Are you willing to die for your patients and your practice? How about risking your family?

[EMSGuy1982]

 

6 hours ago, Paula said:

I just keep washing my hands 500 times a day and go on with life. 

Also, absolutely do not touch your face.

[Joelseff]

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[UGoLong]

Of course we are more at risk for getting it; we will inevitably come in contact with people who have it. Dying from it may be another story.

 

 

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[GMM2019]

I’m much more likely to get the coronavirus on the train commute.... 

[sam619]

Well, I work in ID so this is an everyday thing. I have suited up and helped treat some of the most infectious microorganisms  in the world. It comes with the territory. If I get sick, then at least i'd go with a bang doing something I love. LOL.

 

Also, I don't have kids/a family as that would likely change things. 

[Marinejiujitsu]

The title says it all.  In the dark hours of the night when you are thinking about your patients and the day........are you willing to contract a potential life ending illness while showing up for work in Family Practice and Urgent Care?  It doesn't get anymore real then this.
So what is your answer?
 

Cideous, you seem pretty worried. Im assuming you must be a sicky when you get sick. Well, it was nice having you as a member of this forum. You will be missed.

Jk.

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[kargiver]

Its an interesting question... but why now?  Have we never considered this with other infectious diseases OTJ, the real risk of violence from patients, offended co-workers, etc, or any other unforeseen risks that we inherently encounter practicing medicine?  Worked as a medic for a long, long time and been a PA for quite some time now as well.  I considered this when I was 18-19, reassessed it in my early 20s when I got married, again in grad school, and again when I had a kid - but the answer is always the same: If I wanted a safe job I'd be a police department accountant.

G

[GetMeOuttaThisMess]

Let's see...I had to deal with the pig, the bird, TB, and all sorts of other patients while with the county health dept.  I even had to do radiologic emergency training and BDLS/CDLS/ADLS and yet still made it to retirement.  Oh, and I had to know about the location of the government stockpiles of Cipro for all the bioterrorism agents.  Can't leave out the natural disaster relief as well ("Hi, Katrina" and whatever the second one was that got us activated over the opening weekend of CFB season a year or so later!).  If it's my time, then it's my time and I'm ready to go whenever called (death).

Edited March 4, 2020 by GetMeOuttaThisMess

[cbrsmurf]

The attitudes in this thread are surprising.

 

This is a new, highly contagious disease with higher mortality than influenza without any known effective treatment or vaccine.  It is beyond containment and has likely already infected thousands of Americans.  Yes, the young and healthy seem to do fine, but a lot of the population, especially the ones we treat, are not in that demographic.  I live with a family member that has a serious, chronic medical condition.  I am afraid of her contracting covid19, especially as it appears the disease can spread when asymptomatic.  On top of that, you still have hospitals still dealing with influenza patients, it is very possible that our current medical resources will not be able to handle this.

[Cideous]

2 hours ago, cbrsmurf said:

The attitudes in this thread are surprising.

 

This is a new, highly contagious disease with higher mortality than influenza without any known effective treatment or vaccine.  It is beyond containment and has likely already infected thousands of Americans.  Yes, the young and healthy seem to do fine, but a lot of the population, especially the ones we treat, are not in that demographic.  I live with a family member that has a serious, chronic medical condition.  I am afraid of her contracting covid19, especially as it appears the disease can spread when asymptomatic.  On top of that, you still have hospitals still dealing with influenza patients, it is very possible that our current medical resources will not be able to handle this.

Exactly my point.

[kargiver]

3 hours ago, cbrsmurf said:

The attitudes in this thread are surprising.

 

This is a new, highly contagious disease with higher mortality than influenza without any known effective treatment or vaccine.  It is beyond containment and has likely already infected thousands of Americans.  Yes, the young and healthy seem to do fine, but a lot of the population, especially the ones we treat, are not in that demographic.  I live with a family member that has a serious, chronic medical condition.  I am afraid of her contracting covid19, especially as it appears the disease can spread when asymptomatic.  On top of that, you still have hospitals still dealing with influenza patients, it is very possible that our current medical resources will not be able to handle this.

There are exceptions to the science that have not been identified yet.  The early mortality curve is "high," but this is an artificial construct of both case definition and lack of testing on a large scale.  One only need look at South Korea for a better epidemiological presentation of what this novel virus actually does.

Additionally, this virus will mutate to being less virulent over time otherwise it WILL burn itself out.  This is going to happen much quicker than most people appreciate.  There are already 2 strains circulating (suggesting a strong mutation has already occurred).  That's just the calculus of its virology.  That strain which mutates "best" will propagate itself best.  Just how natural selection works.  

Further, the influenza vaccination rate is estimated at being 10% effective this year - dismal by any standard - and it too spreads before someone is acutely ill and can sit on furniture, counters, etc and infect others when inadvertently touched.  We tend not to fret about it though because we are used to seeing it.  It will be no different with this virus as well.  The South Korean model is doing quite well at identifying who is infected, who is really sick, and treating them early.  This is contributing to their lower mortality rate.  Of course, it requires a paradigm shift in thought and response, one that has not been embraced thus far, but one hopes that WHO advocates for this approach and it is adopted by CDC.  Thus far their response has been less than stellar.  This is scientific criticism, not a political one.  

Finally, I do agree, our current resources CANNOT handle it, not in the manner we are going about it, and it will not get better before it spreads much, much further into the community at large and we start weeding out "sick from not sick," and focus on the ones who actually need aggressive treatment (similar to the South Korean approach).  This i think we can handle, as this surge is coming late in the winter months and into early spring (even though there is a second wave of Influenza A currently making the rounds as well). Hopefully we get it into gear... 

G

[Marinejiujitsu]

Exactly my point.

Yep, totally not containable. Experts are starting to say it maybe less than 1% fatality rate. If you see the total numbers contracted its really not that impressive. I think the thought process is 4x as many are sick and not seeking help because its not that bad. Ones that are 30% of them are having the lower respiratory issues.

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[EMEDPA]

3 hours ago, kargiver said:

There are exceptions to the science that have not been identified yet.  The early mortality curve is "high," but this is an artificial construct of both case definition and lack of testing on a large scale.  One only need look at South Korea for a better epidemiological presentation of what this novel virus actually does.

Additionally, this virus will mutate to being less virulent over time otherwise it WILL burn itself out.  This is going to happen much quicker than most people appreciate.  There are already 2 strains circulating (suggesting a strong mutation has already occurred).  That's just the calculus of its virology.  That strain which mutates "best" will propagate itself best.  Just how natural selection works.  

Further, the influenza vaccination rate is estimated at being 10% effective this year - dismal by any standard - and it too spreads before someone is acutely ill and can sit on furniture, counters, etc and infect others when inadvertently touched.  We tend not to fret about it though because we are used to seeing it.  It will be no different with this virus as well.  The South Korean model is doing quite well at identifying who is infected, who is really sick, and treating them early.  This is contributing to their lower mortality rate.  Of course, it requires a paradigm shift in thought and response, one that has not been embraced thus far, but one hopes that WHO advocates for this approach and it is adopted by CDC.  Thus far their response has been less than stellar.  This is scientific criticism, not a political one.  

Finally, I do agree, our current resources CANNOT handle it, not in the manner we are going about it, and it will not get better before it spreads much, much further into the community at large and we start weeding out "sick from not sick," and focus on the ones who actually need aggressive treatment (similar to the South Korean approach).  This i think we can handle, as this surge is coming late in the winter months and into early spring (even though there is a second wave of Influenza A currently making the rounds as well). Hopefully we get it into gear... 

G

Case definition is key. what if like cholera 90% of those affected have minimal to no sx and never seek care? I agree it is scary for the old and immunocompromised. I think with common sense and treating it like influenza or any other contagious disease we will get through this just like every prior disease scare of the last 50 years. I am guessing a therapy or vaccine will be forthcoming soon. I have heard talk about an antiviral cocktail trial that seems to have reasonable efficacy in south Korea. 

[cbrsmurf]

11 hours ago, EMEDPA said:

Case definition is key. what if like cholera 90% of those affected have minimal to no sx and never seek care? I agree it is scary for the old and immunocompromised. I think with common sense and treating it like influenza or any other contagious disease we will get through this just like every prior disease scare of the last 50 years. I am guessing a therapy or vaccine will be forthcoming soon. I have heard talk about an antiviral cocktail trial that seems to have reasonable efficacy in south Korea. 

It would be a mistake to treat it like influenza.

 

Patients with serious symptoms of COVID19 averaged a 10 day ICU hospital stay in China (https://jamanetwork.com/journals/jama/fullarticle/2761044).  Mortality is 3.4% according to WHO, which will hopefully decrease.  ED and ICU health personnel will be probably be hit hard in hot zones; they may not get critically sick but they have to be taken out of action and are not easily replaced.

 

I think it would be best to be prudent and plan for this, but agree with not panicking.  Unfortunately, the response in this country as been slow for such a new, widespread, highly infectious disease.

[GetMeOuttaThisMess]

As I'm preparing to travel tomorrow to the land of my beachside frozen ice stand, I just got back from the grocery store looking for some hand wipes which they online show to have in stock.  Nadda, zip.  This brings me to my question.  Instead of messing around and wondering about whether or not the airline cleaning crew (minimum wage) did a decent job, and what do I do without hand sanitizer (I found a bottle of same in my luggage), why not just take a couple pair of gloves for our party, multiple pair if they so desire, and just wear them to touch items within the aircraft?  We're in first, my in-laws are in coach so we'll have more to touch within our seating area due to screens and storage compartments.  I haven't seen a run on gloves at Lowes/HD/HF.  Don't tell anyone that this idea was presented.  We don't want to start a glove stampede.

[Cideous]

Nurses union has had it with this terrible response from the govt.  I think we are about to see a full on revolt unless the Trump administration gets it *shite together....and right fast.

[CAdamsPAC]

2 hours ago, Cideous said:

Nurses union has had it with this terrible response from the govt.  I think we are about to see a full on revolt unless the Trump administration gets it *shite together....and right fast.

It always boils down to Trump...………..

 

[PickleRick]

Went to Walmart earlier today to get some trimming line and premix fuel for my weedeater.  Right there with the various lawncare implements and gloves and such, are 3M N95 masks.  No, I didn't buy any.

[MediMike]

1 hour ago, CAdamsPAC said:

It always boils down to Trump...………..

 

Kind of difficult to discuss the government response to this situation without invoking the head of the government isn't it?

[Cideous]

3 hours ago, CAdamsPAC said:

It always boils down to Trump...………..

 

Yesterday, Trump stood at the CDC, looked into he camera and said...and I quote, "Anyone who wants a test can get the test, the tests are there and they are beautiful....."

That my friend is a direct quote from the head of our government.  The guy in charge of our health dept's response.

Beautiful.  

Edited March 7, 2020 by Cideous

[Marinejiujitsu]

Went to Walmart earlier today to get some trimming line and premix fuel for my weedeater.  Right there with the various lawncare implements and gloves and such, are 3M N95 masks.  No, I didn't buy any.

Thats what I was thinking. It's hilarious people are so worried about getting the corona virus so they stock up at costco (where people have good jobs and travel alot....and a lot of asians).

Walmart though people from the hood shop there. I know hood from my childhood. Lol. We walmart shoppers dont have money to travel and we dont even use facemasks to clean mold.

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[deltawave]

This is the strangest post I’ve seen on this site. 
 

Isn’t this what we do everyday? It’s the job. You’re always at risk of getting something or taking something home. As well, you could be treating patient zero at any time and not even know it. This is why we have universal precautions and ID training. 

I didn’t expect to find such sensationalism on this forum. 

[MediMike]

4 hours ago, Marinejiujitsu said:

Thats what I was thinking. It's hilarious people are so worried about getting the corona virus so they stock up at costco (where people have good jobs and travel alot....and a lot of asians).
 

Dude.  C'mon.

[FiremedicMike]

Just curious - what do you all feel the government should be doing about this that they aren’t?

Taking the comparison of the disease itself out of the mix, how does this pandemic really differ from the previous ones?

[Cideous]

5 hours ago, FiremedicMike said:

Just curious - what do you all feel the government should be doing about this that they aren’t?

Taking the comparison of the disease itself out of the mix, how does this pandemic really differ from the previous ones?

 

How about being able to test people?  China, South Korea, Italy are testing hundreds of thousands and we have tested 2-3k.  Providers everywhere here are screaming for testing but the govt refused to use the WHO testing kits instead opting to develop their own.  That would be a good start.

 

How does it differ from other pandemics?  Mortality of the Elderly is appearing to be much higher than other pan's in the last 30 years.  That's bad unless you are trying to move to a 55+ community and looking for some homes to open up....

Edited March 8, 2020 by Cideous