2020 Dumpster Fire (Enter at your own risk)

[Cratter]

I'm all for somebody (National Guard?) having resources (future events) to help handle the overflow of patients that hospitals cant seem to handle.

There seems to be two different issues at play.

1) Stay home. Dont spread the virus.

2) People will die unrelated to the virus because our healthcare systems are already at max capacity.

[UNDfaninMICH]

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. 

[iramurphy]

7 minutes ago, keikla said:

Here are some things that haven't really been mentioned here, but I have found to be the most unexpected (so far) from everything happening related to COVID.  For reference, I work in 2 different hospitals, both of which are currently treating multiple COVID patients as well as many "Patients Under Investigation" (PUI).  We're also past the point of knowing your direct contact for exposure.

1) Those who die from COVID in the hospital may die alone.  Why?  Cause any family they live with or visited with recently are under quarantine and can't come visit.  Maybe if the patient is lucky there will be someone who is a relative or close family friend who hadn't been in direct contact within 14 days of the patient getting sick.  But it means that most patients aren't able to be comforted by those closest to them, and critical healthcare decisions are being made by providers and family members over the phone.  That happens sometimes, but it's definitely not what anyone wants.  This has probably been the most upsetting thing for me.

2) Healthcare education for thousands of people is being put on hold.  Most healthcare programs have a year or two of clinical rotations, something that can't be converted to didactic learning online.  A lot of hospitals around here are banning students because 1) they want to limit the risk of spread/liability and, 2) there isn't PPE to spare on trainees.  So depending on how long this outbreak lasts, there will be a lot of healthcare students (med school, pharmacy school, PA, nursing, etc.) who won't have the required experiential hours to graduate on time. 

That has cascading effects because residencies go from July-June.  What happens if your current residents for MD/DO and pharmacists end their current residencies at the end of June but new residents can't step in because their graduation was delayed?  Larger hospitals and health-systems depend heavily on residents to handle the day-to-day workload, so I'm hoping we don't get to that.  Again, this is all dependent on how long an outbreak and student restrictions last, but we're not that far from those May graduation dates.

3) I've mentioned this before, but there isn't really much data yet on how long you are contagious AFTER you've had covid.  So, again, it's just kind of a guessing game for how soon after being sick can someone return to work without risking their coworkers and/or patients.  Last I saw, the CDC wants 2 negative covid tests before someone can return to work.  But what if they never got tested in the first place?  Each institutional system is setting their own criteria.

 

And now, I need to take a COVID break for the day.  Obviously there are some majorly opposite opinions on this board, extreme to both sides, but it's nice to be able to have the discussions.

It is a mistake for medical schools or residencies  to change rotations for students and residents. This is how they learn. This is exactly where they should be. 

[Kermit's Luck]

I'm impressed and amazed that some of you intelligent and reasonable posters continue to debate this on this thread. I don't know how you do it.

This isn't political. It's also not the time to armchair quarterback everything, or to become an amateur epidemiologist.

To those who are calling this an extreme over-reaction - have you made any effort to educate yourselves about what's happening in Italy? Even if there are underlying reasons that the virus MAY spread differently here, these measures are absolutely worth it. To ignore data like a parabolic rate of infection/death occurring in a highly modernized Western country and to proceed as though things will be different here would be reckless. There are many reports of ICUs running out of beds, ventilators, etc.

https://www.worldometers.info/coronavirus/country/italy/

This link is data about the situation. Look at the graphs.The infection/death rate is acting like a quadratic equation, and without taking extreme measures this could be historically bad.

[UNDfaninMICH]

7 minutes ago, keikla said:

Agreed, but the decision is being made at the hospital levels, not the schools.  As far as I know, residents are still working as normal because they are employed staff, but students are being kept off hospital/clinic campuses.

Around here students on clinical rotations are still attending them.

[SiouxFan100]

It’s interesting how our views change when we think it is all about those other people when we get affected and those other people are us.

[Cratter]

Social distancing too little too late.

Experts predicting over 1,000,000 Americans will die.

 

[ChrisUND1]

Flatten the curve.  Avoid large gatherings.  As mentioned in this thread, don't go to the ER for fever and cough, don't call an ambulance for routine issues.  Call your healthcare facility's hotline if you have questions.  There are some people like Oxbow out there who are going to choose to "live their life" and ignore the pleadings of the experts. Fortunately, there are many more people who are choosing to listen to the national public health experts, and are staying home right now.  Healthcare professionals across the nation thank you for helping to flatten the curve. 

[.357]

Because everyone avoided my last post like the plague, or like the coronavirus, I submit again:

...the US will soon have 30,000 troops doing military exercises throughout western Europe, without masks or any kind or protective gear; coming into contact with the local populations there on a big scale. But Europeans can't fly here for at least the next 30 days, I guess, because of the danger of fanning this dangerous contagion. Lol.

If this is such an infectious pandemic, would we risk such high numbers of the populace there or our troops to such, spreading it further? Of course not. But the locals there have no choice and are being confined against their will, much like is happening to us. 

My wife is a RN & works in the surgical/trauma unit of her hospital. Most of her colleagues are approaching this covid nonsense as a variant or strain of the common cold, which it likely is, & taking the necessary precautions. Not saying policy or perceptions there won't change, but that's the prevailing attitude there as of now amongst the nurses, I can't speak for the administrators there....and don't be surprised if (or when) covid-20 emerges later this year once the temps dip again, and covid-21 next year, covid-22, etc., resulting in more cancellations & reductions in personal freedoms, like our right to freely travel, mandatory vaccinations, what have you.

And I guess we can't test for it, according to Cratter's post above, but we can sure give it a name. Sometimes you just gotta laugh.

 

 

 

[Oxbow6]

9 minutes ago, ChrisUND1 said:

Flatten the curve.  Avoid large gatherings.  As mentioned in this thread, don't go to the ER for fever and cough, don't call an ambulance for routine issues.  Call your healthcare facility's hotline if you have questions.  There are some people like Oxbow out there who are going to choose to "live their life" and ignore the pleadings of the experts. Fortunately, there are many more people who are choosing to listen to the national public health experts, and are staying home right now.  Healthcare professionals across the nation thank you for helping to flatten the curve. 

Who's going to go to Walmart or Target or the groceries store for my family  Chris?

Asking for my wife.

[ChrisUND1]

3 minutes ago, Oxbow6 said:

Who's going to go to Walmart or Target or the groceries store fo my family  Chris?

Asking for my wife.

You know that's not what we are talking about.  That said, sanitize when you get home, dont touch your face while there, etc.  Easy steps.

[Oxbow6]

1 minute ago, ChrisUND1 said:

You know that's not what we are talking about.  That said, sanitize when you get home, dont touch your face while there, etc.  Easy steps.

What are you talking about? Enlighten me. You seem fairly educated.

[yzerman19]

12 minutes ago, Cratter said:

Social distancing too little too late.

Over 1,000,000 Americans will die.

 

So- Andy is usually one of the smartest people in the room.  I’m curious if he’s seen anything or his people have seen anything in the last 36 hours that would alter this projection.  
 

one of the things I’m seeing is that CA models are extremely worried about it ripping through the homeless population unabated.  

[Cratter]

26 minutes ago, yzerman19 said:

So- Andy is usually one of the smartest people in the room.  I’m curious if he’s seen anything or his people have seen anything in the last 36 hours that would alter this projection.  
 

one of the things I’m seeing is that CA models are extremely worried about it ripping through the homeless population unabated.  

He says we're two weeks behind Italy.

That puts us equivalent to about 7,000-8,000 Americans dead in two weeks from the coronavirus.

[ChrisUND1]

3 minutes ago, Oxbow6 said:

What are you talking about? Enlighten me. You seem fairly educated.

If you don't have to go out right now, don't.  If you need life necessities, go get them. Sports and entertainment are on hold right now. This isn't about living in a bubble.  This is a basic public health strategy that someone who works in healthcare should understand.  As geauxsioux mentioned above,  we are fortunate to live in a less densely populated area.  I'd hate to live in a larger city when the numbers get up there.

  

[iramurphy]

1 hour ago, UNDfaninMICH said:

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.

Fever isn’t the marker. I said people with cough and fever should stay home. Testing depends on many factors, including recent, travel, occupation, known exposure, sore throat, cough, fever etc. I do believe every medical facility should have protocols in place that allow the health care providers to test without waiting time with some county administrator  

I can’t vouch for this source, but if you google www.worldometers.info it compares different counties from 3/14. 
The USA has one of the lower number of cases per million population (7.5/million). Of the present 2395 cases 10 were listed as critical. USA death rate was 2.2%.  

Some  talk about hospitals overwhelmed with cases and no resources to care for the sick. I have family in the New Rochelle NY area which is the epicenter of one of their outbreaks and that isn’t the info they are hearing. For those of you experiencing that where are you?  

[The Sicatoka]

Fear sells. 

[UNDfaninMICH]

12 minutes ago, iramurphy said:

Fever isn’t the marker. I said people with cough and fever should stay home. Testing depends on many factors, including recent, travel, occupation, known exposure, sore throat, cough, fever etc. I do believe every medical facility should have protocols in place that allow the health care providers to test without waiting time with some county administrator  

I can’t vouch for this source, but if you google www.worldometers.info it compares different counties from 3/14. 
The USA has one of the lower number of cases per million population (7.5/million). Of the present 2395 cases 10 were listed as critical. USA death rate was 2.2%.  

Some  talk about hospitals overwhelmed with cases and no resources to care for the sick. I have family in the New Rochelle NY area which is the epicenter of one of their outbreaks and that isn’t the info they are hearing. For those of you experiencing that where are you?  

I don't know that anybody in the US is experiencing shortages of resources, but we're told that's true in Italy. It "could" happen here, but if people are careful it shouldn't.

[ChrisUND1]

13 minutes ago, iramurphy said:

Fever isn’t the marker. I said people with cough and fever should stay home. Testing depends on many factors, including recent, travel, occupation, known exposure, sore throat, cough, fever etc. I do believe every medical facility should have protocols in place that allow the health care providers to test without waiting time with some county administrator  

I can’t vouch for this source, but if you google www.worldometers.info it compares different counties from 3/14. 
The USA has one of the lower number of cases per million population (7.5/million). Of the present 2395 cases 10 were listed as critical. USA death rate was 2.2%.  

Some  talk about hospitals overwhelmed with cases and no resources to care for the sick. I have family in the New Rochelle NY area which is the epicenter of one of their outbreaks and that isn’t the info they are hearing. For those of you experiencing that where are you?  

US is 7 to 10 days away from where Italy is. Have heard some accounts from healthcare team members there that are very upsetting. 

[SiouxFan100]

Has Italy peaked?

[UNDfaninMICH]

5 minutes ago, The Sicatoka said:

Fear sells. 

So do conspiracy theories and science denial.

[ChrisUND1]

3 minutes ago, UNDfaninMICH said:

So do conspiracy theories and science denial.

Yep.  Most people are right in the middle, thankfully.

[UND1983]

So an Obama guy is making this political and saying a million people are gonna die because of Trump.  Of course.  

[yzerman19]

2 minutes ago, UND1983 said:

So an Obama guy is making this political and saying a million people are gonna die because of Trump.  Of course.  

This “Obama guy” is not a politician.  He isn’t a talking head either.  I have personally interacted with him in business.  In the circles I run in, his opinion matters.  He’s not always right, but when he speaks I make sure I hear what he’s saying.

[hky]

3 hours ago, keikla said:

To be clear, this is 100% where I'm coming from.  People are going to get sick.  There is no way to completely prevent that.  I just want them to get sick at a slow enough rate that the healthcare system doesn't collapse under the weight of it.

This!