(03-19-2020, 10:12 AM)michaelsean Wrote: Then they immediately quarantine themselves.  We can't afford for everyone in the country to sit at home for a couple months.  

This is the struggle, there are millions of carriers right now and all won't be tested which means you can't contain the spread of it. I am still in the camp of, it isn't as deadly as people are making it out (Check flu mortality in the 60+ age group) so we should move forward like we do during bad flu seasons and do the best we can ( I know unpopular opinion). We are coming out of flu season so hospital capacity should start opening up soon. The issue though is we are already down the road of an eventual national shelter in place order and I think it is coming before the end of the month. The economy is boned at this point either way, the idea should be to just bite the bullet now do the 2-3 week lock down and try to dig out quicker from one big punch rather than taking blow after blow over the next 3-6 months.

(03-19-2020, 09:57 AM)Au165 Wrote: Contact others and tell them what? If you get it you get it, there is nothing you can do to make it better and only those suffering severe symptoms should go to the hospital as to not overcrowd them. Being tested and it being negative also creates a false sense of security. As I mentioned, it only tested one point in time and since then you easily could be infected. That false sense of security could lead to riskier behavior like visiting elderly family members.

People should be doing the exact same things right now if they have it or if they don't. In reality everyone should just assume they have it because the numbers of actual infected is probably in the millions at this point.

I kinda laugh at the idea people shouldn’t come to the ER unless they have severe symptoms so they don’t over burden them.

You’re right, obviously. But, people misuse the ER every day. For example a 1 mm laceration.

1 f’n millimeter.

(03-19-2020, 10:20 AM)oncemoreuntothejimbreech Wrote: I’ve covered most of this already four pages ago. For the most part you’re correct. But, the CDC and the DPH have established a testing protocol which local hospitals use to establish their testing protocols because there is a shortage. So we are in essence rationing the tests to determine who gets a test and who doesn’t. We give that information out to the public so they know who gets tested and who doesn’t. And testing does influence patient behavior. Many times without a positive test result for something patients don’t believe you. Or in the absence of testing the believe they have something they don’t and no amount of patient education will change their mind.

Then on the other hand Mike Pence is announcing if you don’t have symptoms you don’t need testing while Trump and entire NBA teams get tested when the obviously don’t meet the testing protocol.

This mixed messaging undercuts all the information we as providers give to patients about the testing protocol. There is already enough confusion and they just keep adding to it. Me personally, I can’t stand double standards. Especially when it comes to medical care.

When the White House doesn’t follow their own guidance to the public making it more difficult for me to educate the public it pisses me off. I can assure you there isn’t anything fake about it.

If all you are testing is the people who obviously show signs aren't you testing the people who need to "know" the least? It's the asymptomatic people who are going to be spreading this most rapidly as millions of those people are infected and have no idea. If you are sick, you are most likely already changing your behavior as you would do with the flu if you show no signs many are still going to go to work and continue the spread. If you are really sick you are probably going to the hospital anyways for shortness of breath, etc.

This has been my issue with testing from the start, it is essentially one large confirmation bias exercise as it's being done currently.

(03-19-2020, 10:26 AM)oncemoreuntothejimbreech Wrote: I kinda laugh at the idea people shouldn’t come to the ER unless they have severe symptoms so they don’t over burden them.

You’re right, obviously. But, people misuse the ER every day. For example a 1 mm laceration.

1 f’n millimeter.

I 100% get that part, I know people who go for headaches. 

(03-19-2020, 10:23 AM)Au165 Wrote: This is the struggle, there are millions of carriers right now and all won't be tested which means you can't contain the spread of it. I am still in the camp of, it isn't as deadly as people are making it out (Check flu mortality in the 60+ age group) so we should move forward like we do during bad flu seasons and do the best we can ( I know unpopular opinion). We are coming out of flu season so hospital capacity should start opening up soon. The issue though is we are already down the road of an eventual national shelter in place order and I think it is coming before the end of the month. The economy is boned at this point either way, the idea should be to just bite the bullet now do the 2-3 week lock down and try to dig out quicker from one big punch rather than taking blow after blow over the next 3-6 months.

I'm just saying one benefit of testing.  If I get sick, but not sick enough to go the hospital, I won't get tested.  I get tested if I think I have a bacterial infection like strep because there is something they can do about it, but not anything else.  

(03-19-2020, 10:31 AM)michaelsean Wrote: I'm just saying one benefit of testing.  If I get sick, but not sick enough to go the hospital, I won't get tested.  I get tested if I think I have a bacterial infection like strep because there is something they can do about it, but not anything else.  

I get why people want it, but not testing for viral infections is actually relatively common in the hospital when the treatment is the same either way. My son was premature and with that RSV is kind of this cloud hanging over him at all times. RSV can cause bronchiolitis and pnemonia, however so can other viruses. He was hospitalized for both over the last 6 months and while in the hospital both time the doctors didn't run viral panels until I requested them for my own curiosity. The reason they didn't was because, RSV related Pnemonia/bronchiolitis or not, they were treating it the exact same way. My interest in RSV infections were for later understandings of his potential respiratory issues but that wasn't really a concern for the hospital (and I don't expect it to be). In the end both times that panel came back negative, but I learned a lot about how respiratory infections were handled and it makes me even more confused as to why we are using tests on people in the hospital other than for gather inaccurate infection/mortality numbers.

(03-19-2020, 10:26 AM)Au165 Wrote: If all you are testing is the people who obviously show signs aren't you testing the people who need to "know" the least? It's the asymptomatic people who are going to be spreading this most rapidly as millions of those people are infected and have no idea. If you are sick, you are most likely already changing your behavior as you would do with the flu if you show no signs many are still going to go to work and continue the spread. If you are really sick you are probably going to the hospital anyways for shortness of breath, etc.

This has been my issue with testing from the start, it is essentially one large confirmation bias exercise as it's being done currently.

Ideally, we should be able to test for Covid-19 as readily as strep throat or the flu. But, in reality we can’t. So we need a protocol to determine who gets the resources we have. I didn’t make the protocol, but I’m forced to follow the protocol. And unlike the NBA I can’t get anyone tested because of the protocol.

You assume people change their behavior. But, that isn’t necessarily true.

A cold and Covid-19 could cause the same symptoms in a healthy adult with a normal immune system. Is everyone with a cold going to self quarantine for two weeks? No. Especially if they can’t afford to miss work because of a lack of PTO or sick leave. A cold wouldn’t qualify for FMLA, either.

But, a person with mild symptoms of Covid-19 might stay home if they knew it was Covid-19 and not a cold. And that would help contain the spread, ideally. Although some will continue to ignore medical advice as they do now.

Testing critically ill patients helps with resources. Special precautions are needed for Covid-19 patients that aren’t needed with others. Also, symptomatic providers can’t see patients for two weeks. They already asked me to cover for a sick provider toady. But, I’m at home with my daughter because the school is closed.

(03-19-2020, 10:27 AM)Au165 Wrote: I 100% get that part, I know people who go for headaches. 

Worst headache of your life or severe headache, go to ER.

The ones I hate are the non-severe HAs and they haven’t even tried a Tylenol.

(03-19-2020, 10:58 AM)oncemoreuntothejimbreech Wrote: Worst headache of your life or severe headache, go to ER.

The ones I hate are the non-severe HAs and they haven’t even tried a Tylenol.

Then Hudy Delight would have put me in the hospital several times. I don’t know what was in it, but that gave me the worst headache hangovers I’ve ever had.

(03-19-2020, 10:54 AM)oncemoreuntothejimbreech Wrote: Ideally, we should be able to test for Covid-19 as readily as strep throat or the flu.  But, in reality we can’t. So we need a protocol to determine who gets the resources we have. I didn’t make the protocol, but I’m forced to follow the protocol. And unlike the NBA I can’t get anyone tested because of the protocol.

You assume people change their behavior. But, that isn’t necessarily true.

A cold and Covid-19 could cause the same symptoms in a healthy adult with a normal immune system. Is everyone with a cold going to self quarantine for two weeks? No. Especially if they can’t afford to miss work because of a lack of PTO or sick leave. A cold wouldn’t qualify for FMLA, either.

But, a person with mild symptoms of Covid-19 might stay home if they knew it was Covid-19 and not a cold. And that would help contain the spread, ideally. Although some will continue to ignore medical advice as they do now.

Testing critically ill patients helps with resources. Special precautions are needed for Covid-19 patients that aren’t needed with others. Also, symptomatic providers can’t see patients for two weeks. They already asked me to cover for a sick provider toady. But, I’m at home with my daughter because the school is closed.

Just last night our daughter called because she had a sore throat.  22 years old, works at a job that deals with people all day and is deemed necessary.

Today she called off work.  I went and checked her temp, no fever at all.  

She has other health issues: allergies, asthma, woman problems, etc. so I told her to stay home and rest.  Could just be cold/allergies but better safe than sorry.

My complaint about testing is if you’re going to have a protocol then follow the protocol. If you aren’t going to follow the protocol then don’t bother with a protocol you aren’t going to follow in the first place. Because the mixed messages just further adds to the public confusion the White House has already contributed to.

Trump’s doctor publicly announces he doesn’t need testing. So of course Trump gets tested. WTF?

(03-19-2020, 11:19 AM)oncemoreuntothejimbreech Wrote: My complaint about testing is if you’re going to have a protocol then follow the protocol. If you aren’t going to follow the protocol then don’t bother with a protocol you aren’t going to follow in the first place. Because the mixed messages just further adds to the public confusion the White House has already contributed to.

Trump’s doctor publicly announces he doesn’t need testing. So of course Trump gets tested. WTF?

I'm curious as to how the protocol is actually broken.  The President I understand.  He orders someone to get him a test, and nobody is saying no.  But I don't understand what avenues basketball players and congress people are using.    Is it just a doctor saying, "It's OK.  Go ahead and test them."?

(03-19-2020, 11:29 AM)michaelsean Wrote: I'm curious as to how the protocol is actually broken.  The President I understand.  He orders someone to get him a test, and nobody is saying no.  But I don't understand what avenues basketball players and congress people are using.    Is it just a doctor saying, "It's OK.  Go ahead and test them."?

I’m curious, too. Apparently, the NBA is buying the tests straight from the manufacturer. But, when it comes to our politicians, someone somewhere is making the conscious decision to just ignore the protocols our government helped to establish via the CDC and DPH. It’s a case of our government saying do as I say, not as I do.

Trump starts off his press conference with a backhanded compliment to the press...

(03-19-2020, 12:32 PM)BmorePat87 Wrote: Trump starts off his press conference with a backhanded compliment to the press...

His constant time on camera is probably worse than the actual virus in terms of his reelection chances.

(03-19-2020, 12:45 PM)CKwi88 Wrote: His constant time on camera is probably worse than the actual virus in terms of his reelection chances.

Yep.  You can tell he hasn't read anything before going out there and he can't improvise normally, let alone about specifics things during an emergency.

(03-19-2020, 12:45 PM)CKwi88 Wrote: His constant time on camera is probably worse than the actual virus in terms of his reelection chances.

(03-19-2020, 12:54 PM)GMDino Wrote: Yep.  You can tell he hasn't read anything before going out there and he can't improvise normally, let alone about specifics things during an emergency.

His incompetence is on full display. 

Meanwhile out governor is improving his 2024 stock. He's the chair of the Nat'l Governors Association and has been doing a great job. Pushing the federal government on what it needs to do to assist states as they handle this. 

Maybe let Trump have his rallies...he has that need to be in front of a crowd and he's using these important updates to pretend.

That OANN "reporter" is Chanel Rion, a right-wing scammer who claims to have published a series of children's books that don't exist. https://t.co/MjmIP65Hsi

— Peter Pandemic (@BostonJerry) March 19, 2020

 

Well it lasted for a while.

Close up of President @realDonaldTrump notes is seen where he crossed out "Corona" and replaced it with "Chinese" Virus as he speaks with his coronavirus task force today at the White House. #trump #trumpnotes pic.twitter.com/kVw9yrPPeJ

— Jabin Botsford (@jabinbotsford) March 19, 2020