injustice of it all. Just when you were getting entirely lost in the memories, Leedo interrupted your thoughts.

“You know…I was thinking we could have a walk. I won’t let you out of my sight, so don’t try anything stupid.”

Was this actually happening? Or were you dreaming?

“Of course not. I told you already. I changed my mind.”

“Good,” Leedo gave you an encouraging smile, which you desperately wanted to wipe off his smug face. No sooner had he unlocked the metal door leading to the outside world, to the light, to freedom, than you heard unexpected noises coming from somewhere nearby. Was it possible? Had he really come for you?

Seconds later, you were greeted by a heavenly sight. Ravn and Seoho were only a couple of metres away from you. Never before had you felt so grateful to see such familiar faces! You immediately forgot all about your plan to deceive Leedo and rushed into Ravn’s arms. He let you hold him but didn’t say a word, simply welcoming you silently. But why? You had missed the sound of his voice.

“It was a trick, wasn’t it?” Leedo finally realized. “You never loved me, you just said all these things so I’d let you go, didn’t you?”

You gulped nervously and even though you didn’t want to leave the comfort of Ravn’s arms, you felt like you had to confront Leedo yourself.

“Yes, it was all a lie. I never meant any of it,” you confessed.

Ravn gave Seoho a pointed look, which at the time, you didn’t understand.

“Well, I don’t care. If I can’t have you, then neither can he,” Leedo attacked Ravn before you could register what was happening. You wished you could do something other than beg them to stop, but you were so scared that you could barely move. They were going to kill each other right in front of you and you were too frozen to think. Luckily, Seoho’s reflexes worked faster than yours. He hurriedly got between them, trying to make them stop. However, before he could do so, Leedo accidentally pierced him in the stomach with a blade that had somehow appeared from thin air and Seoho stumbled onto the ground. You ran to his side and knelt down next to the magician.

“Oh, God, are you okay?” you asked.

Seoho nodded weakly.

“I didn’t mean to stab him,” Leedo defended himself. “I meant to kill the bloodsucker!”

“Oh, right, ‘cause that makes us all feel so much better!” you hissed sarcastically.

“Just…stop fighting and ask the girl who she wants to be with, you imbeciles!” Seoho murmured before passing out.

“Shit,” you and Ravn swore simultaneously, desperately trying to help Seoho regain consciousness.

“You didn’t answer the question,” Leedo pointed out.

“Is that really your biggest concern right now?” you snapped at him. “Seoho could literally die because of you!”

Leedo looked away as if it wasn’t any of his concern. That bastard…

“I want to stay with Ravn and help Seoho, in case it wasn’t obvious,” you spelled it out.

Leedo nodded and started walking away wordlessly. In the meantime, you were pressing your hand against Seoho’s wound so that he wouldn’t die from the blood loss.

“If I ever see you again, I will kill you,” Ravn vowed, giving Leedo an icy glare.

“Likewise,” Leedo roared and left you all in that damn cave.

Once he was out of earshot, you noticed Ravn slowly backing away from Seoho.

“There’s so much blood,” he panted weakly.

“Fuck, I almost forgot,” you were worried for a second that Ravn would lose control. Despite the fact that Seoho was his best friend, it was only natural that he was disturbed by the smell and look of it.

“I don’t want to hurt him,” Ravn closed his eyes, pained and ashamed to admit that he was so easily affected.

“You won’t. You should get out of here and bring me supplies from your castle. Herbs, medicine, anything you can find,” you sensibly suggested. “It’s my fault he got hurt in the first place. If it hadn’t been for my friendship with Leedo, none of this would have happened,” you couldn’t help but blame yourself for it all.

“It’s not your fault you see the good in people. And…I’ll do what you asked. We’ll talk more when I return, promise.”

You nodded.

“I’ll stay with Seoho and try to stop the bleeding.”

“Thank you,” Ravn said and ran outside at the speed of light.

To be continued…

[worryinglyinnocent]

Fic: The Darkness Within (1/?)

Summary: When washed-up paranormal investigator Rum Gold meets Belle French, he does not quite know what to make of her claim of a supernatural presence in her life, but sensing her genuine fear, he begins to investigate. What he uncovers shakes the cynicism he has so long held to its very core, and he calls in the help of disgraced ex-priest Father Macavoy to help him lay some demons to rest...

A slow burn, eventual rumbellavoy. The rating may increase in later chapters. 

Written for the @a-monthly-rumbelling prompt:  “The only good part about being alone is that I don’t wake anyone up when I start screaming at night.”

Rated: T

[AO3]

=====

The Darkness Within

One

“The only good thing about being alone is that I don’t wake anyone up when I start screaming at night.”

The frank statement, coming as it did completely out of the left field, caught Gold’s ears and made him turn to see who had spoken. There was only one candidate, really. The bar was practically empty like it always was, just a few of the die-hard regulars in one corner drowning their sorrows. Gold supposed that to the outside observer, he, although alone at the bar, would probably be counted among their number: steeped in whiskey, the hardships and trials of their lives lulling them into a sullen silence that still managed speak reams about the past.

The person who had spoken was a young woman. Gold had never seen her before in the bar, and his first instinct was to think how out of place she was. The Spinning Wheel was out of the way, off the beaten track, and one had to know where one was going to find it. Perhaps she was lost, but the tumbler of whiskey on the counter in front of her and the resigned expression in her eyes gave Gold the impression that she was exactly where she wanted to be.

She took a sip of the whiskey, and Gold tried to figure out why she had spoken, to whom, and what the meaning of her words was. She caught him looking then, and gave a world-weary smile that did not quite reach her eyes.

“Don’t worry, I don’t normally make a habit of talking to myself,” she said. “I didn’t realise you’d heard.”

Gold just shrugged and went back to his own whiskey, but he couldn’t help his attention wandering back to the woman every now and then. The regulars in the corner had pulled themselves out of their stupor long enough to realise that something was new, but they were not interested in this stranger enough to pay all that much attention, merely commenting on her presence and returning to their drinks.

There were dark circles of tiredness under her eyes, and Gold presumed that must have to do with the screaming in the night. He wondered what she must have suffered to cause such violent terrors, and why she was drinking to forget them. She drained the tumbler and ordered another; the barkeep didn’t bat an eyelid and simply refilled her glass without a word. She looked up at Gold again.

“What about you?” she asked. “Do you enjoy being alone?”

It was an interesting question and not one that Gold had really ever considered before. He enjoyed peace and quiet and solitude, certainly, but he had been alone for so long that he had forgotten what having other people in his life was like. Enjoyment of the situation didn’t really come into the mix when he had no choice in the matter. His isolation was self-imposed, certainly, a kind of penance for the life he had led thus far. A search for meaning that was so far proving fruitless.

“Not sure,” he said. “I suppose it depends on what it is that is keeping you alone.”

The woman gave a snort, and in that single moment Gold could tell that the story of what was keeping her alone would be a long and complicated one. When she looked back at him, her brow was furrowed, expression thoughtful.

“Have we met before?” she asked.

Gold shook his head. “No, I think I would remember.”

“Memory’s one thing I can’t always rely on,” the woman said. “My name’s Belle. Belle French.”

She reached out a hand along the bar, and Gold shook it tentatively.

“I’m sorry, Miss French, but I don’t believe that we’ve ever met before. Rum Gold.”

Her face changed, from slight confusion to instant recognition and with it, wariness. Inwardly Gold sighed. She knew who he was. He’d hoped that she was young enough not to have been around when he had been at the height of his fame, but apparently not.

“I know you,” she said. “That paranormal guy from the TV.”

Gold nodded. At least ‘that paranormal guy from the TV’ was among the milder epithets that had been used against him over the years.

“I’ve got your book,” Belle continued.

“Oh?” The book had not sold all that well and was no longer in print; Gold was surprised that she’d come across it.

“Yeah. It was interesting.” The sentence sounded unfinished, hanging in the air between them.

“I sense a but,” Gold said. “Interesting but…”

“Ultimately unhelpful,” Belle finished.

“Unhelpful?” His work had been called many things before, but unhelpful was a new one.

“Yes. I think I’d best be going.”

She drained her drink and grabbed her purse from the bar stool next to her, withdrawing enough cash to cover her bill and tip and slipping off. Gold knew that it was clutching at straws, but his conversation with her had led to more questions than answers, and once Gold had grabbed onto the tail of a mystery, he was not one to ever let go.

“Wait, Miss French…”

She turned back to him expectantly, but there was still that guardedness in her face, mental walls being erected and strengthened.

“How was it unhelpful?”

“I would have thought that was fairly obvious, Mr Gold. It didn’t help me.”

“All right…” Gold paused. “What was it that you needed help with?”

Belle scoffed, and the sound was harsh and cruel, at odd with her soft voice and demeanour.

“Mr Gold, you of all people know what industry you made your name in, and you of all people should know that if I told you my trouble, you wouldn’t believe me.”

She left the bar then; the barkeep looked up from cleaning glasses but said nothing and the regulars in the corner did not notice her absence, and Gold was left alone with even more loose ends than he’d started with. Belle was an enigma and he knew next to nothing about her, but he knew enough to want to find out more. She was alone, she had a tendency towards nocturnal screaming, and she had acquired his book in the hope of assistance which had not been forthcoming.

If she’d been looking to him for assistance with whatever it was that ailed her, then she really must be desperate.

He paid his tab and left the bar, walking home in the muggy July evening heat. The town wasn’t perhaps the most comfortable place that he could have settled, but it was nice and secluded, and that was what he had wanted, jaded and tired of life as he was.

Once inside his house (rumoured by the locals to be haunted by the ghost of a restless suicide from 1832, rumours so far unproven), Gold made his way to his study, taking down the single copy of his book that he still possessed and looking at the title page.

The Inexplicable Explained – Debunking Paranormal Phenomena and Urban Legends

He’d once been described as the nation’s favourite cynic, but it had not always been the case. When Rum Gold had been a child, he had been convinced of the existence of ghosts. Every night for the majority of his formative years, he had felt the presence hovering around outside his window, and on the few occasions he had been brave enough to investigate, he had seen it, the shadow that had followed him around. Just an ordinary human shadow, but without a body attached to it.

The eyes had been the worst thing. They were what had sent him racing back into his bed and pulling the covers up over his head, shivering with fear beneath them and praying that the window would hold, that tonight would not be the night that his aunts’ spells failed. The aunts who had raised him were Wiccans, and every night at sundown they had cast a circle of protection over the house to prevent anything malevolent from harming those within. Every time that Gold had seen those unblinking yellow eyes in the darkness, he had thanked whatever force it was that was protecting him from them.

Gold grew up believing in the power of Wicca, a staunch believer in the paranormal, and when he had become an adult, he had devoted his research to such phenomena, investigating claims.

But life and experiences had made Gold into the cynic he was now renowned for being. After his aunts had passed away, he’d had no more link to the Wiccan community and had fallen out of touch with what had been such an everyday part of his upbringing. And so much of what he had investigated during the course of his career had been fake, hoaxes designed for quick cash grabs. In the end, he had turned his career on its head, becoming the famed debunker of paranormal phenomena that he had made his fortune being. Despite the wonder that he had once held for them, each instance that crossed his path was now met with scepticism and the firm belief that whoever was reporting these claims was only in it for the money and the media attention. He’d come to verbal blows with scam artists enough times that he had gained notoriety, and after that, he had retreated into the obscurity he now welcomed.

He put the book back on the shelf and thought back to Belle’s words. She had sought help from his book and it had failed her, but she had said that he would not believe her problem. Some kind of paranormal experience that she could not explain, and that she had looked to his book to try and find a logical, real world reason for.

And he had failed her.

As the light continued to fade around him, Gold wondered. Over the years he had long since let go of his belief in ghosts, figuring that the eyes he had seen in the darkness were fireflies, a trick of the light, nothing harmless at all. But at the time, he had believed, and he had been extremely scared.

Belle had encountered something similar, it would seem. Something that had scared her and that she was desperate to have explained away. It would seem, then, that perhaps she was not the usual kind of quack he had spent his career exposing.

He grabbed the phone directory off the shelf and scanned through it for a B. French, but there was nothing. Perhaps Belle wasn’t her full name – maybe Isabelle, Annabelle, but I. French and A. French were also unsuccessful. It was a long-shot to think that she had lived here any length of time; it was a small town and he’d have run into her before no doubt. Perhaps she was just passing through, searching for answers to her predicament elsewhere.

The words that she had first spoken were etched in his mind, and they had not even been intended for his hearing.

The only good thing about being alone is that I don’t wake anyone up when I start screaming at night.

Here was a terrified young woman seeking help, and for the first time in a long time, Gold felt something, a need for action stirring him out of his apathy. Maybe there was a perfectly logical explanation for her trouble, but if that was what it took to help her, then so be it.

All he had to do now was track her down, and with a sigh Gold realised that was probably going to be a dead end. Still, if their paths every crossed again then he would make sure to listen to her and reassure her that he would not dismiss her concerns out of hand. He might not believe whatever supernatural thing she needed his help with, but he could believe that she genuinely believed, and that was enough for him.

He got up out of his chair, night having well and truly fallen in the interim, and he went to leave the study. As he did so, he felt the prickling feeling of the hairs on the back of his neck standing on end. It was a feeling that he had not experienced in many a year, and he could feel the fear coating the back of his throat. Something was watching him.

He didn’t want to turn around, didn’t want to confront whatever it was behind him, but at the same time, he knew that if he didn’t then the feeling of being watched would continue to haunt him. All of a sudden he was seven years old again and there were very real shadows outside his window, begging to be let in to perform nefarious deeds unknown.

Gold took a deep breath and turned.

There was nothing to see, just his own reflection in the window, and he inwardly kicked himself for being so silly. He crossed the room with purpose, grabbing the curtains and pulling them closed. As he did so, something caught his eye in the overgrown yard beyond. Just the briefest flash of movement, a stray cat or some kind of wild animal. Maybe a raccoon. There was absolutely no need to panic.

Nonetheless, Gold still found himself dusting off his aunts’ old journals and murmuring the words of the circle of light to himself.

[phooll123]

New story in Health from Time: As U.S. Braces for Coronavirus to Spread, Hospitals Worry About Shortages

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

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[itsfinancethings]

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

[pinktheoristcollector]

New top story from Time: As U.S. Braces for Coronavirus to Spread, Hospitals Worry About Shortages

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

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[newstechreviews]

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

[olaluwe]

"Thinking, says the book: Speech: A High School Course", starts with a problem; a difficulty that is felt." Really, if there is anything for which humanity has consistently been called out since the morning of creation I can say with a fairly high degree of accuracy that it is ' Thinking.' Even at individual level, it is pretty the same thing. It is so because much of our advancements have been accomplished on the back of thorough thinking around many a societal or existential challenges whether it is in the field of natural or social science. Therefore straight thinking is a skill worth having by everybody; more so because we are bound to be challenged everyday of our life. Among others, challenge could manifest itself in form a faulty car, an empty pocket, unemployment, sickness, unwanted pregnancy, barrenness, failure in examination or business, chronic single's life, rape, rejection and loveless marriage.  I can go on and on and on! But which life if I may ask doesn't at some point in its evolution suffers one or two of these aforementioned challenges? None! Where there is one even seemingly; it must be so categorized as a clear case of fraud. For life without challenge just as living without prayers is fraudulent; a fallacy. Don't get too excited, Pals, if today by some luck, magic or ingenious contrivances you are neither faced with any challenge nor are you praying to get by in life. It is most probable they are piling up for you somewhere along the journey of life. And you're bound to pick them up anyways as you stride on. So brave it when it hits you any moment from now. This goes to show that life is a constant battle for adjustment for the living. 'Therefore adjustment defined, is what a man gained when he comes to himself."   Adjustment from disequilibrium to equilibrium; from discomfort to comfort. Where there is no maladjustment as enumerated above then, adjustment wouldn't necessarily be a topic here. If for anything, it is because most challenges of life are largely unpredictable leaving us more often than not desperately exposed to all manners of equally contrary sprits. i.e. fears, anxiety, hypertension, low self esteem, depression, and worst of all suicidal thoughts. Before I go on, can we just ponder briefly these questions- I mean why problems, challenges or maladjustment at all? The answer it must interest you lies in the fact that there is absolutely nothing in life without a purpose; a divine purpose; and that include problems or challenges as it were. They spring up on our paths either as a test of our resolve and faith or as a filter for our becoming the very best that we can possibly be. And the analogy still suffices here that: "Then iron wouldn't be as tough as it comes without the true test of fire". And the same applies to human kind. Can anyone call himself brave without been battle tried? God forbid! So have you been grappling with some challenges and you are at a loss on how best to solve them, at least dependably; without allowing things get messier. Now don't worry. In a way you are in the right company. I'm a life coach? No, I'm not. I'm just your regular passionate online guy who is always striving to help change the world in my own little ways in the pursuit of my 'philosophy of positively being and becoming by all'. Many times over I've had and still have my own share of some of life's meltdowns and I didn't get overwhelmed by them. So if I'm not; I bet you can't too. All it takes is being attentive to some of the suggestion I'm about to offer here. But before then, maybe I should share a story from my own personal experiential archive. "Some ten or so years ago I face the first romantic rejection in my life. You know when you love a woman so much you want to go down the aisle with her. And then one day she hits you with a 'No' for an answer even when all signs had strongly indicated it’s a foregone conclusion. Like every human I was naturally gutted and forlorn. But my response has been that of calm assurance and perfect wisdom in the midst of this sudden romantic storm and tidal waves. To her break up text message which reads "I can't marry you. God will provide you your own wife”. I replied “thank God it's never too late to seek a newer world".  Despite that confident air of positivism, It will interest you that those ten years down the    line the anticipated newer world never really materialized neither for me nor her. And today she has returned to the rejected stone http://ift.tt/2xqVcwy she ought to be in the first place". In a scenario like this, some men with different level of maturity are known to have done drastic things either to themselves or the women in question because they lack what is needed at a time like this which is ignoring the lies that they are inadequate as a men or women for some reasons. Worse still, some of these reasons may not even be your making. Creation for all I know is based on the principle of compensation. If you lose one thing; another will be giving unto you as replacement. And if that which you've lost is divinely yours; it would definitely navigates back to you. So, I got my justice. End of story." Now shall we get down to business? Thinking through a life challenge is pretty within the grasp of those who can excites their thing faculty. And that includes those who have ignorantly taken their own lives. I mean if not ignorance, what can possibly explain a young chap who committed suicide because he failed his semester exam. Or a woman who was sexually abused by a gang of morally depraved men resorting to killing herself or continue to wallow in feelings of inadequacy, dejection and shame. Agreed they needed help; and they could have gotten it. Many have the world because they were deliberate about it. Now to the list of my recipes for thinking through life’s challenges to a dependable solution: 1.  Identify the problem and knowing what the immediate and remote causes are. Like I said earlier, life challenge can be any one of unemployment, disappointment in love or business, unwanted pregnancy and so on and so forth. The key to starting out towards a solution is identifying what yours is and knowing what the causes are immediate or remote. It could due to lack of self control in sexual matters as regards unwanted pregnancy. It could be due to lack of financial prudence, non-dedication to duty as regards why a business failed. 2. Reaching out or unburdening your heart to an ally, family and friends. You might want to talk to someone you feel would have a superiorly matured way of looking at things from among your allies, family and friends. After all, problem share is problem half solved. 3. Be open to the possibility of solution. Don't shut yourself out in disbelief, ignorance, self pity and grief. You're not the first to be in such situation and would not be the last. It doesn't matter for how long you've been under the yoke of the problem. Never shut yourself out to the possibility of solution by lackadaisically resigning to fate confining yourself to seclusion. 4. Be ready to go the extra mile. The lesson of the Biblical woman with twelve years issue of blood who brave the odds of the mammoth crowd surrounding our Lord Jesus Christ to get her healing by touching the hem of his robe cannot be over referenced. A few snippets of the narratives that were not told would be one or all of the following. I personally believe she must have spent quite a fortune in the interval leading to encountering Christ from consulting with one physician or the other. She must have been abandoned by some family members and friends. She must have become a pariah in the women associations or circles. But she got her healing anyways because she was always ready to go the extra mile. You can't begin to imagine how many people today have surrendered when they were closest to solution to some of the challenges confronting them. They simply tired out when it was the least thing expected of them. And how tragic! 5. Show determination even if people have made you subscribe to unworkable prescriptions some other time. You know just as we have fake doctors so we have certified ones. So it doesn't matter if you've lost monies to these horrible wretch; you just have to keep on trying; more so because just as we have lies so we have truth. 6. Learn to be calm in the face of storm sweeping through the ward of your life. Avoid taking a rash and irrational decision. Christ in God who speaks peace to the raging storm and tidal waters couple of millenium ago can still speak peace to your life or circumstances. All you need is faith and being meticulous. Don't resort to deathly escapism yet because you fail your semester exam, got separated from your wife or husband, ran into debt and the likes. 7. Do not resort to self help. In many instances, it has led to serious complications and even deaths avoidably. i.e. unwanted pregnancy is a good case in point. That's by the way an illustrative example. Prevention here is better than cure. Talk to someone in the know who might be eager to help for free or for a token. It is better that way than attempting to help yourself around something you knew practically nothing about. 8. Motivate yourself. It is normal to feel depressed some time; but what is not normal is staying depressed. So one of the best ways to handle depression is self motivation. Motivate yourself through positive thinking. You can also motivate yourself by listening to soul lifting music and motivational speeches. Tell yourself, you're not indomitable. Engage more in group activities. Do more of out-dooring chores. Devote yourself to helping others achieve their set goals. I bet in no time you will gain morale as a by product. Above all, ****Don't give up yet; because you're closer to dependable solution than you can imagine. The Rejected Stone

[phooll123]

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

[phooll123]

New story in Health from Time: As U.S. Braces for Coronavirus to Spread, Hospitals Worry About Shortages

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

via Blogger https://ift.tt/2wg35pI

[itsfinancethings]

March 16, 2020 at 08:06PM

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”

[pinktheoristcollector]

As doctors in the U.S. have watched Italy’s health care system buckle under the sudden strain of the coronavirus, the magnitude of the problems that could be heading their way have begun to sink in. The crises Italian medical staff have been reportedly facing — overwhelming conditions, choosing which patients get treatment, and desperately working to expand their manpower — are all things that hospitals in the U.S. could encounter if the virus continues on its path, doctors say.

“For me it flipped from, ‘This is a real concern, I wonder what’s going to happen’… to ‘Holy cow, I think we’re in trouble,’” says Laurel Fick, a residency director and an internal medicine physician at Ascension St. Vincent Hospital Indianapolis hospital, when she realized how grim the situation in Italy had grown.

As of Monday, the U.S. had more than 4,000 confirmed coronavirus cases, according to Johns Hopkins University, only a fraction of the approximately 28,000 cases in Italy. But the slow start of rolling out testing has made it impossible to know exactly how widespread the pandemic actually is in the U.S. What is clear is that the rate at which cases are increasing is similar to Italy’s trajectory. The Surgeon General said Monday that the U.S. is two weeks behind Italy.

“When you look at the projections, there’s every chance that we could be Italy,” U.S. Surgeon General Jerome Adams told Fox News on Monday.

As health care professionals watch the potential future unfold across the Atlantic, they are growing increasingly anxious that the novel coronavirus, which is particularly dangerous for the elderly and people with underlying medical conditions, could overrun the American healthcare system. As public officials and businesses try to enforce social distancing to slow the spread, hospital staff say they are concerned about shortages of specialized equipment like ventilators, hospital beds, masks and personnel. If the system grows too stretched, they worry they may ultimately have to ration health care.

For now, hospitals can only prepare for the worst. One estimate reportedly presented by the American Hospital Association predicts there could be 96 million cases of coronavirus in the U.S. in the next couple of months, with 1.9 million intensive care unit admissions, 4.8 million hospitalizations, and 480,000 deaths associated with the virus.

“We are not ready. We are not ready virtually anywhere in the country for that kind of onslaught on our health care system,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University.

For instance, Redlener estimates that there are 95,000 intensive care beds in the country, but “even in the moderate attack rate of the coronavirus,” he believes there could be a need for more than double that number. He also believes the U.S. has only a “fraction” of the mechanical ventilators that could be needed, a device that will be crucial for a virus that aggressively attacks the lungs and for which there is no good substitute. A 2010 survey estimated that there were likely around 62,000 mechanical ventilators in U.S. hospitals.

The Trump Administration has slowly begun to publicly recognize the gravity of the situation hospitals and medical staff are facing. Health and Human Services Secretary Alex Azar acknowledged during a White House briefing on Sunday that a “pandemic like this runs the risk of exceeding our health care system capacity.”

In a sign of how difficult these resources are to come by as the pandemic spans the globe, Trump held a call with governors on Monday telling them they should seek crucial equipment on their own, according to a New York Times report. “Respirators, ventilators, all of the equipment — try getting it yourselves,” Trump reportedly said. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”

Some of these supplies are available in the federally managed, secretive Strategic National Stockpile (SNS), which distributes supplies during crises like this one. On Sunday, Azar said there are “thousands and thousands” of ventilators available in the SNS, but cited national security reasons for not disclosing specific numbers of the supplies available.

Knowing their facilities cannot handle experts’ worst-case scenarios, doctors have been aggressively calling for social distancing to “flatten the curve,” or slow the rate at which the population gets infected and therefore keep the health care infrastructure from being overwhelmed. On Sunday, the Centers for Disease Control put out new guidelines recommending events with 50 or more people be cancelled for the next eight weeks, as well as events of any size where social distancing could not be incorporated.

By Monday, Trump was urging people to avoid gatherings of groups of more than ten. Several cities have now started cracking down on social life, closing restaurants and bars and asking residents to “shelter in place,” and businesses across the country have sent employees to work from home.

“I actually worry that there are a lot of individuals who are not taking it seriously,” says Avital O’Glasser, medical director for the Preoperative Medicine Clinic at Oregon Health & Science University in Portland. “I worry about the banter that people are still saying, ‘I’m going out to bars. I want to go celebrate St. Patrick’s Day. This isn’t going to affect me. I’m young and healthy. Why do I have to isolate myself?’”

If the country is unable to reduce its infection rate, the nation’s health care infrastructure will not be able to cope, and it could result in a decline of adequate care both for coronavirus patients and people suffering everyday health issues, complications or trauma, experts across the country worry.

On Friday, the American College of Surgeons released guidance on minimizing, postponing, or cancelling elective operations in the midst of the pandemic. The Surgeon General also tweeted for hospitals to consider stopping elective procedures, citing the tax it would put on personnel needed for coronavirus response. If there aren’t enough resources to provide proper continuing care to people with chronic illness, medical professionals say that in itself may also have long-term consequences in the health care system.

And while medical professionals are thinking that far ahead, they have more urgent advice. “If we don’t keep that curve flat, and try to keep the critical cases down to a minimum, we’re going to get to a point where we just don’t have enough resources,” says John Hick, medical director for emergency preparedness and emergency physician at Hennepin Healthcare in Minneapolis.

Hick worries about the number of ventilators available, as well as the number of extracorporeal membrane oxygenation, or ECMO, systems, which function like an external blood pump. “So that’s kind of what we’re wrestling with right now — in addition to just space and the staffing,” he said.

He also pointed to appropriate hospital beds as something difficult to work around, describing how unrealistic it would be, for example, to place an 80-year-old patient on a makeshift cot. “Their skin breaks down. A lot of times we have to position those patients differently in order to ventilate them appropriately,” he said. “There’s just no substitute for a good, quality hospital bed.”

Hospitals are also increasingly concerned about the short supply of the personal protective equipment (PPE) used to keep health care workers safe and healthy, like gowns, N95 respirators, surgical masks, gloves and eye protection.

“We’re seeing significant shortages of personal protective equipment and [a] shift to having to really conserve personal protective equipment to make sure that our nurses, physicians and others are adequately protected,” says Paul Biddinger, Vice Chairman for Emergency Preparedness in the Department of Emergency Medicine at Massachusetts General Hospital. “Every health care system has been having to very carefully determine how they allocate and use their PPE so that they try to preserve it to protect the workforce.”

As an increasing number of first responders are likely to come in contact with and contract coronavirus — and therefore be unable to continue working themselves — staffing could become a major problem. Facing furloughed workers, or workers simply exhausted after endless hours on the job, trained professionals out of the workforce may be looked to as standby substitutes. Health care professionals who are not normally considered frontline workers are also figuring out how they can jump in and get involved in the fight.

“I think we’re having to all get comfortable with the idea of practicing outside of our comfort zone,” Fick says. “I’m an internal medicine physician, I’m trained in critical care for my residency, but that was 10 years ago. I haven’t operated a ventilator in 10 years, but I’m preparing to rapid-fire relearn that skill in the event that I have to use that.”