mgriffiths Posted March 16, 2020 Share Posted March 16, 2020 (edited) 51 minutes ago, BruceBanner said: As usual, admins are nowhere to be seen in the clinics; they're safe in their ivory tower sending emails. ours are ALL working from home, our manager showed up to work this morning because she felt she should be here with us, but her boss found out and she was told it is mandatory for her to work from home...honestly I get it, but at the same time how in world can they make informed policy decisions when they don't see what's going on? Oh, wait, they couldn't make informed policy decisions before because they didn't know what was going on... Edit: and as of about 15 minutes ago, our elective surgeries are cancelled... Edited March 16, 2020 by mgriffiths 1 2 Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 16, 2020 Administrator Share Posted March 16, 2020 16 hours ago, einstein2u said: from a source, curfews are coming this week. we will know more in the next 48-72 hours What sort of curfews are you hearing about? Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted March 16, 2020 Share Posted March 16, 2020 Purely rumor, but in Michigan supposedly they are discussing curfews where businesses close at 7pm and no one outside without valid reason after 8pm. Again, PURELY RUMOR...but some of those involved in the conversation would know before others. Quote Link to comment Share on other sites More sharing options...
PAinPenna Posted March 16, 2020 Share Posted March 16, 2020 Everything in Pennsylvania is closed except grocery stores and pharmacies as of midnight tonight . Restaurants may still do food pick up and delivery , but nothing else is allowed to be open . Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 16, 2020 Share Posted March 16, 2020 We should be on full lockdown. These half-measure policies aren't enough; we'll get overwhelmed and people will die unnecessarily. Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 16, 2020 Share Posted March 16, 2020 With the expectation that 1.5 million Americans will die in the next 12 months compared to 50K for influenza - yeah, we should be doing more and doing it quickly. We don't have enough respirators and we don't have enough medical staff to last that long if we are dropping like flies already. Not panic - realistic pragmatic thinking. We don't have the societal support or infrastructure to support the citizens in a shut down. Common sense isn't that common anymore. Everyone be safe! Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted March 16, 2020 Share Posted March 16, 2020 For those with more public health and epidemiology expertise: what is the current best guess as to how long the "flattened" curve lasts? Specifically, how long before it's likely that we can relax the "social distancing" measures? Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 16, 2020 Author Share Posted March 16, 2020 7 minutes ago, ohiovolffemtp said: For those with more public health and epidemiology expertise: what is the current best guess as to how long the "flattened" curve lasts? Specifically, how long before it's likely that we can relax the "social distancing" measures? Through summer, but those that don't get it this spring will likely get it next Fall when it re-emerges. This thing will be with us until we get a vaccine for it. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 17, 2020 Administrator Share Posted March 17, 2020 24 minutes ago, Cideous said: Through summer, but those that don't get it this spring will likely get it next Fall when it re-emerges. This thing will be with us until we get a vaccine for it. I dunno, I haven't seen any evidence of any summer season slackening. Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 17, 2020 Author Share Posted March 17, 2020 43 minutes ago, rev ronin said: I dunno, I haven't seen any evidence of any summer season slackening. Like all respiratory viruses, they slow down in the summer with reduced community contact. Hopefully that happens here. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 17, 2020 Administrator Share Posted March 17, 2020 8 minutes ago, Cideous said: Like all respiratory viruses, they slow down in the summer with reduced community contact. Hopefully that happens here. That may be, but it seems to be spreading equally efficaciously in both sides of the equation as well as the tropics, so it doesn't appear to be seasonal/temperature based spread like that of seasonal influenza. Quote Link to comment Share on other sites More sharing options...
chaitea Posted March 17, 2020 Share Posted March 17, 2020 San Fran and surrounding counties on lockdown. Can only leave house to go to hospital, doc, bank, gas, or grocery store. Also, has anyone heard a status update in the PA that was infected? I hope he’s ok. Quote Link to comment Share on other sites More sharing options...
Marinejiujitsu Posted March 17, 2020 Share Posted March 17, 2020 Did any other ERs finally get hit hard today? 20 people in 1 hr hour with possible COVID. PPE all day, exhausting. I was working at a smaller ER 45 minutes from Santa Clara County and only 3 providers all day. Sent from my SM-N975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 17, 2020 Author Share Posted March 17, 2020 1 hour ago, Marinejiujitsu said: Did any other ERs finally get hit hard today? 20 people in 1 hr hour with possible COVID. PPE all day, exhausting. I was working at a smaller ER 45 minutes from Santa Clara County and only 3 providers all day. Sent from my SM-N975U using Tapatalk It's about to get a hell of a lot worse. Quote Link to comment Share on other sites More sharing options...
Moderator True Anomaly Posted March 17, 2020 Moderator Share Posted March 17, 2020 On 3/16/2020 at 9:00 AM, mgriffiths said: If only we had PPE...other than gloves we have nothing in our outpatient clinics. They don't even have any N95s at our official "coronavirus clinic." One of my NP friends bought some N95s herself when she was volunteered to cover that clinic but she isn't allowed to wear them because "they weren't purchased by the hospital." If someone is being told they can't wear something to protect themselves while doing direct patient care because it "wasn't purchased by the hospital", that's an VERY easy story for a local media outlet to blow up. Myself and my other colleagues at work have bought eye protection online. There's no way anyone is going to tell me that I can't use equipment that I purchased for myself in order to practice safely 3 1 Quote Link to comment Share on other sites More sharing options...
DarwinStarwin Posted March 17, 2020 Share Posted March 17, 2020 Once upon a time (aka last Friday at 11am), in a small, small clinic in the rural southwest, the nurse i had been working with all week was instructed to self quarantine due to working up a patient tracked by CDC with known positive contact 4 days earlier. Our clinic which is already incredibly resource poor (FQHC) came up with the relatively terrible idea of rotating our entire staff though the front desk triage process. So not only increasing contact risk, but also involving non-medical.The nurse was told to go directly home and not come back for 14 days. The doc she worked with that day of potential exposure had already developed what sounded to be a rough flu-like illness. We're already understaffed... and we have 24 N95 masks TOTAL. Lol. I just wish our network had initiated a "no-contact" triage process earlier in the game and started developing a telemedicine protocol. I would happily take the role of being one of the providers dedicated to taking on a higher risk and seeing patients in person. But I have a lot of medically confusing elderly patients who literally just need to come in once for an unnecessary visit, ie to request getting their meds refilled, and with transmission, are statistically at very high risk of an early death. Its overwhelming to think of the implications this disorganization has on the lives of the more vulnerable population. Sent from my SM-G973U using Tapatalk 1 1 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted March 17, 2020 Moderator Share Posted March 17, 2020 If they keep sending home everyone in contact with a positive patient we will run out of providers and staff pretty darn quick...A friend of mine diagnosed the first case in our county and was sent home for 2 weeks despite wearing PPE and he still feels fine....gotta draw the line somewhere... 3 Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted March 17, 2020 Share Posted March 17, 2020 2 hours ago, EMEDPA said: A friend of mine diagnosed the first case in our county and was sent home for 2 weeks despite wearing PPE and he still feels fine Assuming it was appropriate PPE, that is goofy. With appropriate PPE there shouldn't be exposure...that's kind of the point. Quote Link to comment Share on other sites More sharing options...
SedRate Posted March 17, 2020 Share Posted March 17, 2020 As of right now, 4,226 confirmed cases and 75 deaths in the U.S. in two months, which is 1.7%. And given that testing is being restricted, who knows how many actual cases are out there, likely lowering the total mortality rate. Are you guys basing your number projections (1.5 million) and concerns for high mortality off other country's data? I'm really having a hard time seeing how this thing will devastate our country other than completely screwing the economy by bringing manufacturing and commerce to a screeching halt, thereby exposing those in healthcare unnecessarily due to lack of resources to PPE and mandated quarantines causes understaffed workloads. I guess I must be missing something that you guys are seeing that I'm not. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-in-us.html 1 Quote Link to comment Share on other sites More sharing options...
SedRate Posted March 17, 2020 Share Posted March 17, 2020 6 hours ago, EMEDPA said: If they keep sending home everyone in contact with a positive patient we will run out of providers and staff pretty darn quick...A friend of mine diagnosed the first case in our county and was sent home for 2 weeks despite wearing PPE and he still feels fine....gotta draw the line somewhere... Exactly. Where will the line be drawn and at what economic cost? Quote Link to comment Share on other sites More sharing options...
SedRate Posted March 17, 2020 Share Posted March 17, 2020 Approximately 8,000 deaths and 198,000 cases worldwide up until now, which is 4% mortality, but that's with lack of testing capability in the U.S. and other countries which means number of unreported and undiagnosed cases are likely much higher and therefore a lower mortality rate. Quote Link to comment Share on other sites More sharing options...
mgriffiths Posted March 17, 2020 Share Posted March 17, 2020 29 minutes ago, Sed said: I'm really having a hard time seeing how this thing will devastate our country other than completely screwing the economy Personally, I don't really expect this to devastate our country in terms of deaths or even illness. I am not expecting anything even mildly related to the Spanish Flu. But, it is good to be prepared for the worst, and I could absolutely be wrong...hence the trying to be prepared. With all of that, my expectations are similar to yours...a screwed economy that will have lasting effects and significant changes to healthcare procedure. But, I also saw a statement from the Lake George CSD Superintendent: “We will never know if we did too much or overreacted as some may say, however, it will be abundantly clear if we didn't do enough in the weeks and months to come.” That is a powerful statement, and one that gives reason to this potential "over reaction." The bottom line is that in a country as rich as the USA we should be able to ride through a blip like this economically...key word is "should." Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 17, 2020 Share Posted March 17, 2020 Some survivors in China have lost up to 30% pulmonary function which will lead to longer term dysfunction, disability with higher repeat illness rates, shorter life spans and decreased productivity. This pandemic will have long term effects we haven’t even thought of yet. I am more interested in functional survival and reducing infection than the economy. Pavlovaclouds posts show the math for the expected mortality rate. The positive diagnoses where I live jumped by 500% in 3 days. The US is a month behind and seriously unprepared. Quote Link to comment Share on other sites More sharing options...
Reality Check 2 Posted March 17, 2020 Share Posted March 17, 2020 https://www.medscape.com/viewarticle/926973?nlid=134545_3901&src=wnl_newsalrt_200317_MSCPEDIT&uac=218206AV&impID=2314666&faf=1 BBC News expert reported that ONE infectious person can expose 250 people by vector contact. So, not enough tests and we cannot clear people to work or shut down the spread effectively. Definition of system failure. Quote Link to comment Share on other sites More sharing options...
SedRate Posted March 18, 2020 Share Posted March 18, 2020 1 hour ago, Reality Check 2 said: This pandemic will have long term effects we haven’t even thought of yet. I am more interested in functional survival and reducing infection than the economy. Pavlovaclouds posts show the math for the expected mortality rate. The US is a month behind and seriously unprepared. Yes, I read the posts. I've pasted one in particular for reference. They were based off "guestimates" and a 50% transmission rate. 50%?! I would rather not see the economic collapse of our country and healthcare fronts based on guesses. As the post said, we're past containment at this point. Shutting down our economy for 12-18 months while this thing plays out sounds like a terrible idea when "at this point, we are past containment." Going forward, we need to keep our wits about us. We should exercise caution but continue to live healthfully, get rest, stay home if we're sick (why can't people understand this concept during annual flu season?), sleep, exercise, and exercise good hygiene. I do hope these closures are short-lived. We are due for another recession and here it is, further thrust forward by these closures, quarantines, manufacturing halts, etc. I do hope everyone about to retire within the next 5 years has safely tuck away their 401k into something safe... "At this point, we are past containment. Containment is basically futile. Our containment efforts won’t reduce the number who get infected in the US.Now we’re just trying to slow the spread, to help healthcare providers deal with the demand peak. In other words, the goal of containment is to "flatten the curve", to lower the peak of the surge of demand that will hit healthcare providers. And to buy time, in hopes a drug can be developed.How many in the community already have the virus?No one knows.We are moving from containment to care.We in the US are currently where at where Italy was a week ago. We see nothing to say we will be substantially different.40-70% of the US population will be infected over the next 12-18 months. After that level you can start to get herd immunity. Unlike flu this is entirely novel to humans, so there is no latent immunity in the global population.[We used their numbers to work out a guesstimate of deaths— indicating about 1.5 million Americans may die. The panelists did not disagree with our estimate. This compares to seasonal flu’s average of 50K Americans per year. Assume 50% of US population, that’s 160M people infected. With 1% mortality rate that's 1.6M Americans die over the next 12-18 months.]The fatality rate is in the range of 10X flu.This assumes no drug is found effective and made available.The death rate varies hugely by age. Over age 80 the mortality rate could be 10-15%." Quote Link to comment Share on other sites More sharing options...
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