Moderator LT_Oneal_PAC Posted August 6, 2020 Moderator Share Posted August 6, 2020 1 minute ago, ohiovolffemtp said: LT Oneal, So can I quote Henny Youngman in responses to posters I don't like? A man goes to a psychiatrist. The doctor says, "You're crazy" The man says, "I want a second opinion!" "Okay, you're ugly too!" Yes, I know you'll have to ask either your parents or Google who Henny Youngman was. This is grade A comeback material. i have heard the joke, but I doubt I heard it from a comedian doing standup in 1969. Yes, I googled it. Not ashamed... Quote Link to comment Share on other sites More sharing options...
ohiovolffemtp Posted August 6, 2020 Share Posted August 6, 2020 That's why young PA's like you are so important to me - you're where my future Social Security payments are coming from..... 2 Quote Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted August 6, 2020 Moderator Share Posted August 6, 2020 3 minutes ago, ohiovolffemtp said: That's why young PA's like you are so important to me - you're where my future Social Security payments are coming from..... I knew who you were talking about... 1 Quote Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted August 6, 2020 Moderator Share Posted August 6, 2020 3 minutes ago, ohiovolffemtp said: That's why young PA's like you are so important to me - you're where my future Social Security payments are coming from..... It’s okay, your taxes paid for my extra income in residency and my doctorate through the GI bill. I suppose you can have some of it back 2 Quote Link to comment Share on other sites More sharing options...
surgblumm Posted August 13, 2020 Author Share Posted August 13, 2020 I appreciate the remarks of PAs who are involved in the care and treatment of Covid-19 patients and who risk their lives, yes, risk their lives and the health of their families to care for patients who can transmit the disease to them. This is not a game when we look at the statistics and it makes my minds spin when I hear or read the apathy that exists among some of us. As a veteran PA who understands life and death, it also makes my heart heavy that we can spend more time worrying about salaries and fail to hear what causes fear among both patients, medical professional and other professions. Are we losing the spirit that gave birth to our profession? Hopefully, we are not. And I must sy that the administrators did talk with me and told me not to advocate for any particular company and I am following their direction.80 % of my articles have to do with a present truth and I add the concluding sentence about a malpractice company but eliminate it for this forum, Huddle and Doximity. thank you for doing your jobs and for fulfilling your oath. Bob 1 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted August 14, 2020 Share Posted August 14, 2020 I have been calculating CFR since this kicked off. There was a point in early June or late may I thought this was going to hit above 7% but since we have had an increase in CASES, there has been a steady drop in CFR. Today it's around 3.1%. That's bad but I think the glass half full view is it could have been worse (may still get worse seeing as Flu season is coming... My question though is what are we classifying as COVID cases... In HIV, HIV is the virus while AIDS is the end stage (well once end stage) disease. And we have specific criteria for the diagnosis of the disease because not everyone develops AIDS...like not everyone has symptomatic Sarscov2... It seems we are including EVERY case of SARS-cov2 positive PCR tests as "COVID" cases regardless of symptomatology. If I recall, at onset the diagnostic criteria for COVID-19 was +PCR WITH high fever, cough, CP and SOB. How many of these new cases will actually become COVID given that criteria? It's great for the CFR (well in this case it's closer to IFR) but the CFR should be higher for new cases meeting COVID diagnostic criteria, which I cannot get a good source to define it. It seems the CDC is defining COVID as ALL + PCR testing...is this a good practice? I suppose it may be due to the whole "well we don't know who will develop sxs" but can't the diagnostic criteria include a waiting period say 2 weeks to see if pts actually develop sxs WHILE quarantining them to prevent spread, BEFORE we call it a COVID case? [emoji848] Wouldn't that be a better way to track this instead of reporting every new case or increase in cases on the news every day? Increased Cases, as of late anyway, don't seem to be resulting in increased deaths given the daily dropping of CFR/IFR... Am I making sense? [emoji23] [emoji23] [emoji23] Sent from my SM-G975U using Tapatalk 1 Quote Link to comment Share on other sites More sharing options...
MediMike Posted August 14, 2020 Share Posted August 14, 2020 3 hours ago, Joelseff said: My question though is what are we classifying as COVID cases... In HIV, HIV is the virus while AIDS is the end stage (well once end stage) disease. And we have specific criteria for the diagnosis of the disease because not everyone develops AIDS...like not everyone has symptomatic Sarscov2... It seems we are including EVERY case of SARS-cov2 positive PCR tests as "COVID" cases regardless of symptomatology. If I recall, at onset the diagnostic criteria for COVID-19 was +PCR WITH high fever, cough, CP and SOB. How many of these new cases will actually become COVID given that criteria? It's great for the CFR (well in this case it's closer to IFR) but the CFR should be higher for new cases meeting COVID diagnostic criteria, which I cannot get a good source to define it. It seems the CDC is defining COVID as ALL + PCR testing...is this a good practice? I suppose it may be due to the whole "well we don't know who will develop sxs" but can't the diagnostic criteria include a waiting period say 2 weeks to see if pts actually develop sxs WHILE quarantining them to prevent spread, BEFORE we call it a COVID case? Wouldn't that be a better way to track this instead of reporting every new case or increase in cases on the news every day? Increased Cases, as of late anyway, don't seem to be resulting in increased deaths given the daily dropping of CFR/IFR... Am I making sense? Are you asking that there be a certain severity of symptoms prior to classifying an individual who is COVID positive as a COVID positive individual? A case is a case is a case in regards to numbers. They can be further broken down into asymptomatic, moderate severe/life threatening which we are using to dictate some of our interventions for study purposes. Attempting to institute diagnostic criteria like you mention would be nigh on impossible in my mind. We can't get folks to cooperate with contact tracers, wear masks and ya'll know a dang decent portion of the population doesn't wash their %$# hands, there's no way we'll have the kind of follow up needed for that. And does it really matter? When you're looking at the rate of case growth, you're looking at the transmission of the virus. There's equivocal evidence that folks are are asymptomatic are able to spread the disease so what point would leaving them out accomplish? By that logic should you only count folks who have reach the stage of full-on AIDS and ignore individuals with HIV? I don't recall the abovementioned criteria as being required for inclusion at the onset of all of this...but our testing abilities were complete and utter crap too Quote Link to comment Share on other sites More sharing options...
hemegrupe Posted August 14, 2020 Share Posted August 14, 2020 What's 'eerie and surreal' is there being no conversation about it being a vasculotropic virus with long-term implications just beginning to be understood, beyond the patients who don't make it in the short term. https://www.statnews.com/2020/07/27/covid19-concerns-about-lasting-heart-damage/#:~:text=Taken together%2C the two studies,blood throughout the body declines. Quote Link to comment Share on other sites More sharing options...
hemegrupe Posted August 14, 2020 Share Posted August 14, 2020 https://www.cnbc.com/2020/08/13/scientists-say-the-coronavirus-is-at-least-as-deadly-as-the-1918-flu-pandemic.html Quote Link to comment Share on other sites More sharing options...
Joelseff Posted August 14, 2020 Share Posted August 14, 2020 Are you asking that there be a certain severity of symptoms prior to classifying an individual who is COVID positive as a COVID positive individual? A case is a case is a case in regards to numbers. They can be further broken down into asymptomatic, moderate severe/life threatening which we are using to dictate some of our interventions for study purposes. Attempting to institute diagnostic criteria like you mention would be nigh on impossible in my mind. We can't get folks to cooperate with contact tracers, wear masks and ya'll know a dang decent portion of the population doesn't wash their %$# hands, there's no way we'll have the kind of follow up needed for that. And does it really matter? When you're looking at the rate of case growth, you're looking at the transmission of the virus. There's equivocal evidence that folks are are asymptomatic are able to spread the disease so what point would leaving them out accomplish? By that logic should you only count folks who have reach the stage of full-on AIDS and ignore individuals with HIV? I don't recall the abovementioned criteria as being required for inclusion at the onset of all of this...but our testing abilities were complete and utter crap too [emoji846]I remember at the beginning, can't recall the source CDC maybe?, but I remember someone making a distinction between viral infection and COVID 19 as "the disease that SARSCOV2 causes" which was characterized by Fever, cough, SOB, CP and then they added anosmia and dysgeusia a bit later and that impressed upon me a distinction between viral infection and actual "COVID" cases. I must admit I was actually on disability and wasn't practicing at the time so I was just getting articles and of course the ever confusing and contradictory news media sources....I suppose you are correct in that we do not have the capability of surveillance that would suffice to cover what my post was talking about. I just thought that if we did, we could risk stratify "cases" like they were proposing a few mos ago with the "passport" idea and some of the people who were infected but were either asymptomatic (non spreaders) or people with mild sxs and recovered after a prescribed period (14 days per CDC guidelines?) with confirmed Neg Viral testing, can go about their life again. As we are seeing many of these new cases/viral pos ppl are not getting bad disease or not getting disease at all as the CFR trend would suggest.But, it's way above my pay grade so I suppose I gotta keep on keeping on. [emoji53]Sent from my SM-G975U using Tapatalk 1 Quote Link to comment Share on other sites More sharing options...
Joelseff Posted August 14, 2020 Share Posted August 14, 2020 https://www.cnbc.com/2020/08/13/scientists-say-the-coronavirus-is-at-least-as-deadly-as-the-1918-flu-pandemic.htmlI agree with the article that had COVID hit in the days before vents and modern medicine it would have been much more catastrophic and I still think it could've been much worse.Thanks for sharing that. Sent from my SM-G975U using Tapatalk Quote Link to comment Share on other sites More sharing options...
surgblumm Posted August 19, 2020 Author Share Posted August 19, 2020 News > Kaiser Health News Dying Young: The Health Care Workers in Their 20s Killed by COVID-19 Alastair Gee, The Guardian August 13, 2020 Quote Link to comment Share on other sites More sharing options...
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