2020 Dumpster Fire (Enter at your own risk)

[iramurphy]

1 hour ago, dlsiouxfan said:

We wouldn't have this lockdown situation if the country would have had access to testing earlier and had testing readily available.  We didn't have access to testing and do not have access to testing now because Trump declined the WHO's test. He declined the tests because he figured positive tests would be bad for his re-election.  He also fired most of the people with experience handling something like this in 2018 and hampered the work of those left behind.  

You can try and blame this on the media all you want but we're here because this administration is incompetent and criminally corrupt and you're not going to get 60% of this country to turn a blind eye to it just because you have.

Let me start by admitting I’m not a Trump fan but that doesn’t mean I would support people continuing to regurgitate misinformation.  Nobody knows what would happen if testing was available earlier. If you do the minimum research, you would learn that the WHO did not offer nor did the US refuse test kits. A laboratory in Germany and the CDC both developed the first test kits on January 21. No one new that production of the test kits in the US would be complicated and slowed by problems with a reagent used in these tests. The other problem was that on February 4 the head of Health and Human Services declared a “public health emergency “.  That meant that capable labs across the country were prohibited by legislation passed in 2009, to produce test kits. That meant those labs had to petition the FDA to get permission to produce test kits. One of the labs in Wadsworth,NY received permission on February 28.  Other labs also received permission. His mistake was the early comments understating the seriousness of this disease and later overstating our ability to test. Trump did not fire “everyone with experience handling this”. He did close down the National Security Council’s office assigned responsibility for “Pandemics/“Bioterrorism”.  There are many who worked there who felt then, and now, that was a mistake. There was also a recent article where a former Obama administration official stated that Trump closed the office, but he consolidated those responsibilities to another office in a move consolidating 3 departments in order to decrease costs and improve efficiency.  I couldn’t verify that article about consolidation nor if true if they are effective. Having said that the CDC has the personnel with the training and experience to deal with this. To criticize and insult  those who disagree with your opinions is exactly what helped Trump get elected in the first place. 
We tested a patient yesterday. Where do you live where you don’t think you can be tested.  If you mean you can’t get tested because you are “afraid” but have no symptoms or exposure, that is because routine testing for asymptomatic patients with no known risks is not medically indicated. 
We will get through this better if people put their politics aside and wait to point fingers and blame until we get through this. 

[Siouxperman8]

36 minutes ago, yzerman19 said:

Good info- so case growth is similar, but death rate is very different.  Coronavirus deaths tracking same slope as infections where H1N1 was a very different slope on death.  This chart would indicate a lethality far greater than the overall % being described broadly.

I hear Osterholm often on the radio and probably depend on his info too much.   I just heard an interview from yesterday and he said the statistics say 160-214 million in US infected over the next 6-8 months.   Also at very best 200k will die and up to 1.7M.

[dlsiouxfan]

12 minutes ago, iramurphy said:

Let me start by admitting I’m not a Trump fan but that doesn’t mean I would support people continuing to regurgitate misinformation.  Nobody knows what would happen if testing was available earlier. If you do the minimum research, you would learn that the WHO did not offer nor did the US refuse test kits. A laboratory in Germany and the CDC both developed the first test kits on January 21. No one new that production of the test kits in the US would be complicated and slowed by problems with a reagent used in these tests. The other problem was that on February 4 the head of Health and Human Services declared a “public health emergency “.  That meant that capable labs across the country were prohibited by legislation passed in 2009, to produce test kits. That meant those labs had to petition the FDA to get permission to produce test kits. One of the labs in Wadsworth,NY received permission on February 28.  Other labs also received permission. His mistake was the early comments understating the seriousness of this disease and later overstating our ability to test. Trump did not fire “everyone with experience handling this”. He did close down the National Security Council’s office assigned responsibility for “Pandemics/“Bioterrorism”.  There are many who worked there who felt then, and now, that was a mistake. There was also a recent article where a former Obama administration official stated that Trump closed the office, but he consolidated those responsibilities to another office in a move consolidating 3 departments in order to decrease costs and improve efficiency.  I couldn’t verify that article about consolidation nor if true if they are effective. Having said that the CDC has the personnel with the training and experience to deal with this. To criticize and insult  those who disagree with your opinions is exactly what helped Trump get elected in the first place. 
We tested a patient yesterday. Where do you live where you don’t think you can be tested.  If you mean you can’t get tested because you are “afraid” but have no symptoms or exposure, that is because routine testing for asymptomatic patients with no known risks is not medically indicated. 
We will get through this better if people put their politics aside and wait to point fingers and blame until we get through this. 

If a person presents with symptoms and is negative for the flu and other diseases can they be tested for Covid19?  Can nurses, doctors, EMT's and other personnel who are exposed to Covid19 be tested?  They absolutely cannot in most metropolitan areas and absolutely cannot be tested in the state of Minnesota per the Minnesota Department of Health's statement in the Star tribune today.   That's unacceptable.  

Also I call BS on your statement that insulting people who disagree with your opinions is what led to Trump's election.  Insulting his political opponents is all that he does as evidenced by him going after the Democratic Governor's of Michigan, Illinois, and Washington for defying him politically.  If he'd devoted one-tenth of his attention to this epidemic as he does to insulting people on Twitter and at his hate rally's we wouldn't be in this place.

[Siouxphan27]

9 minutes ago, dlsiouxfan said:

If a person presents with symptoms and is negative for the flu and other diseases can they be tested for Covid19?  Can nurses, doctors, EMT's and other personnel who are exposed to Covid19 be tested?  They absolutely cannot in most metropolitan areas and absolutely cannot be tested in the state of Minnesota per the Minnesota Department of Health's statement in the Star tribune today.   That's unacceptable.  

Also I call BS on your statement that insulting people who disagree with your opinions is what led to Trump's election.  Insulting his political opponents is all that he does as evidenced by him going after the Democratic Governor's of Michigan, Illinois, and Washington for defying him politically.  If he'd devoted one-tenth of his attention to this epidemic as he does to insulting people on Twitter and at his hate rally's we wouldn't be in this place.

Just curious- what place would we be in?

[Goon]

2 hours ago, keikla said:

 

2) hydroxychloroquine 400mg BID x1 day then 200mg BID x4 days

 

I think I read somewhere this pill was .05 really cheap. 

[iramurphy]

1 hour ago, dlsiouxfan said:

If a person presents with symptoms and is negative for the flu and other diseases can they be tested for Covid19?  Can nurses, doctors, EMT's and other personnel who are exposed to Covid19 be tested?  They absolutely cannot in most metropolitan areas and absolutely cannot be tested in the state of Minnesota per the Minnesota Department of Health's statement in the Star tribune today.   That's unacceptable.  

Also I call BS on your statement that insulting people who disagree with your opinions is what led to Trump's election.  Insulting his political opponents is all that he does as evidenced by him going after the Democratic Governor's of Michigan, Illinois, and Washington for defying him politically.  If he'd devoted one-tenth of his attention to this epidemic as he does to insulting people on Twitter and at his hate rally's we wouldn't be in this place.

I don’t listen to Trump cuz I can’t stand to listen to him. You seem to think when I expect normal intelligent people to act civilized I am making any supportive/critical  comment about Trump or our other politicians. I’m not because it’s not the time or place.  
The issue is how best to deal with this virus. You have zero basis to claim we wouldn’t be in the situation we are in if not for him. It is divisive and counterproductive. 
In answer to your question, yes we can be tested. One of my colleagues was tested last week because of possible exposure. One of my patients was tested yesterday and we didn’t ask the state for permission. We are setting up a drive up testing station and will soon be able to do the testing in our small rural hospital here in Minnesota. 
I have no idea what people in the metro area are doing, but if we can do these things in rural hospitals in Minnesota then the big city physicians should be able to figure it out. 
There is no indication for everyone  to be tested. We follow the guidelines recommended by Infectious Disease specialists and the CDC. I’ve only taken care of over 100,000 patients over the years. I have ER, ICU, Combat experience and I don’t know how the response team acted and reacted. How do you know so much. How many patients do you care for?  Are you on the Trump team with first hand info?  
I don’t have all of the answers,  but I’m learning. I will attend a briefing at 7 am to update our local protocols and evaluate what we are doing well and where we need to improve. I am going to log in to a live Mayo Clinic presentation tomorrow afternoon that includes an Infectious Disease update. My sister in law is a recognized world authority on tuberculosis and has a lengthy list of publications on TB but also other Infectious Diseases including Ebola.  She has done contract work for the CDC and speaks to government health departments all over the world on tuberculosis.  I get my info from those sources not the Star Tribune. 
With all of that, you seem to know more about all of this than I and other medical people.  We would be happy to pay you to come here and give us a presentation on COVID-19. 
 

[siouxfaninseattle]

58 minutes ago, dlsiouxfan said:

 

Also I call BS on your statement that insulting people who disagree with your opinions is what led to Trump's election.  Insulting his political opponents is all that he does as evidenced by him going after the Democratic Governor's of Michigan, Illinois, and Washington for defying him politically.  If he'd devoted one-tenth of his attention to this epidemic as he does to insulting people on Twitter and at his hate rally's we wouldn't be in this place.

Perhaps had Inslee not insulted Trump when VP Pence called him last week offering help maybe Trump wouldn't have returned the favor.

[nodakgirl93]

2 minutes ago, keikla said:

I feel like this thread has split into two different topics... the politics of all things covid, and the detailed medicine of all things covid.

This thread should be moved or continued elsewhere on forum.

[iramurphy]

7 minutes ago, keikla said:

Okay so ARBs bind AT1 only, not AT2.  Covid (and SARS) is believed to bind and enter the cell via ACE2.  I'll be the first to admit that the RAAS system isn't my forte, but I don't get how that will provide benefit.

I agree. I think we are “shotgunning” a bit but losartan should be relatively safe.  

[geaux_sioux]

6 minutes ago, keikla said:

I feel like this thread has split into two different topics... the politics of all things covid, and the detailed medicine of all things covid.

It’s kinda like Playboy. Except more people are here for the articles.

[iramurphy]

8 minutes ago, keikla said:

It is (or was).  But if demand goes up suddenly and extensively cause everyone wants to throw the kitchen sink at the more critical covid patients, that extra supply just isn't available.  And, as Oxbow noted, that could negatively impact a lot of people who are on it as a maintenance med.

My guess would be the producers wouldn’t price gauge at least for awhile. 

[farce poobah]

Just now, geaux_sioux said:

It’s kinda like Playboy. Except more people are here for the articles.

I'd be okay with pictures.   

[Oxbow6]

1 hour ago, Siouxperman8 said:

I hear Osterholm often on the radio and probably depend on his info too much.   I just heard an interview from yesterday and he said the statistics say 160-214 million in US infected over the next 6-8 months.   Also at very best 200k will die and up to 1.7M.

If anyone thinks this society can deal with 6-8 weeks more less 6-8 months of lockdown, an unknown end point, no security financially and reduced personal freedom wise.......not even taking into account the overall mental toll those making the decision are missing the big picture. We can't as a society of 330M+ wait 6-8 months to watch the last body hit the floor before we pick up the pieces in all sectors of society and move on. Might sound jaded but we didn't bat an eye when 36K (estimated) died from this year's flu season.

[iramurphy]

6 minutes ago, Oxbow6 said:

If anyone thinks this society can deal with 6-8 weeks more less 6-8 months of lockdown, an unknown end point, no security financially and reduced personal freedom wise.......not even taking into account the overall mental toll those making the decision are missing the big picture. We can't as a society of 330M+ wait 6-8 months to watch the last body hit the floor before we pick up the pieces  in all sectors of society and move on. Might sound jaded but we didn't bat an eye when 36K (estimated) died from this year's flu season.

You are correct in stating this has to be considered. I believe the hope is that we get lucky with one of the treatments being tested or lucky with speed of vaccine. Our area schools were told 2-4 weeks. If we stem the tide somehow they may loosen the recommendations. Like it or not as time goes on the economy becomes a big part of the health of our people and no longer just about money. 

[SWSiouxMN]

5 minutes ago, iramurphy said:

You are correct in stating this has to be considered. I believe the hope is that we get lucky with one of the treatments being tested or lucky with speed of vaccine. Our area schools were told 2-4 weeks. If we stem the tide somehow they may loosen the recommendations. Like it or not as time goes on the economy becomes a big part of the health of our people and no longer just about money. 

Its time to get lucky. 

I'm optimistic they will get lucky.  The world is due for a break. 

[yzerman19]

We just surpassed annual bee sting deaths with Covid19.

[yzerman19]

Next we will surpass auto-erotic asphyxiation 

[Siouxperman8]

I want to offer a hearty thanks to Ira, Keikla and the others on here that are in the health care industry.

We rely on you to keep fighting the good fight.

[yzerman19]

3 minutes ago, Siouxperman8 said:

I want to offer a hearty thanks to Ira, Keikla and the others on here that are in the health care industry.

We rely on you to keep fighting the good fight.

Yes- thank you.  Frontline docs, nurses, and other care givers are so deserving of that thank you. 

[Oxbow6]

As of tomorrow our system will be scrubbing all non-essential outpatient clinic visits from all departments for 3 weeks......to start.

[iramurphy]

Happy St. Patrick’s Day.  It’s a great day to be Irish and always a great day to be an American. We are just getting started but stick together and we will get through this. 

[iramurphy]

 

3 minutes ago, Oxbow6 said:

As of tomorrow our system will be scrubbing all non-essential outpatient clinic visits from all departments for 3 weeks......to start.

Did they say why???  

[geaux_sioux]

58 minutes ago, yzerman19 said:

Next we will surpass auto-erotic asphyxiation 

Or will we...... lots of people with a lot of alone time.

[geaux_sioux]

45 minutes ago, Siouxperman8 said:

I want to offer a hearty thanks to Ira, Keikla and the others on here that are in the health care industry.

We rely on you to keep fighting the good fight.

I second this, it’s been great to have qualified people on here who are in the fight keeping us all up to date.

[Oxbow6]

Think about this as we shut down everything everywhere.......99.9% of all businesses in the US fall under category of "small business". Think of where we are at if 5-10% of these can't recover and go under after all the dust settles from COVID.