UNDfaninMICH
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Posts posted by UNDfaninMICH
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1 minute ago, iramurphy said:
Canceling unnecessary gatherings is important in minimizing the spread of this virus. Thinking everyone infected with COVID-19 should go to a clinic or hospital is flawed. That is the type of behavior that is more likely to overwhelm our system and spread the disease. People who are ill especially with cough and fever should stay home. The shouldn’t call an ambulance for non-emergencies. They should not go to ER or hospital until directed to unless they are experiencing a serious or life threatening emergency. They should not go to their clinics unless told to come in. There is no treatment yet for this virus except supportive care for serious cases that may need ventilators/oxygen/IV fluid resuscitation. That is why the 85% of people without serious symptoms should stay home. That is how we will have the resources to care for the other 15%. If you aren’t sick you likely won’t need to be tested. Stay away from hospitals and clinics where you are more likely to be exposed. I’m in a rural area and no one sits in the waiting room waiting. You are taken to an isolation room and evaluated by medical staff wearing appropriate protection. Please stop the scare tactics. If the public follow the advice to stay home when ill, wash hands and call before coming to clinic or hospital we can do a lot to further slow this thing.
Where did I say that all people should be seeking care? I am not in a rural area, I accept patients from rural areas. When we’re very busy, patients sometimes wait hours in ER’s of rural hospitals for an EMS crew to transport them to us. Maybe things aren’t that way in MN/ND, but I didn’t realize the discussion was limited to specific geographic areas.
100% agree that people shouldn’t call an ambulance to their homes for a large amount of the things they do call for, and that people go to the ED way too often when they have zero emergency, but that’s not changing.
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5 minutes ago, yzerman19 said:
Just wait until some junky on a speedball dies because we ran out of vents...the moral outrage! If we just had more control and more govt services we could save the world!
snowflake mentality. Nobody is special, we are carbon, hydrogen, and oxygen (splattering of most other elements)brilliantly organized for a nanosecond in space time as we propel towards entropy.
Love one another, live each minute as if it’s your last, and accept What cannot be controlled.
So why do we have medical care at all?
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Just now, yzerman19 said:
I’d celebrate those we would be able to save as opposed to mourning those lost. We can not save everyone.
WTF. If my loved ones are going to die I want them to die on the utmost amount of support that they choose, within reason. I sure as hell don't want them to die because there was no ICU bed, or no ventilator, or because the ER wait time was too long.
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6 minutes ago, iramurphy said:
Your co-workers who have cough and fever shouldn’t be at work in the first place. Testing for for COVID-19, if negative, only means it was negative that day. That is why you shouldn’t routinely test. It may give some a false sense of security. What is your protocol for routine testing? Every week? Every cough? Makes no more sense than your pulmonary testing. This is what happens as the government takes over health care. They take away providers authority to act appropriately and promptly. You should have protocols and triage system in place. When you have that your state and county authorities should authorize someone in your clinic and hospital to proceed with testing. Public service announcements and communication to your patients about the importance of hand washing, minimizing unnecessary exposure to groups or high risk areas, covering coughs etc. Staying home when sick and calling for instructions before coming to clinic or hospital are more important than making Oxbow wear a mask all day.
I have grave concern about fever being the marker that should lead to quarantine/isolation/testing. Chinese data showed 84% of their patients who were positive for Covid-19 had fever. I don't know to what degree they were testing the ambulatory person with simple cold symptoms. If we could be confident that fever is the indication that a person is shedding, we could get back to business as usual aside from screening everybody for fever as they're queuing up for whatever public gathering they're wanting to attend. People don't want to hear this message because it's a nightmare for hospital staffing. Fortunately it sounds like my hospital system will have on-site testing soon, so I'm hopeful that's true for other areas as well.
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54 minutes ago, Cratter said:
As a society we decided that the 60,000 flu deaths last year was less important than the economy.
Can we stop with this? It is recognized that viruses will kill people, and to stop that from happening would require virtually complete isolation. People who have died from influenza in recent years have by and large died while receiving maximum therapy for their degree of illness, assuming they didn't elect personally to just let the flu kill them without intervention. The H1N1 outbreak may be an exception, and one could argue that more should have been done back then.
The concern with a pandemic from a novel virus strain is that the volume of patients needing major interventions to keep them alive will be greater than the number of beds, staff, and equipment available to provide them that care. EMS transport crews may be overwhelmed, requiring people chill at home for a while if they have rapid onset of symptoms, or requiring people to wait in their doctor's office or rural hospital for hours until a crew can transport them. Yes, this stuff is already happening far more than it should happen, but there is potential for a huge increase in these issues, leading perhaps to people dying not because there was nothing more technology and medical care could do for them, but because we ran out of technology for them.
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Just now, Oxbow6 said:
If no one comes in contact with anyone else ever will be ok.
I'm more on the side of infection being pretty damn hard to prevent, but let's not get entire communities infected at once so that we don't run out of beds, staff, equipment, etc.
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4 minutes ago, keikla said:
All of that fear and unknown goes away if we could just get access to testing. In the meantime, yeah, I think people should be more conservative in their actions.
I don't know that access to testing is going to be a panacea. Get tested now, be negative. Maybe your next illness is coronavirus. How many resources are we going to plow into repeatedly testing each person each time he or she has a cold?
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43 minutes ago, yzerman19 said:
Supply and demand.
most healthcare is not for profit, so executive comp is heavier in salary due to no stock
Supply: Here's what happens in my community: Get extensive training in medicine, become a practicing physician. Get put on a committee or two, do things that please the higher ups, like find ways to get the grunts to do even more work. Maybe have some connections to wealthy donors. Get sent to an MBA program at the expense of the hospital system (truly, at the expense of the general public who pay for it via their insurers). That MBA will be from a school that is not at all respected outside of our little community. Finish MBA, become a newly minted executive, abandon your clinical practice that you were heavily trained for and experienced in, double your salary.
Demand: Who is creating this demand? The executives who want to decrease their workloads, so they find a few sub-executives? Again, the growth in executive positions in healthcare systems (including medical schools) is growing at a staggering rate, at least around here. Someone retires, and his job is then split into two brand new positions. Add in the executives at the medical board for each specialty, as well as the executives in professional organizations for each specialty. Oh, and look out for NEW subspecialties to be needlessly created so that people in academic medicine can have new ways to make money without seeing patients.
https://www.kevinmd.com/blog/2014/05/physician-regulators-paid-front-line-doctors.html
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47 minutes ago, Oxbow6 said:
In any "business" there's really only two groups...those who pull the wagon and those that ride in the wagon. Rarely does it make sense or is it equatable..... especially in healthcare.
So if it doesn’t make sense, should healthcare be a business venture? The number of “executives” at my institution has grown by leaps and bounds over the last 15 years, with little improvement in delivery of care. I assume the same is true across the country.
There are quite a few people who perform huge roles related to service for the people of our country without the expectation of seven figure salaries. Hint: look north of Minot and west of Grand Forks.
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Just now, LeftyZL said:
In my opinion, The reality is in the business world you don’t make or buy things you don’t need at that moment. That’s why we are in more of a reactive state vs. proactive state. That’s just the reality, I don’t stock things at my business that I might need in 3, 6, or 9 months.
That’s wasting money and preventing me from buying other things with that money.
That is exactly true. Why do we run healthcare enterprises as "businesses" rather than entities for the good of our citizens? Right now the "things" being bought with the money "saved" by remaining in a reactive state are big salaries to executives in hospitals, pharma companies, and insurance companies, to name a few. Hospital execs are being compensated in the millions, yet heaven forbid there be a nurse working a shift without a packed full assignment.
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1 hour ago, Oxbow6 said:Our containment measures here started when? We are 8 weeks into this....41 CDC reported deaths. They death total will inevitably go up but some here make it sound like dead bodies will be falling from the sky soon.
As far as panic........some civil unrest took place at a Costco in NY and a Sam's Club in GA yesterday. Someone was stabbed at the Sam's Club.........over bottled water. Bottled water!
The widespread opinion amongst experts in epidemiology, infectious diseases, and public health is that the containment measures will reduce the number of dead as compared to what would happen with no containment measures. We will never know how bad things "could" have been if we chose to just live life as usual. But we can get some ideas of that from Italy, where the response to the initial cases was rather passive. Anyone who has an understanding of science will acknowledge that we can't truly know how bad things would have been by doing nothing. On the flip side, people who don't understand science are going to look at the numbers when/if this pandemic ends and say, "See, I told you it wasn't that bad!".
I agree that hoarding foods and other items with a "me first" attitude is ludicrous, but that is a microcosm of American behavior as a whole. When public events were shut down in China, Italy, and South Korea were there riots?
People shouldn't panic to that degree. Some people seem to be saying that public health experts are advocating for such panic, but that is patently false.
My snarky side would say that apparently the bar for acceptable deaths is anything less than caused by H1N1 flu, so as long as the stabbing victim didn't die, things are apparently ok and stabbings should be tolerated as "not that bad" for now.
When things settle down, will Americans be ready to have a conversation regarding why hospitals operate on very thin margins when it comes to resources like ICU beds, staffing, isolation gear, diagnostic test kits, devices, etc? Here's a starter: even though a pandemic from viruses like coronavirus has widely been anticipated, pharma companies have little motivation to work on medications that "might" be needed and won't see daily ongoing use even if they are needed, because such work isn't profitable to them.
*Edited because I didn't mean to imply that there were in fact riots in China and South Korea.
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36 minutes ago, Oxbow6 said:
So stay curled up in the fetal position in you basement...and our "medical" expertise on this issue compared to Dr. Carlson is you beat your wife in a game of "Operation" last night?
Clarify...is that great medium article you cite "facts", "truths" or both?
Outliers statically are just that outliers. Doesn't mean it didn't happen but it's like Sesamee Street.......one of these things in not like the others.
Let's do this, even though I'm wrong as is Dr. Carlson......let's take his worst suspected transmission rate across the board at 7%. Then I'll play the game of "this is 10x deadlier than the flu". So 1% mortality of all the 7% that get infected and we know that number is high and dropping.
Here's what you get potentially from this outbreak:
330M in US population
23.1M infected
231K deaths
The CDC just posted these numbers for this flu season thru March 7 and I picked their low end range to soften the blow...
36M infected
22K deaths
We can argue about the mortality rate of corona but numbers appear most likely to be around 1/2% in the end if not lower but still higher than the flu. More severe than the flu....but less contagious as was in my original post from Dr. Carlson. As of yesterday 4 pm the CDC reported 41 deaths from the corona outbreak in this country with a first reported case almost 8 weeks ago. An average seasonal flu season is 13-15 weeks.
What if....just what if Dr. Carlson is remotely close to what he thinks of the virus from a contagious standpoint? This country will have been ravaged from a normalcy standpoint and our society flipped upside down because basically we are in the midst of a 2nd bad "flu" season. Let that sink in.
What if... just what if Dr. Carlson based his data on the experience in China and South Korea, where containment measure were rapidly put into place and more widespread testing was available? Some people may have called those containment measures “panicking” at that time.
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1 hour ago, CMSioux said:
Here is a path of how we got here.
I can tell by the headline that this article won’t support my narrow worldview, so I’m not going to read it. Or maybe I will read it, but I will reject it as fake news.
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11 hours ago, Yote 53 said:
The only people who need to be tested are health care workers, the elderly, and those with underlying health conditions. If you are young (under 50) and healthy and are taking up a test kit, crowding the ER, or otherwise taking up the health systems time and resources you are an a$$hole and part of the problem. Stay home, self quarantine, ride the illness out. If things start getting worse for you then seek help, otherwise use some common sense and don't be a strain on the system.
Oh, and the media lies, they are a bunch of liars that push their narrative and it has been that way for a couple decades now. The Trump administration, they lie too. So did the Obama administration, do did the Bush administration, so did the Clinton administration, etc., etc. It's all a game of gotcha and spin, and that folks is the F'ing problem, we can't believe any of them.
Rant over.
Rather than testing the elderly and people with chronic conditions, I’m interested in testing the people who have some symptoms but are not all that sick. This would help us know the extent to which it may be spread by people who feel good enough to leave the house, as well as help guide which hospitalized patients should be maintained in special isolation.
My local health department has said to test patients with symptoms who have risk by contact with known cases or by travel, or patients with severe illness even in the absence of other risk factors. Makes no sense to me. -
6 minutes ago, Oxbow6 said:
But the precedent has been set.
Maybe the CDC will be hiring and you can make change.
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6 minutes ago, Oxbow6 said:
This "right" call, as you call it, has set a precedent moving forward...........
I said that perhaps it will be right. In the end we’ll never know, unless we match regions of the country into social distancing vs life as usual groups, and introduce the same number of infected people into each.
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3 hours ago, geaux_sioux said:I always love hindsight geniuses. I’d love to see anyone who talks all kinds of !@#$ about these disease control scientists make a prediction about a novel virus and it’s potential impact world wide.
And if some of the public health actions cut down on deaths, some around here will point at the total number of deaths and say, “See, I told you it wasn’t that bad!”, rather than acknowledging that perhaps officials made the right call.
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15 minutes ago, Cratter said:
There was a global pandemic in 2005.
Bird flu pandemic 'could kill 150m'
Fast forward 15 years...
Less than 500 people have died worldwide.
Oops. Guess there were a little off on those projections.
You missed the big "if" in that article, which was if the bird flu virus mutates and becomes readily transmissible between people.
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The president of Michigan State University just announced suspension of in-person classes until April 20, at a minimum. Some of his credentials follow:
"Dr. Stanley has served as chair of the National Science Advisory Board for Biosecurity, which advises the U.S. government on issues related to the communication, dissemination and performance of sensitive biological research. He was a member of the National Advisory Allergy and Infectious Diseases Council at the NIH and a member of the NIH director’s
Blue Ribbon Panel on the National Emerging Infectious Diseases Laboratories. He also served as an ambassador for the Paul G. Rogers Society for Global Health Research and has received an Honorary Doctorate in Science from Konkuk University in South Korea. He is a member of the Board of Directors of the Association of American Universities and has served on the NCAA Board of Directors and NCAA Board of Governors."
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1 minute ago, Cratter said:
You told me the same amount of people will get it regardless.
You told me cancelling March Madness will just slow down the rate.
So grandma's chances remain equal.
Not really. Slowing down the rate means ER wait times will be less, EMS crews won’t be as overwhelmed, and medical equipment like ventilators will be more readily available. Medical systems are generally not built with a lot of excess capacity.
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9 minutes ago, Oxbow6 said:
Got it.....we'll agree to disagree. This is not the flu. 60 years and younger in good health in THIS country you're better off getting corona than the flu. Severity of critical illness and mortality is less ......and I don't live in Italy.
Text me if you need me to deliver you a pizza or toilet paper. I'll Skype you to keep you company too.
If only everybody in THIS country was younger than 60 and in good health. Neither of those viruses are terribly likely to be harmful to that crowd. It’s the potential spread to vulnerable populations that should have people concerned. Most people with flu are (hopefully) wise enough to avoid others when they are experiencing the fever, chills, and cough that come with flu. I’m concerned that younger, healthy people with Covid-19 are going to simply have colds, and they’re going to want to keep on living their lives, putting others at risk.
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15 minutes ago, Oxbow6 said:
That's what you have gleaned from all this media coverage? Do you not think anyone over 60 isn't at risk of mortality from influenza?
Seriously...…..
I do not think people over 60 aren’t at risk from flu complications, I’m well aware that they are. How about addressing the other part of my post?
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1 hour ago, Oxbow6 said:
I go back to if this is the precedent that is being set because of something slightly greater than the common cold for a vast majority of the population why the **** do we have school for our kids in this part of the country from October thru April moving forward???
Perhaps because those people who aren’t severely affected are going to think that since they’re not very sick, it’s okay for them to go to work, school, church, public gatherings, etc. This would lead to spread to the elderly. Do people who are saying, “It’s not that bad if you’re under 60!” not care about older citizens?
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12 minutes ago, 90siouxfan said:
I observed some blurb about having a new style ID in order to fly, sounded like an impromptu trip to Detroit is behind the wheel.
I think that requirement starts October 1.
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2020 Dumpster Fire (Enter at your own risk)
in Community
Posted
Around here students on clinical rotations are still attending them.