COVID-19

[Derrico]

On 3/27/2020 at 10:37 PM, Brawndo said:

Liger’s Response was about the US having the most reported cases of Covid, not about transferring patients upstate from NYC. 
 

And he was being sarcastic about that. 

Liger also said this was essentially just a political issue in the old thread that got locked down.  If people and governments listened and reacted when concern over this was first raised as it happened in Asia and started the spread to Europe we would be much further ahead of the curve.  Wish I could quote that old thread but it got locked because people turned into into a political issue.  Oh well, let’s focus on what can be done now. The lack of testing (still!) in North America is absolutely mind bending when compared to how quickly countries like South Korea and Germany started rolling out mass testing.

[Derrico]

19 hours ago, SwampD said:

Do you think it’s because we’ve never had this level of social media usage before?

Are you still of the mind this is just a bad flu season??  JFC......

[LGR4GM]

19 hours ago, Indabuff said:

I never said my family member was more important than anyone else.  I used my MIL as an example.  Not sure where you pulled that from my responses but that is clearly not the argument I'm making.  If someone 300 miles away is in the process of receiving or is in need of receiving medical treatment for the virus, I find it ridiculous they would a) be transported to an area from dense infection to an area of low infection jeopardizing the new area to further probability of increasing infections and b) potentially deprive someone locally (MIL, you, me, Sabretooth) of any locality for that matter (patient from Detroit, MI->Sharon, PA) of necessary medical treatment for the virus. 

I voiced my opinion on the topic, received a seemingly snarky retort, and asked for a logical explanation from the poster.  I followed that up with a statement that I wasn't interested in a pissing match (see last night posts) and still have no interest in said pissing match.    

I won't get into a pissing match either. 

[SABRES 0311]

19 hours ago, nfreeman said:

The question of whether a city could legally refuse to accept patients from another city, especially in the same state, and especially where the hospitals receive state money, is interesting. I doubt that a city could do this.

The question of whether it would be morally right to do so is a separate and also interesting question.  I think in considering that question, weighing one city’s lives against the other’s is unavoidable.

You would have local police squaring off with state police like Super Troopers. 

Morality of this touchy. If said hospital was beyond it’s capabilities or the introduction of more patients would collapse its capabilities then the city would have an argument. Then again how can you turn someone away like that? 

[nfreeman]

25 minutes ago, SABRES 0311 said:

You would have local police squaring off with state police like Super Troopers. 

Morality of this touchy. If said hospital was beyond it’s capabilities or the introduction of more patients would collapse its capabilities then the city would have an argument. Then again how can you turn someone away like that? 

Exactly.  It's a tricky question.  On the one hand, if City A is overwhelmed and City B has plenty of capacity, it's easy to say that City B should take patients from City A -- but everyone knows that this will substantially increase the risk of widespread contagion in City B.

[PASabreFan]

Back in the real world, the health system said the rumor that patients will be transferred are "false" while still acknowledging the possibility it will happen. And the county with Hospital B just got its first case, after the county with Hospital A got its second.

[Eleven]

22 hours ago, Wyldnwoody44 said:

H1N1 killed 40 million people, and we didn't do anything. 

H1N1 is differentiable, though.  In 1918, we didn't exactly know what we know now, and there also was this small matter of a world war going on.  In 2009, it didn't kill 40M.

[Tondas]

Makes me think of this.

 

[Curt]

23 hours ago, Wyldnwoody44 said:

H1N1 killed 40 million people, and we didn't do anything. 

This I am not understanding.  You are talking about 1918, right?

The people of that time most certainly did do things to try to stop the spread.  Scientists/Doctors urged “social distancing” type measures.  Some places headed the advice, others did not.  It was a totally different world then, but that pandemic was a huge social issue that had people terrified.  It wasn’t something that just happened in the background as people went about their daily lives.  It destroyed communities.

If you’re point is just that this is not as bad as the 1918 pandemic, then yes, of course, I think all would agree.  I know you are just venting to an extent, but you go from lamenting how unprepared the health care system is for this in one post, to saying that this is not such a big deal in the next.

Edited March 29, 2020 by Curt

[Wyldnwoody44]

6 minutes ago, Curt said:

This I am not understanding.  You are talking about 1918, right?

The people of that time most certainly did do things to try to stop the spread.  Scientists/Doctors urged “social distancing” type measures.  Some places headed the advice, others did not.  It was a totally different world then, but that pandemic was a huge social issue that had people terrified.  It wasn’t something that just happened in the background as people went about their daily lives.  It destroyed communities.

If you’re point is just that this is not as bad as the 1918 pandemic, then yes, of course, I think all would agree.  I know you are just venting to an extent, but you go from lamenting how unprepared the health care system is for this in one post, to saying that this is not such a big deal in the next.

Yes, I am mixing up my years and my diseases, my apologies. The sheer amount of crap we're being put through in the Healthcare field is causing some flip flopping for all of us, mentally speaking. Every day, new guidelines, new procedures, new stories, wading through the muck, etc. 

I'll put it as plainly as I can from a personal perspective. I was trained in the military to prepare for stuff like this, quarantine, etc. I dont personally belive this is as bad as we are making it out to be; I don't think it's just the flu, but I don't think it warrants national and international shutdown. 

With that being said, if we are going to declare a national emergency and a pandemic I do have an expectation that those in charge (leaders of health organizations, hospitals, etc) will have their crap together, and we simply do not. I may not agree with everything that is going on, but in my job, I can take orders well. Someone level headed needs to take charge and it's simply not happening (especially in my current local situation). The lack of preparedness and the lack of following through on this social distancing thing makes this feel like a joke. 

[darksabre]

A really close friend's aunt just died from it. She was 73, lived in Florida. I'm heartbroken for him. 

[Curt]

12 minutes ago, Wyldnwoody44 said:

Yes, I am mixing up my years and my diseases, my apologies. The sheer amount of crap we're being put through in the Healthcare field is causing some flip flopping for all of us, mentally speaking. Every day, new guidelines, new procedures, new stories, wading through the muck, etc. 

I'll put it as plainly as I can from a personal perspective. I was trained in the military to prepare for stuff like this, quarantine, etc. I dont personally belive this is as bad as we are making it out to be; I don't think it's just the flu, but I don't think it warrants national and international shutdown. 

With that being said, if we are going to declare a national emergency and a pandemic I do have an expectation that those in charge (leaders of health organizations, hospitals, etc) will have their crap together, and we simply do not. I may not agree with everything that is going on, but in my job, I can take orders well. Someone level headed needs to take charge and it's simply not happening (especially in my current local situation). The lack of preparedness and the lack of following through on this social distancing thing makes this feel like a joke. 

I honestly do feel for you and all health care workers.  My fiancé is one, currently in Westchester NY.  I think the constantly shifting of policies is happening everywhere as hospitals are forced to adapt their policies to their availability of resources.  It’s certainly not ideal, to say the least.

I don’t know if we are doing too much social shutdown, as I haven’t studied epidemiology.  However, I do feel that if the healthcare system in general was more prepared (resources and organization) less social distancing would be necessary because we would be able to handle a greater influx of cases.

PS:  There will be more frustration and difficulties ahead.  Try not to get too discouraged.  Do your best.  We are all lucky to have healthcare workers like you who care so much about what you do.

Edited March 29, 2020 by Curt

[Marvin]

A point to remember about the 1918-9 epidemic was that all the troops who were returning from the trenches brought the flu with them.  It was all over Europe and North America before people really knew it how bad it was.

[Curt]

5 minutes ago, E4 ... Ke2 said:

A point to remember about the 1918-9 epidemic was that all the troops who were returning from the trenches brought the flu with them.  It was all over Europe and North America before people really knew it how bad it was.

This is kind off topic, but this is true, and I feel like indulging.  Another reason that flu was so bad was because it was so destructive was because it was especially deadly to people in the prime of their lives (20-40) with especially strong immune systems.  It left a lot of children without parents and a lot of jobs without anyone to perform them.

[Wyldnwoody44]

36 minutes ago, Curt said:

I honestly do feel for you and all health care workers.  My fiancé is one, currently in Westchester NY.  I think the constantly shifting of policies is happening everywhere as hospitals are forced to adapt their policies to their availability of resources.  It’s certainly not ideal, to say the least.

I don’t know if we are doing too much social shutdown, as I haven’t studied epidemiology.  However, I do feel that if the healthcare system in general was more prepared (resources and organization) less social distancing would be necessary because we would be able to handle a greater influx of cases.

Honestly I am just hoping for a quick conclusion, we have world renound virologists and people of science on this. 

On a side note health care workers are being attacked in public, people coming up to them in gas stations and spraying them with lysol, and other ridiculous things. 

I had to stop at Wal mart (shiver) this morning, after I left an overnight shift, I changed into clean scrubs and showered before leaving, but I was still out and about in scrubs... The evil eyes and stares I was getting was out of hand, all the hoarders were looking at me like an alien with death stares. Kinda eerie, and firmly keeping me in mind mind of belief that we need natural selection ?

[PASabreFan]

The increase in the rate of new hospitalizations in NYC is slowing even more and now doubling every six days. The number of people getting discharged has been steadily increasing in recent days. Both good signs.

[Weave]

This is from the twitter account of @justinwolfers econ prof at Michigan

 

Point is, these data show that ZERO actual economists believe that the economic costs of current anti-Covid measures exceed the benefits. NO ECONOMISTS are arguing for re-opening the economy.

It's pretty rare to see this degree of consensus among econs. 
 

http://www.igmchicago.org/surveys/policy-for-the-covid-19-crisis/

[SABRES 0311]

24 minutes ago, PASabreFan said:

The increase in the rate of new hospitalizations in NYC is slowing even more and now doubling every six days. The number of people getting discharged has been steadily increasing in recent days. Both good signs.

Going up here in California.

 

[nfreeman]

The Frenchies are making progress:  https://techstartups.com/2020/03/27/coronavirus-cure-new-results-french-study-shows-combination-hydroxychloroquine-plaquenil-azithromycin-successfully-treated-80-coronavirus-patients-significant-dr/

Quote

In 80 in-patients receiving a combination of hydroxychloroquine and azithromycin, the team found a clinical improvement in all but one 86 year-old patient who died, and one 74-year old patient still in intensive care unit.

 

[Curt]

1 hour ago, Wyldnwoody44 said:

Honestly I am just hoping for a quick conclusion, we have world renound virologists and people of science on this. 

Agreed, that’s what we all want.  It’s probably going to be a patchwork type of improvement though, with little outbreaks popping up here and there over the next few months.  Some places will probably require re-shuttering at times.  It’s going to be a balance between reopening things and controlling outbreaks as we come out of this thing.

Edited March 29, 2020 by Curt

[Brawndo]

4 hours ago, PASabreFan said:

The increase in the rate of new hospitalizations in NYC is slowing even more and now doubling every six days. The number of people getting discharged has been steadily increasing in recent days. Both good signs.

I discharged 79 and 81 yo today. 
 

I also placed a 24 yo on a vent and transferred a 51 yo to St Joes who has had worsening respiratory failure. 
 

Mixed results for sure 

3 hours ago, nfreeman said:

The Frenchies are making progress:  https://techstartups.com/2020/03/27/coronavirus-cure-new-results-french-study-shows-combination-hydroxychloroquine-plaquenil-azithromycin-successfully-treated-80-coronavirus-patients-significant-dr/

 

Kaleida and Catholic Health in WNY are both using this off label 

[PASabreFan]

12 minutes ago, Brawndo said:

Kaleida and Catholic Health in WNY are both using this off label 

When it's used, is it part of the trial or at least informally reported to someone?

[Eleven]

Just now, PASabreFan said:

When it's used, is it part of the trial or at least informally reported to someone?

It's reported here on SabreSpace.

[Claude_Verret]

1 hour ago, PASabreFan said:

When it's used, is it part of the trial or at least informally reported to someone?

All bets are off at this point as far as normal reporting for clinical trials. I have a friend who travels the country monitoring clinical trials and he's completely shut down like everyone else. 

I'm sure there will be some leeway given for reporting given the current circumstances,  but I'd still be leery of fudged/cooked data.

[Brawndo]

1 hour ago, PASabreFan said:

When it's used, is it part of the trial or at least informally reported to someone?

We are not part of any trials, we are using it for patients who have an increasing oxygen requirements in an attempt to prevent them from needing ventilators.