Marinejiujitsu Posted March 8, 2020 Share Posted March 8, 2020 Dude. C'mon.Maybe this is a northern california thing. But yeah, you are more likely to pick up supplies at walmart.Sent from my SM-N975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted March 8, 2020 Share Posted March 8, 2020 3 hours ago, Cideous said: 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.... In terms of tracking the epidemiolgy, testing is useful.. Beyond that, it doesn't change the fact that you should be exercising the same basic exposure control measures that you do with every other virus we've faced.. The tests are a feel good, I'm not sure the lack of tests is really the issue.. Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 8, 2020 Administrator Share Posted March 8, 2020 1 hour ago, FiremedicMike said: In terms of tracking the epidemiolgy, testing is useful.. Beyond that, it doesn't change the fact that you should be exercising the same basic exposure control measures that you do with every other virus we've faced.. The tests are a feel good, I'm not sure the lack of tests is really the issue.. The tests, if done well and thoroughly, would likely fuel panic and not significantly change public health outcomes: By the time we had a test/no test choice, our supply chains, all running through China, were already decimated... so who could benefit from an improved readiness level? No one! Thus, not testing is either keystone cops level bufoonery, or brilliantly ice cold Machiavallian strategy. I'm not sure which is the worse option... 1 Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 8, 2020 Share Posted March 8, 2020 Getting good data for epidemiology is the first and most important step in developing a proper response to any pandemic. Even if containment is no longer possible, slowing the spread will help reduce health resource strains. It allows healthcare workers to protect themselves reasonably while not over utilizing resources (ie equipping n95s to ED personnel in hot zones vs nonaffected regions). In addition it provides data and better information for treatment and management of sick patients. 1 Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 8, 2020 Share Posted March 8, 2020 i guess testing people say, in a SNF, with a cough and/or fever would cause just cause panic. Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 8, 2020 Author Share Posted March 8, 2020 1 hour ago, FiremedicMike said: The tests are a feel good, I'm not sure the lack of tests is really the issue.. Except that every epidemiologist in the world would strongly disagree with you that testing the general public and those on the front lines during a pandemic is only...."Feel good". Mercy. 1 Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted March 8, 2020 Share Posted March 8, 2020 7 minutes ago, Cideous said: Except that every epidemiologist in the world would strongly disagree with you that testing the general public and those on the front lines during a pandemic is only...."Feel good". Mercy. Alright let’s approach this differently.. How would tests change your day to day? Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 8, 2020 Share Posted March 8, 2020 6 minutes ago, FiremedicMike said: Alright let’s approach this differently.. How would tests change your day to day? Outpatient clinic: confirmed case. Wipe downs after each exam. Notify patients of active case. Wait in car to be called instead of waiting room. N95 use of MA, receptionists and providers. Stricter enforcement of medical personnel to stay home if sick. Increase clinical suspicion of covid19 of patients w flu or uri symptoms. inpatient: Should be obvious Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted March 8, 2020 Share Posted March 8, 2020 26 minutes ago, cbrsmurf said: Outpatient clinic: confirmed case. Wipe downs after each exam. Notify patients of active case. Wait in car to be called instead of waiting room. N95 use of MA, receptionists and providers. Stricter enforcement of medical personnel to stay home if sick. Increase clinical suspicion of covid19 of patients w flu or uri symptoms. inpatient: Should be obvious Unless I’m mistaken, current CDC recommendations DO NOT require a positive test for those things to occur... Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted March 8, 2020 Share Posted March 8, 2020 26 minutes ago, mcclane said: Irrelevant in the big picture of epidemiology. Epidemiology will not stop the spread, only track it. Good data sharing with the CDC accomplishes the same thing. A positive test only confirms what you should have already concluded based on your assessment and interview. For full disclosure, I spent 4 years as the infection control officer, while epidemiology interests me, I don’t believe that actual testing is as impactful as people are making it seem. The government is doing what the government can do. They can’t force tamiflu production to increase, they can’t invent a vaccine any faster than normal, they can’t invent new ICU beds.. all they can do is track data, which they are doing. 1 Quote Link to comment Share on other sites More sharing options...
MediMike Posted March 8, 2020 Share Posted March 8, 2020 The government can also stop telling people that anyone that wants to get tested can get tested... 3 Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 9, 2020 Author Share Posted March 9, 2020 26 minutes ago, MediMike said: The government can also stop telling people that anyone that wants to get tested can get tested... Right? Jesh. More misinformation in an attempt to stop panic. Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 9, 2020 Share Posted March 9, 2020 1 hour ago, FiremedicMike said: Epidemiology will not stop the spread, only track it. Good data sharing with the CDC accomplishes the same thing. A positive test only confirms what you should have already concluded based on your assessment and interview. For full disclosure, I spent 4 years as the infection control officer, while epidemiology interests me, I don’t believe that actual testing is as impactful as people are making it seem. The government is doing what the government can do. They can’t force tamiflu production to increase, they can’t invent a vaccine any faster than normal, they can’t invent new ICU beds.. all they can do is track data, which they are doing. That’s not true. Individual practitioners, clinics, and hospitals can develop their own policies depending on epidemiological data. Government can (should) enact policies based on data. Government can speed up development of vaccines and treatments (which they recently did with the $8.3b bill, where $3b is going to r&d). Government can give PSAs, restrict travel, use FEMA, Etc etc Quote Link to comment Share on other sites More sharing options...
FiremedicMike Posted March 9, 2020 Share Posted March 9, 2020 7 hours ago, cbrsmurf said: That’s not true. Individual practitioners, clinics, and hospitals can develop their own policies depending on epidemiological data. Government can (should) enact policies based on data. Government can speed up development of vaccines and treatments (which they recently did with the $8.3b bill, where $3b is going to r&d). Government can give PSAs, restrict travel, use FEMA, Etc etc Real quick recap, because I think you took my comment out of context - the assertion was made that Trump wasn’t doing anything, the only example was that tests weren’t more readily available. I mentioned that confirmed tests were really only useful for epidemiology and won’t stop the spread or treat the patients, then we started debating epidemiology.. To your point: The government was working on enacting policy in January, and the first correspondence I got from the CDC was towards the end of The month (Jan), which included known epidemiology, exposure control methods, and isolation suggestions. As this has continued, the government has now put out travel warnings which have led to several soft travel bans (my daughters school trip to Japan in June, which she has been looking forward to for 2 years, is likely going to be delayed for a year). There is no need for FEMA yet. I suppose government funding could (and will) be used to incentivize treatment and vaccine development, but that really only incentivizes companies to put energy into them.. Money doesn’t change the time it takes to research and test new medicine.. I might agree that this money should have been made available sooner, but on the other hand, the numbers didn’t really add up until the last week or two.. Quote Link to comment Share on other sites More sharing options...
Moderator ventana Posted March 9, 2020 Moderator Share Posted March 9, 2020 posted on my door this AM If you have a fever or symptoms of a respiratory illness.pdf 1 Quote Link to comment Share on other sites More sharing options...
sas5814 Posted March 9, 2020 Share Posted March 9, 2020 I read this morning some members of congress are self isolating due to contact with known cases. I tried to get 2 weeks off because I was in the congressional offices last week but no joy.... Never waste a good crisis... 2 Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 9, 2020 Share Posted March 9, 2020 6 hours ago, FiremedicMike said: Real quick recap, because I think you took my comment out of context - the assertion was made that Trump wasn’t doing anything, the only example was that tests weren’t more readily available. I mentioned that confirmed tests were really only useful for epidemiology and won’t stop the spread or treat the patients, then we started debating epidemiology.. To your point: The government was working on enacting policy in January, and the first correspondence I got from the CDC was towards the end of The month (Jan), which included known epidemiology, exposure control methods, and isolation suggestions. As this has continued, the government has now put out travel warnings which have led to several soft travel bans (my daughters school trip to Japan in June, which she has been looking forward to for 2 years, is likely going to be delayed for a year). There is no need for FEMA yet. I suppose government funding could (and will) be used to incentivize treatment and vaccine development, but that really only incentivizes companies to put energy into them.. Money doesn’t change the time it takes to research and test new medicine.. I might agree that this money should have been made available sooner, but on the other hand, the numbers didn’t really add up until the last week or two.. I think the main issue being debated (or at least my interpretation) was whether widespread testing is needed. The argument against widespread testing is whether it will effect health outcomes. The simple answer is yes, which I have previously provided examples as to why. While I do not see any strong evidence against widespread testing, I understand the limitations could be the limited availability of testing (currently being ramped up exponentially) and cost (unknown to me). In terms of policy, I think government responses and policy implementation could always be better. For this outbreak, our government's response has been disappointingly slow, which is objectively seen by other countries' much quicker abilities to test for the disease (see South Korea and Italy). I disagree about money changing time to R&D. In any industry, pouring money and resource into R&D always produces faster results. I'm not quite sure how this point is debatable. Quote Link to comment Share on other sites More sharing options...
sas5814 Posted March 9, 2020 Share Posted March 9, 2020 22 minutes ago, cbrsmurf said: In terms of policy, I think government responses and policy implementation could always be better. For this outbreak, our government's response has been disappointingly slow, which is objectively seen by other countries' much quicker abilities to test for the disease (see South Korea and Italy). Do you have any data on the sensitivity and specificity of their tests? I just got an email that our area, which is fairly rural and somewhat suburban, will have a testing center with a capacity of 20 tests a day and should be ready to start in 2-3 weeks. I'm not conversant enough in the matter to opine as to the slow response here vs there but wonder about the quality of testing they were able to do so quickly. Is poor sensitivity testing better or worse than not testing? Quote Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted March 9, 2020 Administrator Share Posted March 9, 2020 So, if we're preparing for potential nationwide medical needs that will overwhelm our ICUs... should we all be taking (or retaking) FCCS before that happens?https://www.sccm.org/Fundamentals/FCCS Quote Link to comment Share on other sites More sharing options...
cbrsmurf Posted March 9, 2020 Share Posted March 9, 2020 1 hour ago, sas5814 said: Do you have any data on the sensitivity and specificity of their tests? I just got an email that our area, which is fairly rural and somewhat suburban, will have a testing center with a capacity of 20 tests a day and should be ready to start in 2-3 weeks. I'm not conversant enough in the matter to opine as to the slow response here vs there but wonder about the quality of testing they were able to do so quickly. Is poor sensitivity testing better or worse than not testing? That's a good question. I don't know (couldn't find any data on it). Quote Link to comment Share on other sites More sharing options...
Guest Paula Posted March 9, 2020 Share Posted March 9, 2020 4 hours ago, sas5814 said: I read this morning some members of congress are self isolating due to contact with known cases. I tried to get 2 weeks off because I was in the congressional offices last week but no joy.... Never waste a good crisis... There are certain members of congress who should isolate themselves permanently. Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 10, 2020 Author Share Posted March 10, 2020 The first case in New Jersey....a PA currently in the hospital is struggling right now. https://nypost.com/2020/03/10/new-jersey-patient-fighting-coronavirus-uable-to-talk-from-illness/ 32 with no underlying conditions. This is what this thread is about. Just something to think about. Quote Link to comment Share on other sites More sharing options...
PickleRick Posted March 10, 2020 Share Posted March 10, 2020 (edited) 2 hours ago, Cideous said: ...32 with no underlying conditions. This is what this thread is about. Just something to think about. Except, he's Asian. Likely genetically high ACE2 receptors. Virus has an affinity for those folks. Forgot to add smiley face, tongue in cheek emoticon... Edited March 10, 2020 by PickleRick Quote Link to comment Share on other sites More sharing options...
surgblumm Posted March 14, 2020 Share Posted March 14, 2020 It seems like this is pretty unanimous on this thought. The Veterans Caucus has a motto ;Lifesavers then--Caregivers now.it is all part of the progression. From the war zones of Vietnam, Iraq and Afghanistan to the facilities where we apply our knowledge,. nothing has changes except the smell of cordite Quote Link to comment Share on other sites More sharing options...
Cideous Posted March 16, 2020 Author Share Posted March 16, 2020 (edited) https://www.foxnews.com/health/emergency-room-doctors-critical-condition-coronavirus So I wonder how many will stop going to work when they are placed intentionally in dangerous situations without proper gear, cleaning or planning. The topic of this thread seems a bit more relevant now than it did a few weeks ago.... Edited March 16, 2020 by Cideous Quote Link to comment Share on other sites More sharing options...
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