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I'm a first year PA student at WesternU. I thought I would update you guys about this and calm most of you down. First off, we just went online this past Thursday. The faculty are working diligently to make sure that the first and second year students are well accounted for. They are trying as hard as they can to manage everything with this craziness. Most of us have NO idea when we are going to return. We are purely online now for the time being. Also, this week is spring break for the program so I am not sure if they are going to get back to you guys this week, but multiple people that have interviewed have told me that they should get back to you before the end of March so praying for you guys! As for the risk of a large class, hopefully the situation does die down before the new cohort begins in August. Even so, there are more than enough seats in the classroom to avoid close contact with each other. It isn't just WesternU that is at risk...as long as you sit close to anybody in a classroom, you are at fair risk. Wish you guys well and be safe! Good luck!

I think anyone who has been paying attention to South Korea vs our Administrations down played response would strongly disagree with your statement.

Our governor said today, (my paraphrase), "We are grateful for those on the front lines during this pandemic, Doctors, nurses, and Physician Assistants." I agree, we loose these battles far too often, but it was nice to hear Inslee include us.

Anyone else losing their minds ?

this is advocacy!! MAPA Memo to Secretary Sudders Secretary Marylou Sudders Executive Office of Health & Human Services One Ashburton Place, 11th Floor Boston, MA 02108 RE: URGENT Request for Emergency Action to Remove State Requirement for Supervising Physician Dear Secretary Sudders, The COVID 19 pandemic has challenged the globe with its virulence and quick spread. The global community is facing the potential for significant challenges to their healthcare systems and this is only the beginning. At this time, we urge you make the below regulatory change to ensure that physician assistants have the ability to best respond during this time of national emergency. As you know well, Massachusetts has experienced a rapid uptick in cases over the past week and this is predicted to continue to climb significantly. As all hospitals and healthcare settings prepare for this onslaught of patients who need to be cared for with COVID 19 infections as well as others who need any type of urgent medical care, the ability to be nimble and allocate resources is imperative. The most valuable resource we have is our healthcare providers. We will need to have more providers than needed in daily operations to care for the newly sick, the recovering and the day-to-day care of chronically ill people. We will need to have replacements for providers who get sick themselves or are quarantined due to exposure. This is happening in increasing numbers every day at healthcare clinics and hospitals. There are over 4,000 Physician Assistants (PAs) working in Massachusetts with the majority in the hospital or healthcare system settings. These PAs are, and will be, a critical part of the team and contribution to keeping the healthcare system in Massachusetts working. However, the current requirement of having PA scope of practice defined by the requirement of a supervising physician severely limits the utilization of PAs efficiently during a healthcare crisis. In order to most effectively and quickly utilize the qualified healthcare providers we have, we must give hospitals and healthcare systems the ability to reallocate and deploy PAs to allow for maximum staffing when and where needed. An example of how this might work: Currently most hospitals are delaying or cancelling elective procedures. This, combined with decreased inpatient volume as non-urgent patients are discharged, frees up PAs from their specific department work (ex: surgical services). These experienced PAs could be reallocated to the inpatient medicine teams, procedural areas, emergency, urgent care, or other teams in need of staff due to increased volume from COVID or loss of providers from quarantine. These real-life situations are playing out in Massachusetts’ hospitals as plans are being developed for the unknown and for an undetermined amount of time. In the current state of PA practice, a hospital will need to find new supervising physicians for each PA it redeploys and have multiple documents signed and filed in order to comply with state law. This adds no value and squanders precious time. We need maximum flexibility in our healthcare teams to be successful in combating this pandemic. At this time, the Massachusetts Association of Physician Assistants (MAPA), joins Rhode Island, Vermont, California, and other states, in proposing an emergency act that would temporarily remove the state requirement for having a supervising physician registered with the state that determines scope of practice. This change would allow healthcare teams to determine how to best utilize their staff when and where the demand is without the administrative burden to distract them and slow down care. All PAs work on teams side by side with physicians, NPs and other healthcare providers and this would remain the same. Proposed language: “During a state of emergency enacted by the Governor of the Commonwealth of Massachusetts, a PA may perform medical services as defined by CMR section 263 within a healthcare team including a physician without the identification of a new supervising physician.” We respectfully urge you to make this requested emergency regulatory change in order to allow PAs to most effectively care for those across the Commonwealth during this emergency time period. We are available at any time to speak with you further about this. Sincerely, Josh Merson, MPAS, MS-HPEd, PA-C President, Massachusetts Association of Physician Assistants (MAPA) jrmerson@gmail.com Sarah Christie, MPAS, PA-C Legislative Chair, Massachusetts Association of Physician Assistants (MAPA) Slchristie1084@gmail.com; 1 (339) 221-0709 (cell) Jason Parente, MPAS, PA-C President-Elect, Massachusetts Association of Physician Assistants (MAPA) j.parente@northeastern.edu CC: The Honorable Charlie Baker, Governor of the Commonwealth of Massachusetts Dr. Monica Bharel, Commissioner of the Massachusetts Department of Public Health Massachusetts Board of Registration of Physician Assistants Catch up with MAPA on Social Media!

I recently had an email conversation with a thinktank guy who doesn't understand why we have all these restrictions. He likened our training to the GP that is common in many other parts of the world. They graduate and go out into the wide world and practice medicine. He wondered if we, in the US, are so stupid we need 3 to 7 more years of training to do what the rest of the world does. Maybe we should skip OTP and just go independent....period. If we are going to have to fight tooth and nail to get somewhere lets make it somewhere worth being.

There are some weird MFers on this site.

I take this to show what we've known for decades. What most people consider medical "emergencies" aren't in fact medical emergencies, otherwise they'd still be coming in.

Regardless of what type of life you hold sacred, if you practice medicine, you're going to be exhibiting some degree of hypocrisy. Our knowledge of anatomy is based on the works of grave robbers who "desecrated" interred bodies. Every medicine, most surgical techniques and physiologic research was conducted, practiced or perfected on living, breathing animals (honestly bothers me more). The exam supplies you use, the medicines you prescribe, heck, the TVs in your waiting room are often produced by poverty stricken individuals in countries that provide no support for them or their families. You've got to come to grips with it, do what's best FOR YOUR PATIENTS, and move on. Medicine isn't about serving ourselves and our unscientific beliefs, it's about serving our patients.

I don't mean this to be crass, but if this is truly the case then you need to disclose this to your future employer PRIOR to being hired, or pursue a job where you would not be involved in vaccines. But even then I believe it would be prudent to state your belief as once you are a PA you become a healthcare provider. As a healthcare provider you hold a respected position within our society and others within our society look to us for EVIDENCE BASED information. To go against the basics of allopathic medicine is a significant ethical issue. Secondly, as a born again, evangelical Christian myself I agree that "the ends don't justify the means." But that is a decision that is made at the beginning of a pathway, not the end. This is the classic philosophical "train car problem" (I'll allow you google it, rather than repeat it here). As a Christian I believe abortion to be wrong. Does that mean that I am happy about the root of some of the vaccines that we provide? Of course not, but I also believe that God can use any situation for good, and for His glory. That is what I believe is occurring here. God took an awful terrible decision and turned it into something that is powerfully good. Do we as Christians truly believe in ignoring science that we would doom individuals to suffering and death? Again, it is not that we violate our beliefs in the pursuit of scientific breakthroughs, but the decision was made. No further fetuses are being aborted to produce vaccines today. Is it tacit approval to partake in vaccines derived from an aborted fetus, or is it choosing to allow God to control a situation (I apologize if I sound repetitive)? Thirdly, if you look throughout the history of man and science there are so many egregious violations of Biblical truth. What about the Tuskegee Experiment? We (the medical community) withheld treatment for syphilis to learn if it effected blacks any different than whites. While absolutely breathtakingly awful moral treatment of another human, we did learn something. Furthermore, a BLACK physician was involved and he decided to remain involved once he learned what was occurring because he felt that it would help show that blacks and whites were the same. So, do we just not use the knowledge that we learned from that experiment because the root was awful, racist treatment of humans? I could continue with so many more examples, but will stop as it is approaching 1am. I will finish by saying, if I drew the same conclusion as you I truly could not have pursued a career in medicine. I honestly believe that this could (and probably should) be considered an ethical violation that would prevent you from being licensed as a PA. Aunt Val, you need to truly think this through, pray about it, seek Christian counsel, and seek counsel from others that you respect before you continue down this path.

Time to step out of the dark ages. The earth is round. We are one of billions of Galaxies with more planets than we have zeros for... Dinosaurs were real and they lived a hell of a lot longer than a few thousand years ago. Oh ...and Vaccines have saved countless lives and will continue to do so. Such an arrogant species we are to still, in this day and age, think we are the center of it all.

https://www.governor.ny.gov/news/no-20210-continuing-temporary-suspension-and-modification-laws-relating-disaster-emergency Paragraph 1 of Section 6542 of the Education Law and Subdivisions (a) and (b) of Section 94.2 of Title 10 of the NYCRR to the extent necessary to permit a physician assistant to provide medical services appropriate to their education, training and experience without oversight from a supervising physician without civil or criminal penalty related to a lack of oversight by a supervising physician;

That's not a personal attack. Those of you who think *we* moderate things badly... 90% of what makes this site great would never be permitted on Huddle. I'd encourage all those of you us are AAPA members to write AAPA leadership and express their displeasure. Scott, I think it's time for PAFT to start pushing for regime change at the state level when appropriate. Probably at first by offering surveys and endorsements. While we need to be sensitive to local contexts, PAs who are FOR the things that make us less attractive than NPs in hiring decisions have no place in PA society leadership in any way.

Found this through a friend. Written by an ER doc resident. Pretty much sums up everything. “In one of the most vivid scenes in the HBO miniseries "Chernobyl" (among many vivid scenes), soldiers dressed in leather smocks ran out into radioactive areas to literally shovel radioactive material out of harm's way. Horrifically under-protected, they suited up anyway. In another scene, soldiers fashioned genital protection from scrap metal out of desperation while being sent to other hazardous areas.Please don't tell me that in the richest country in the world in the 21st century, I'm supposed to work in a fictionalized Soviet-era disaster zone and fashion my own face mask out of cloth because other Americans hoard supplies for personal use and so-called leaders sit around in meetings hearing themselves talk. I ran to a bedside the other day to intubate a crashing, likely COVID, patient. Two respiratory therapists and two nurses were already at the bedside. That's 5 N95s masks, 5 gowns, 5 face shields and 10 gloves for one patient at one time. I saw probably 15-20 patients that shift, if we are going to start rationing supplies, what percentage should I wear precautions for?Make no mistake, the CDC is loosening these guidelines because our country is not prepared. Loosening guidelines increases healthcare workers' risk but the decision is done to allow us to keep working, not to keep us safe. It is done for the public benefit - so I can continue to work no matter the personal cost to me or my family (and my healthcare family). Sending healthcare workers to the front line asking them to cover their face with a bandana is akin to sending a soldier to the front line in a t-shirt and flip flops.I don't want talk. I don't want assurances. I want action. I want boxes of N95s piling up, donated from the people who hoarded them. I want non-clinical administrators in the hospital lining up in the ER asking if they can stock shelves to make sure that when I need to rush into a room, the drawer of PPE equipment I open isn't empty. I want them showing up in the ER asking "how can I help" instead of offering shallow "plans" conceived by someone who has spent far too long in an ivory tower and not long enough in the trenches. Maybe they should actually step foot in the trenches.I want billion-dollar companies like 3M halting all production of any product that isn't PPE to focus on PPE manufacturing. I want a company like Amazon, with its logistics mastery (it can drop a package to your door less than 24 hours after ordering it), halting its 2-day delivery of 12 reams of toilet paper to whoever is willing to pay the most in order to help get the available PPE supply distributed fast and efficiently in a manner that gets the necessary materials to my brothers and sisters in arms who need them.I want Proctor and Gamble, and the makers of other soaps and detergents, stepping up too. We need detergent to clean scrubs, hospital linens and gowns. We need disinfecting wipes to clean desk and computer surfaces. What about plastics manufacturers? Plastic gowns aren't some high-tech device, they are long shirts/smocks...made out of plastic. Get on it. Face shields are just clear plastic. Nitrile gloves? Yeah, they are pretty much just gloves...made from something that isn't apparently Latex. Let's go. Money talks in this country. Executive millionaires, why don't you spend a few bucks to buy back some of these masks from the hoarders, and drop them off at the nearest hospital.I love biotechnology and research but we need to divert viral culture media for COVID testing and research. We need biotechnology manufacturing ready and able to ramp up if and when treatments or vaccines are developed. Our Botox supply isn't critical, but our antibiotic supply is. We need to be able to make more plastic ET tubes, not more silicon breast implants.Let's see all that. Then we can all talk about how we played our part in this fight. Netflix and chill is not enough while my family, friends and colleagues are out there fighting. Our country won two world wars because the entire country mobilized. We out-produced and we out-manufactured while our soldiers out-fought the enemy. We need to do that again because make no mistake, we are at war, healthcare workers are your soldiers, and the war has just begun." Spot on

If you withhold potentially life saving vaccines/medications due to YOUR religious beliefs you should not be practicing medicine period.

you don’t have to provide the vaccine - someone else can (nurse, pharmacist, another provider). What you can’t, in my opinion, do is steer them away from getting a vaccine because you don’t ethically believe in it. You have to practice evidenced based medicine as a provider, and it could even be considered malpractice or at the very least poor care to advise against vaccination when it is indicated. What if someone who you decided not to vaccinate got measles and died? You don’t have to be upfront with your patients about your beliefs, because frankly they don’t matter. What matters is what the medical evidence shows and what the standard of care is that all medical providers should strive to follow. In short, you don’t have to like it, but you would be doing a disservice to any patient where there is no contraindication to not recommend and provide a means for a patient to get vaccinated. No employer should/would likely allow you to practice substandard care as it opens up substantial liability to them as well.

Hey guys, current student. I was accepted and did not receive a phone call (I got an e-mail) so no, I wouldn’t say you are waitlisted if you didn’t get a call. As for not hearing about your status yet, try to keep in mind our faculty not only deals with admissions but most of them (including De Rosa) are our lecture professors. We have been pretty loaded with exams as of late and they have been working on scheduling for summer as well for us so just try to stay positive/patient! Fingers crossed you guys hear by the end of the week!

Hey guys. I finished my interview a while ago. Just some tips/thoughts: -When waiting for them to email the essay question, I suggest logging in about 5-10 min before the time they gave you. I assumed they were going to send me my question on the dot, but they sent it 3 min earlier. It caught me off guard. -Keep track of time when writing your essay. It's easy to be too absorbed in your writing. Also keep in mind that you'll probably spend a minute or two from the 30 min you were given to 1) read their email with the essay question and 2) reply with the attached file in the format they requested. I'm not sure if they have a grace period when submitting the essay.. I was scared to be a minute late with my submission in fear of them not accepting it, so I made sure to send it in 30 min or less. -Before the skype interview, make sure you have good connection. I experienced slight technical problems (lagging, choppy audio), so be prepared for that. I had two interviewers, both were very nice. Typical PA school interview questions were asked and a few out-of-the-box questions/ice-breakers. This was actually the most I smiled and laughed at an interview. I wouldn't stress too much about it! Good luck everyone and stay safe!

Nah...they are too busy chastising people for trying to do things the state chapters weren't doing. I'm particularly stunned by one PA (who will spend half of every post telling you all the things he has done in his 40 years) that if you don't like what the state is or isn't doing run for office. F*** you. I have lived in a state where the society remained in the warm embrace of the physicians while they screwed us again and again. The notion you should just sit quietly while your state org either screws things up or does nothing galls me to the extreme.

As you wish... (JMPA is now permanently restricted from posting)

Exactly what I would expect to happen with our corporate, for profit, $$$ first healthcare system. The Corporate Overlords {*tm) will drop our asses in a New York second when we are no longer filling their coffers. All short term next quarter profit thinking....always.

I realized the other day why COVID19 has bothered me so much. I am over 50 now and very mortal. I am being faced for the first time in my life with a disease that could actually kill me - a disease worse than meningitis and C.Diff, MRSA, even influenza and more likely to touch me than Ebola. When I was just out of school in my 20s and didn't know yet about my autoimmune issues and my asthma wasn't very bad then - I was rearing to go and would be suited up in trauma without a thought. Now I work in an environment where I am not first line exposure and I am pretty ok with it. This is a novel disease - not in man before - we just don't know everything we need to know about it and can't know it all right away. We are a global community with data capacity that is overwhelming - fed from the firehose with ever changing information and conflicting information. The data overload in itself can be frightening. We are also in a time of poor leadership plagued by deflection, outright lies and no reliance on science or facts. Who to trust? CDC, WHO, Johns Hopkins.... Rush Limbaugh........................ Folks in my town are not behaving very well. Either complete panic and hoarding food and goods - muggings in parking lots for groceries - or they are brusque and cavalier spouting conspiracy theories and basically contacting everything they can touch without a second thought. So, I feel vulnerable. I don't want to expose my family - I don't want to be exposed myself - selfish or not. I am at work, seeing only a few patients face to face and only after they insist. Most of my patients aren't trying to come in to be seen. I am not fully confident in my environment. I do feel compelled to do whatever it takes to stem the spread and flatten out the curve because it works and other countries have proven it. So, I would stand in front of a train for my kids and go to lengths to support patients but I am not ready to do dumb things with this virus.

Take the GRE. Most put very little emphasis on this, especially in an otherwise very qualified candidate. If I were a admissions committee, the interview would basically be to make sure you’re not a douche canoe.

Not really ready for a debate today. I am a scientist. I don’t believe in evangelism or bringing religion into my medical practice decision making. Vaccines have prevented deadly diseases. I believe in immunizations. I am done with this subject as I desire no debate on this.

Just as a positive counter point to this, I had a wonderful interaction today. For background I recently transitioned to ortho from FM, so am still doing a mixture of seeing patients myself and "shadowing" my surgeon. But, with the almost complete halt of clinic and any elective surgeries am pretty much just shadowing. But anyway, had clinic this morning and shadowed on a fracture case. After the surgeon completed his evaluation, I went back in to cast him and he innocently asked if I was an athletic trainer. Before I could answer he saw my badge and said, "Oh, you're a PA! Sorry...you guys don't get the respect you deserve!" This both showed that we have made progress in the decades that our profession has existed, but furthermore shows that we still have progress to make and I believe that progress will be made so much more easily with a QUALITY name change.

Dear Pre-PAs, I would like to thank you for participating in the Zoom meeting yesterday. It was very productive and enriching for me to share with you and hear from your own experiences at the health care field or out of it. Let's repeat it some time next week. If you think that's something you would like to do, please "like" this post so I can set up the next encounter. Stay safe and be blessed. Sincerely, Kele

Stay retired. It's a shit show out here brother.

Using non n95 masks, scarfs or bandannas and thinking they are going to do anything to protect you from this virus is like going to war with air soft guns when the enemy has M16's. Give me a break. I hate to say it, but it's going to take 5 or 6 providers and nurses dying ...be flashed all over the news and then threats of a medical strike before this administration nationalizes a few companies and starts moving heaven and earth to protect what's left us us.

Per new law: Collaborative agreement requirements. A physician assistant with less than 4000 hours of clinical practice documented to the board shall work in accordance with a written collaborative agreement with an active physician that describes the physician assistant’s scope of practice, except that a physician assistant working in a physician group practice setting or a health care facility setting under a credentialing and privilege plan and scope of practice agreement may use that credentialing and privilege plan and scope of practice agreement in lieu of a collaborative agreement. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a collaborative agreement under this subsection. Under a collaboration agreement, collaboration may occur through electronic means and does not require the physical presence of the physician at the time or place that the medical services are provided. A physician assistant shall submit the collaborative agreement, or, if appropriate, the scope of practice agreement, to the board for approval and the agreement must be kept on file at the main location of the place of practice and be made available to the board or the board's representative upon request. Upon submission of documentation for 4000 hours of clinical practice to the board, a physician assistant is no longer subject to this requirement. Practice agreement requirements. A physician assistant who has more than 4000 hours of clinical practice may be the principal clinical provider in a practice that does not include a physician partner as long as the physician assistant has a practice agreement with an active physician or physicians, and other health professionals as necessary, that describes the physician assistant’s scope of practice. A physician assistant is legally responsible and assumes legal liability for any medical service provided by the physician assistant in accordance with the physician assistant’s scope of practice under subsection 2 and a practice agreement under this subsection. A physician assistant shall submit the practice agreement to the board for approval and the agreement must be kept on file at the main location of the physician assistant's practice and be made available to the board or the board's representative upon request. Upon any change in the parties to the practice agreement or other substantive change in the practice agreement, the physician assistant shall submit the revised practice agreement to the board for approval. Under a practice agreement, consultation may occur through electronic means and does not require the physical presence of the physician, physicians or other health care providers who are parties to the agreement at the time or place that the medical services are provided.

I'm nearly 74 and today elected to stop rounding in hospitals and stop taking shifts with EMS twice a month. It makes me sad to leave my coworkers but the rough estimate of a 10% mortality estimate for my age is daunting. And the worse mistake I can think of would be to bring home the virus and cause the death of my wife of nearly 52 years. I lived through the early days of AIDS in EMS and remember being 10 feet tall and bulletproof (albeit double-gloved when starting IVs.) If I were younger, I'd still be out there now. But I'm not. It's a personal decision. Let's let people make it without adding pressure. I hope to be back in the trenches someday soon.

It's really a good time to cut your program some slack. Most were blindsided by the need to isolate and having large systems stop clinical rotations. The same has been true in med school too. Right now, faculty members are trying to learn new software, ramp up on-line lectures, develop exercises that will fill in for in-person labs and SimLabs, decide on safe on-line testing strategies, and get ready to on-board new students in the coming months. And all the while, the external environment continues to change as well. Everyone means well and will do their best to keep you moving towards graduation. And most everyone in the outside world is trying to keep their lives together while staying safe. Now that I think of it, let's cut everyone some slack!

NOTES FROM THE FRONT LINES: I attended the Infectious Disease Association of California (IDAC) Northern California Winter Symposium on Saturday 3/7. In attendance were physicians from Santa Clara, San Francisco and Orange Counties who had all seen and cared for COVID-19 patients, both returning travelers and community-acquired cases. Also present was the Chief of ID for Providence hospitals, who has 2 affected Seattle hospitals under his jurisdiction. Erin Epson, CDPH director of Hospital Acquired Infections, was also there to give updates on how CDPH and CDC are handling exposed health care workers, among other things. Below are some of the key take-aways from their experiences. 1. The most common presentation was one week prodrome of myaglias, malaise, cough, low grade fevers gradually leading to more severe trouble breathing in the second week of illness. It is an average of 8 days to development of dyspnea and average 9 days to onset of pneumonia/pneumonitis. It is not like Influenza, which has a classically sudden onset. Fever was not very prominent in several cases. The most consistently present lab finding was lymphopenia (with either leukocytosis or leukopenia). The most consistent radiographic finding was bilateral interstitial/ground glass infiltrates. Aside from that, the other markers (CRP, PCT) were not as consistent. 2. Co-infection rate with other respiratory viruses like Influenza or RSV is 3. So far, there have been very few concurrent or subsequent bacterial infections, unlike Influenza where secondary bacterial infections are common and a large source of additional morbidity and mortality. 4. Patients with underlying cardiopulmonary disease seem to progress with variable rates to ARDS and acute respiratory failure requiring BiPAP then intubation. There may be a component of cardiomyopathy from direct viral infection as well. Intubation is considered “source control” equal to patient wearing a mask, greatly diminishing transmission risk. BiPAP is the opposite, and is an aerosol generating procedure and would require all going into the room to wear PAPRs. 5. To date, patients with severe disease are most all (excepting those whose families didn’t sign consent) getting Remdesivir from Gilead through compassionate use. However, the expectation is that avenue for getting the drug will likely close shortly. It will be expected that patients would have to enroll in either Gilead’s RCT (5 vs 10 days of Remdesivir) or the NIH’s “Adaptive” RCT (Remdesivir vs. Placebo). Others have tried Kaletra, but didn’t seem to be much benefit. 6. If our local MCHD lab ran out of test kits we could use Quest labs to test. Their test is 24-48 hour turn-around-time. Both Quest and ordering physician would be required to notify Public Health immediately with any positive results. Ordering physician would be responsible for coordinating with the Health Department regarding isolation. Presumably, this would only affect inpatients though since we (CHOMP) have decided not to collect specimens ordered by outpatient physicians. 7. At facilities that had significant numbers of exposed healthcare workers they did allow those with low and moderate risk exposures to return to work well before 14 days. Only HCW with highest risk exposures were excluded for almost the full 14 days (I think 9 days). After return to work, all wore surgical masks while at work until the 14 days period expired. All had temperature check and interview with employee health prior to start of work, also only until the end of the 14 days. Obviously, only asymptomatic individuals were allowed back. 8. Symptom onset is between 2-9 days post-exposure with median of 5 days. This is from a very large Chinese cohort. 9. Patients can shed RNA from 1-4 weeks after symptom resolution, but it is unknown if the presence of RNA equals presence of infectious virus. For now, COVID-19 patients are “cleared” of isolation once they have 2 consecutive negative RNA tests collected >24 hours apart. 10. All suggested ramping up alternatives to face-to-face visits, tetemedicine, “car visits”, telephone consultation hotlines. 11. Sutter and other larger hospital systems are using a variety of alternative respiratory triage at the Emergency Departments. 12. Health Departments (CDPH and OCHD) state the Airborne Infection Isolation Room (AIIR) is the least important of all the suggested measures to reduce exposure. Contact and droplet isolation in a regular room is likely to be just as effective. One heavily affected hospital in San Jose area is placing all “undifferentiated pneumonia” patients not meeting criteria for COVID testing in contact+droplet isolation for 2-3 days while seeing how they respond to empiric treatment and awaiting additional results. Feel free to share. All PUIs in Monterey Country so far have been negative. Martha L. Blum, MD, PhD Sent from my Pixel 3 using Tapatalk

Completely disagree. One of the main reasons China has been able to contain the virus as well as other countries such as Singapore and Taiwan was the widespread use of testing. With testing and actually identifying regional exposure, proper preparation and policies can be designed, planned and implemented. The reason our health department and CDC has been denying tests is the poor capacity for testing capability, essentially managing a limited resource. Once the ability to test ramps up, the pushback and threshold for testing will decrease. This is already happening in Washington, where UW has had a significant ramp up of testing capability.

Good Evening, Future PAs! Hope you are all well. I know many of you are anxiously waiting for the list of accepted candidates to be released, so I wanted to give you a heads up. This week they should be ranking the applicants and you should start receiving emails on Friday. Please note that this is not official information and my words here have nothing to do with the MDC PA Program. I am speaking out of my own head and based on previous experience. If you have any questions, do not hesitate to send me a private message and I will get back to you as soon as possible. Thanks and have a restful night.

Any further attempts to “persuade” JMPA is an act of insanity.

How do you eat an elephant? One bite at a time.... I'm just back from the LAS in DC. Our congressional visits were in regards to direct payment and ordering home health. It is a job that never ends.

Could just pick up the phone? Sent from my iPad using Tapatalk

Do we need a way--not tied to any formal body--where we can report other PAs who do stuff like that? I mean, a friendly, "Hi, I'm not anyone official, just a fellow PA, but this made PAs look bad. What were you thinking and how can I help you?"

contact your state PA society and have them spell it out for your employer, and if they don’t listen quit. https://www.aapa.org/wp-content/uploads/2017/01/Third_party_payment_2017_FINAL.pdf

To those still waiting on an interview, I have just declined my invite to interview after being accepted to my top choice. Hope this trickles down to find someone deserving.

Hey everyone! Super random but did anyone get an email about their financial aid eligibility for LIU today but havent heard back about their PA admission or not???

Dallas Co judge looking for volunteers. Sent tweet saying that he and the governor are missing out on the highest trained medical providers short of physicians and yet not a word has been uttered about us. State’s website says that “physician’s assistants” can volunteer. If you can’t get the name right then you probably can’t utilize me correctly either.

Personal attack or not, it's important for folks, especially in the medical field, to understand that changes in manufacturing processes can't happen quickly. So, when a medical resident makes long posts like the one which has been quoted, people who may not know better can be influenced. In the same way we need to caution people we encounter that just because someone says something, whether about a promising treatment, new test, or vaccine, it may not be correct or complete. Instead it must be looked at carefully. In the same way it's not possible to rapidly ramp up new medical knowledge and manufacture of these products, it's also not possible to rapidly ramp up production of the various medical and decon supplies currently needed. It's useless to make statements like that resident made. Rather, it's helpful to learn the long timelines needed to be prepared, so better plans can be made is useful. Setting correct expectations for the public about how all facets of this pandemic and our response will progress is useful.

Because this is such a dynamic process and recommendations and processes are shifting so quickly it has been hard to determine exactly what our organizations response is going to be. I was told because of my age my medical director wanted me asigned to our "healthy clinic" rather that one of the clinics doing COVID screening. Now I'm 60 and healthy as a horse. I discussed it with my wife, told her I though that was BS, and I wanted the organization to protect people with young families and single paycheck households rather than trying to protect me (who doesn't really need protecting). She asked where my will was and the life insurance policies and told me to go for it. She's a good woman. I told my administrator and med director and they just smiled and said "ok". Let me add that while I'm in no hurry to embrace the great beyond I'm not fearful of death either. I doubt it will come to that but if it does....well it does.

If there's anything in life I've learned--it's that the people you work with/work for end up being 95% of your happiness or unhappiness. My short term advice is to find a more positive work environment, with people you enjoy being around.

UPDATE TO MY PREVIOUS POST: Please expect an email at the end of March. Right now the whole world (literally) is very busy making sure we prepare for the coronavirus pandemic, and that delays everything else. Be patient and keep your hopes up. Continue studying and preparing for PA School. Also take this time to recharge, to reflect upon important things, and to take care of any unfinished business you might have - you will thank me for this advice once you are in the fall semester of PA School. If you need anything or feel like freaking out with this looong wait, talk to a friend about it. If you don't have a friend to talk to, take advantage of this free time to make new friends (or simply text me on the private message and I will be your friend for now LOL) Now, seriously, I feel you and understand the anxiety. Have a good night. thanks

Technical term, often utilized in the profession. Would recommend familiarity with such.

Heh. I'm just a guy, and other than some GI distress, am feeling MUCH better and afebrile today.

The history of things can be involved. In the case of these particular vaccines, you researched them and found a step you disapprove of. You have elected not to use the end product, even though — at least for now — we have no alternative. In the process, we may risk a life because of another life that was ended. We live in a country that was taken away from its original inhabitants, somewhat violently, taking lives in the process. Yet we’re all here, enjoying the fruits of that action. There is no practical way of reversing any injustice that ended in death. To me, what would be sadder is to risk lives now. To what end? To discourage use of an existing cell line in the future? To insure that that an already aborted fetus died in vain? I think we should carefully consider remedies for already-taken actions like the use of a cell line and to what end they are being proposed. Sent from my iPad using Tapatalk