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2020 Dumpster Fire (Enter at your own risk)

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12 minutes ago, NDSU grad said:

Stupid question but does the FDA have an emergency provision like the EPA does for herbicide registration?

That is probably not a stupid question but I don’t know anything about the EPA and herbicides so I don’t know what that means. 

Since hydroxychloroquine is already approved by the FDA, prescribers are free to use it for any reason they choose, even if it’s complete nonsense. That is off-label use. Ideally some well-designed studies would show a benefit before off-label use happens, but FDA approval isn’t needed for those studies to my knowledge. 

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4 minutes ago, iramurphy said:

I am doing an online Mayo Webcast so not in clinic today or tomorrow. I attended our briefing yesterday. We were still doing elective surgeries but will likely stop after this week to preserve supplies. Outpatient clinics still open. Discussing designating “clean clinics” for OB visits and patients without symptoms or risks but the problem is you may have it and not know. We tell people with respiratory symptoms to stay home. Adults no longer need to be tested for strep because antibiotics are no longer used in adults. Kids would be cultured. If patients have had flu symptoms more than 72 hours no reason to screen because Tamiflu hasn’t been shown to be efficacious. The Minnesota Department of Health stopped our testing except for travelers, health care workers or NH etc. We tell patients with URI to call before coming to ER, Hospital or clinic. Every employee enters by separate entrance and signs in, answers questionnaire and takes temp. We screen every clinic patient or select hospital visitors at the entrance with interviews and take temp. Most hospital visitors are turned away. As of last night, the Minnesota cases were in Twin Cities 200 miles away. The NDak cases are 70 miles away. We are trying to make sure we have day care for our employees children. We deal with difficult patients who want to be tested “just to be safe”. I’m sure it’s still coming if not here already. Our drive up testing is on hold til MDH eases restrictions. We have test kits but State labs are backed up with testing. State and regions are working to determine resources and how the different organizations will work together. 
Stay healthy. Thanks for the work you do. 

We were told yesterday that our state lab is capable of running 72 tests per day. Health systems are developing their own tests which are coming online soon. Watch for the number of cases in Michigan to blow up soon, related to results coming back and not necessarily spread of disease. 

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2 hours ago, petey23 said:

I realize it is tough for CNN and MSNBC "reporters" to try and contain their excitement and hopes that things will get worse but hopefully they refrain from busting out the pom poms.

 

...or the Fox News ‘reporters’ that continually push an agenda.  

All our media is rubbish.  Outlets are political echo chambers that prey on people’s biases and preconceived worldviews as a means of lining the pockets of its owners and investors.  

We’re a long way from Cronkite. 

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23 minutes ago, UNDfaninMICH said:

I continue to wonder about the utility of testing people in this situation. Assume they have it and quarantine appropriately vs do a test that has an unknown specificity? Unless of course some treatment is found helpful and we have enough of it to use for ambulatory exposure. Otherwise reasons to test might be related to workplace exposure and worker’s compensation could apply?

Valid question about the utility.  I know everyone says "stay home if you're sick", but I don't know of a single health system (inpatient or outpatient) that can afford to have every employee with a common cold stay home for the entire duration of the cold.

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18 minutes ago, keikla said:

Valid question about the utility.  I know everyone says "stay home if you're sick", but I don't know of a single health system (inpatient or outpatient) that can afford to have every employee with a common cold stay home for the entire duration of the cold.

This is entirely true but demonstrates we need massive numbers of tests with quick turnaround, as people with Covid may present with common cold. Barring that, serologic test for previous infection along with evidence that infection confers immunity. In the case of symptoms plus known exposure, quarantine is a must. 

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6 minutes ago, Old Fella said:

North Dakota:

Yesterday 7

Today 15

9 in Burleigh County

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3 hours ago, MafiaMan said:

CNN interviewed Cuomo the other night - you could actually see the disappointment on her face when Cuomo said that he had a good conversation with Trump regarding how things were going in New York.

Either the CNN interviewer was disappointed as you say or you saw in her face what you wanted to see. Could be either one.

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45 minutes ago, UNDfaninMICH said:

That is probably not a stupid question but I don’t know anything about the EPA and herbicides so I don’t know what that means. 

Since hydroxychloroquine is already approved by the FDA, prescribers are free to use it for any reason they choose, even if it’s complete nonsense. That is off-label use. Ideally some well-designed studies would show a benefit before off-label use happens, but FDA approval isn’t needed for those studies to my knowledge. 

Let's say a herbicide gets labelled in wheat for a specific weed.  Then there's an 'outbreak' of that same weed in flax.  A section 18 label can be applied for to legally use that product in flax.  It has restrictions as to how long it can be used for that application.  Just curious if something like that could work in the pharma industry.

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I don't have a background in medicine,  but I do have a background in data analysis in other scientific field. I've seen the suggestion that the significance of testing for coronavirus has been overblown. The suggestion was made in the context of a discussion of the lack of testing capacity, especially in the initial phase of the pandemic. What any experienced data analyst knows is that data analysis often leads to insights that were not anticipated prior to the analysis. Indeed, inductive reasoning is commonly underappreciated. 

 

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13 minutes ago, Oxbow6 said:

9 in Burleigh County

And I believe 2 in Morton.  Is the capital-area getting more tests done, or is it actually more prevalent there than the rest of the state?

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22 minutes ago, TBR said:

Either the CNN interviewer was disappointed as you say or you saw in her face what you wanted to see. Could be either one.

I’ll be happy to post a link to the video if I can find it...

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12 minutes ago, TBR said:

I don't have a background in medicine,  but I do have a background in data analysis in other scientific field. I've seen the suggestion that the significance of testing for coronavirus has been overblown. The suggestion was made in the context of a discussion of the lack of testing capacity, especially in the initial phase of the pandemic. What any experienced data analyst knows is that data analysis often leads to insights that were not anticipated prior to the analysis. Indeed, inductive reasoning is commonly underappreciated. 

 

I don’t disagree that it would be incredibly useful for data analysis.  The practical application of testing the universe to learn things that I believe we all know intuitively i.e it’s a highly contagious bug that is probably going to get everyone sick at some point in their lives however is moot in my opinion.  Unless you are talking full blown Marshall law containment.

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2 minutes ago, yzerman19 said:

I don’t disagree that it would be incredibly useful for data analysis.  The practical application of testing the universe to learn things that I believe we all know intuitively i.e it’s a highly contagious bug that is probably going to get everyone sick at some point in their lives however is moot in my opinion.  Unless you are talking full blown Marshall law containment.

Well, I wasn't referencing testing for what we already know. I was alluding to gaining insight into details of the virus that we don't know.

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17 minutes ago, TBR said:

I don't have a background in medicine,  but I do have a background in data analysis in other scientific field. I've seen the suggestion that the significance of testing for coronavirus has been overblown. The suggestion was made in the context of a discussion of the lack of testing capacity, especially in the initial phase of the pandemic. What any experienced data analyst knows is that data analysis often leads to insights that were not anticipated prior to the analysis. Indeed, inductive reasoning is commonly underappreciated. 

 

I don’t think the significance of testing is overblown at all. It’s a moot point until we have the resources to do so. Give us the ability to test and we can test everyone. Right now we don’t have the capacity to do so, therefore we tell people with milder symptoms to stay home in order to protect others. Data analysis will have to wait until we have the resources to test everyone. In the meantime we deal with patients with the resources we have. 

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1 minute ago, TBR said:

Well, I wasn't referencing testing for what we already know. I was alluding to gaining insight into details of the virus that we don't know.

Yeah, right now the approach of testing people who seem like they have it isn’t all that helpful, especially in locales where results are taking nearly a week to come back. I work with a lot of learners and I always talk with them about how we are prone to overusing tests simply because of the gratification that comes with thinking your patient has a particular virus, then being proven correct by a test. 

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29 minutes ago, UNDfaninMICH said:

Yeah, right now the approach of testing people who seem like they have it isn’t all that helpful, especially in locales where results are taking nearly a week to come back. I work with a lot of learners and I always talk with them about how we are prone to overusing tests simply because of the gratification that comes with thinking your patient has a particular virus, then being proven correct by a test. 

I agree with this in general, but I struggle with it when it's a HCP.  Per current state guidelines (prone to change at any minute), anyone who worked with the positive employee and continues to work while asymptomatic needs to wear a mask for 14 days post-exposure.  We can't spare the masks unless we know the symptoms were really covid.

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47 minutes ago, iramurphy said:

I don’t think the significance of testing is overblown at all. It’s a moot point until we have the resources to do so. Give us the ability to test and we can test everyone. Right now we don’t have the capacity to do so, therefore we tell people with milder symptoms to stay home in order to protect others. Data analysis will have to wait until we have the resources to test everyone. In the meantime we deal with patients with the resources we have. 

If you think you have it, assume that you do and self quarantine. If you start to have serious issues call your doctor.

If you feel as though you are healthy and do not have it, assume the next person you will run into does. Practice Social Distancing.

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I started feeling sick on Monday with what I perceived to be influenza and have been at home since then.  Must have had 20 friends and co-workers suggest that I immediately go get tested for COVID-19.  Shaking my head...

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24 minutes ago, keikla said:

I agree with this in general, but I struggle with it when it's a HCP.  Per current state guidelines (prone to change at any minute), anyone who worked with the positive employee and continues to work while asymptomatic needs to wear a mask for 14 days post-exposure.  We can't spare the masks unless we know the symptoms were really covid.

if the incubation period is up to 12 days and infected people may start shedding before symptom onset, it would take way more that one test to clear the exposed person from mask use. Unfortunately there’s not an easy answer, given the PPE shortage.  

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14 minutes ago, petey23 said:

If you think you have it, assume that you do and self quarantine. If you start to have serious issues call your doctor.

If you feel as though you are healthy and do not have it, assume the next person you will run into does. Practice Social Distancing.

 Yes that’s called common sense, unfortunately a large segment of Americans don't exhibit as such.  

 

   

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25 minutes ago, MafiaMan said:

I started feeling sick on Monday with what I perceived to be influenza and have been at home since then.  Must have had 20 friends and co-workers suggest that I immediately go get tested for COVID-19.  Shaking my head...

If you have the means to do it, why wouldn't you? 

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3 hours ago, Siouxperfan7 said:

Siouxsports admins trying to enforce the “no politics” rule on this thread.....:D

0B0BA091-6087-41CF-B9AA-AE5B8E6EC1F5.gif

45 minutes ago, keikla said:

hahaha the edited title of this thread.  Well done.

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