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The OFFICIAL 2nd Wave Covid19 thread...This winter is going to suck.


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This spring and summer were only a warm up, this winter is going to be the main event and folks... it's going to be UGLY. Hold on to your butts and start padding your savings now, we are in for a wild and terrible 6 months.  The real second wave is just now starting to hit in Europe and is right on track as predicted to hit the US in about 3 months.  While 42% of our country's residents are still waiting for it to "Go away like a miracle!"....the rest of sane America knows better. So here we go..

1.  Some Americans are acting like we are are on the downslope of this pandemic and resuming super spreader events.  As this continues over the next few months and influenza hits, it's going to be a double whammy.  Add to this that we will NOT have a Vaccine ready for the masses this year, no matter what the dear leader says, and our therapeutics are questionable at best.

2.  I believe we have not seen anything yet when it comes to hospital/ICU capacity overloads.  Drop the flu on top of Americans interacting more and Covid+Influenza is going to be common place.  

3.  If you are working as a PA and have not made a will.....do it.  This is good advise in the best of times, but never more important then now.  I use Legal Zoom.  It's cheap, easy and valid.

4.  If you work in a sub-specialty, start getting ready now for the possibility of being furloughed again.  I can not see hospitals continuing elective specialties with Winter+Covid+Influenza running over them.

5.  Have a plan.  Have some cash on hand and maybe hold off on any big purchases if it can be helped for a few months.

6.  The really bad flu seasons go into June.  Which is probably about the time the vaccine, if they get out of phase 3, will be available in mass.  I am praying that the efficacy of this year's flu shot is good, but so far we have not been terribly lucky as a species in 2020.

 

And for the inevitable people who will proclaim "Your so negative!", I say this:  Wishful thinking never accomplished anything, but planning for the worst and hoping for the best might just get us through this nightmare.

Edited by Cideous
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Public Health should not be political. Public Health officials should determine what needs to be done and administrations should follow the advice. Presidents shouldn't threaten to cut off fundin

There will be two sudden and dramatic drops in the hysterical media reporting of how Covid is going to kill us all.  The first drop will come November 3rd of this year, and then the disease will (edit

It’s very difficult to take another medical professional seriously when they claim a virus that has killed 200k people in our mutual home will stop immediately based solely on a political transition.

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WE'RE ALL GOING TO DIE!! This is not a drill! Lose the optimism and panic. Quit your job and start digging your own grave today because you won't be able to afford the shovel tomorrow.



P.S. Donald Trump is a bad man who says mean things and lies. A lot.

Sent from my Pixel 3 XL using Tapatalk

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I agree we need to be prepared for an increase in cases this fall as people in cold-weather climes spend more time indoors, and a general 'covid precautions fatigue' sets in (goodness knows I have it). However I disagree on a couple of points:

1. Influenza may not be as much of a problem as in years past, as we have had a lot less travel from the Southern Hemisphere to the Northern, this (northern H) summer. I understand that the Southern H has had a relatively light flu season in 2020.

2. Therapeutics and COVID management strategies are helping. Remdesivir works some, plasma works maybe, proning definitely works, steroids definitely work in the seriously ill. The end result is shorter ICU stays on average, and better outcomes. This improves both patient flow in the ICU as well as better morale.

3. Occupational infections seem to be fairly well controlled now that we are universal masking in the hospital. Although more N95's would probably be better - oh well, I guess things aren't perfect. Another large hazard that is not well addressed, is eating together in the break room.

So hopefully the furloughs won't be as bad, because the overall hospital overload will be less.

As for the vaccine, I wouldn't be TOO optimistic. We've never had a successful human coronavirus vaccine, the mRNA vaccine technology has never been used at scale, and the fastest vaccine ever developed (mumps) took 4 years. That said, there's unprecedented level of effort, for this one.

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Remdesevir's cost/benefit equation renders it pointless.  Convalescent plasma looks far more effective, but very difficult to scale.

I think furloughing PAs was a bad idea, and I think that most places are going to want to NOT stop elective procedures, because that hits them in the pocketbook.  I expect as much as possible will be virtual rather than in person, but with reimbursement parity, that's not such a bad thing.

Vaccines?  We'll see what the rapidly-rushed-multi-pronged-phase-3 trials show. I honestly have no idea which way this is legitimately going to go.

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I choose optimism this time. The amount of pts that I've convinced to get their first flu vaccine this year (who were previously vehemently opposed) has been awesome and surprisingly not difficult. People are actually taking precautions, wearing masks, washing their hands correctly (some for the first time). Shutting everything down again might be our biggest enemy.

Edited by EastCoastPA
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It is going to be a mixed bag. COVID is gonna spike again, I think there is sufficient recon data to support that. In the south (where I am), I think we will be looking at a surge like we had in June-July in the mid fall. Lots of COVID, maybe shutting down electives in the hospitals again. 

There will be the issue of flu mixed in there but I really think that we are in for a pretty mild flu season due to the fact that most places are exercising the proper measures to dampen the number of flu cases we will see. COVID is going to actually help us here. 

I have no data or charts to back this up. Only my gut. 

 

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3 hours ago, Will352ns said:

 I really think that we are in for a pretty mild flu season due to the fact that most places are exercising the proper measures to dampen the number of flu cases we will see. COVID is going to actually help us here.

If this ISN'T the case, then we are well and truly screwed.  I happen to agree that we're not: Covid precautions SHOULD severely impair influenza transmission.

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There will be two sudden and dramatic drops in the hysterical media reporting of how Covid is going to kill us all.  The first drop will come November 3rd of this year, and then the disease will (edited-seemingly) go away on Jan 20th as a new President is inaugurated.

Edited by Boatswain2PA
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43 minutes ago, Boatswain2PA said:

There will be two sudden and dramatic drops in the hysterical media reporting of how Covid is going to kill us all.  The first drop will come November 3rd of this year, and then the disease will entirely go away on Jan 20th as a new President is inaugurated.

It’s very difficult to take another medical professional seriously when they claim a virus that has killed 200k people in our mutual home will stop immediately based solely on a political transition.

This logic is of course why we have the response and outcomes we do. 

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8 minutes ago, turnedintoamartian said:

It’s very difficult to take another medical professional seriously when they claim a virus that has killed 200k people in our mutual home will stop immediately based solely on a political transition.

This logic is of course why we have the response and outcomes we do. 

Not to mention the other 800,000 around the world who, apparently, died solely for American politics...

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10 minutes ago, turnedintoamartian said:

It’s very difficult to take another medical professional seriously when they claim a virus that has killed 200k people in our mutual home will stop immediately based solely on a political transition.

This logic is of course why we have the response and outcomes we do. 

Ignore them. His goal is to shut the thread down. 

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22 minutes ago, turnedintoamartian said:

t’s very difficult to take another medical professional seriously when they claim a virus that has killed 200k people in our mutual home will stop immediately based solely on a political transition.

of course, if you read what I posted, I never said the virus would stop immediately (or stop at all), did I?

The media hysteria will stop.

Whoops, I stand corrected.  I did say it would go away. I meant to write that it would seemingly go away (because of the drop in media hysteria).

 

 

Edited by Boatswain2PA
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I think Boats was making a point about the media coverage. I too think the tone of the conversation will change after the elections.

I cannot begin to predict how this flu season will go but I don't think there is much doubt flu season on top of the current pandemic is going to be a rough ride. My sincere hope is employers are better prepared to pivot instead of just doing wholesale layoffs in a panic.

 

PS: is there a spell check built into this thing? It seems to tag my spelling errors but not button for corrections.

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1 hour ago, ANESMCR said:

Of course the media will calm down. Simply because there will be less ludicrous material to cover. Nobody should be surprised of the hysteria when you have anti-science, anti-expert, and anti-common sense content to discuss every single day. 

This^^^

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I agree that there is some hysteria about covid, some warranted, some not. Health care providers are guilty of this as well. I saw six patients with covid on my last shift, and sent them all home. A local urgent care sent them in, 2 by ambulance, with sx that could have been managed at home. I discharged the 2 by ambulance from the ambulance bay. They both felt fine. Cough + covid with stable VS and benign exam does not equal 911.

The other hysteria is XYZ pt "might have covid".  Nurse yesterday: He is short of breath, it might be Covid!!!. Me: I think more likely it is all the rib fx he sustained when he was assaulted and hit with a bat...

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I agree there is an element of hysteria even amongst health care providers who should know better. For instance, inpatients with scheduled procedures need a covid swab beforehand (even if they have been in the hospital 2 weeks). Which is fine, go ahead and send the test. But why do we need to put them on precautions? (face shield) These are asymptomatic people, nothing has changed for them except we put them on a schedule...

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I haven't got time for this COVID mess (ABC World News, you're wearing me out with the same stories and video clips!).  We've had TWO bats test positive for rabies in my community, and they're getting closer to MY house (all that matters)!  Someone PLEASE turn out the bat signal at night!  Every time we had to give prophylaxis injections at my old gov't job everyone thought that they were still in the gut and brought a leatherbelt with them to bite down on.th?id=OIP.BWEM07_N7wiAhIm56xkvzAAAAA%26p

Edited by GetMeOuttaThisMess
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1 minute ago, GetMeOuttaThisMess said:

I haven't got time for this COVID mess (ABC World News, you're wearing me out with the same stories and video clips!).  We've had TWO bats test positive for rabies in my community, and they're getting closer to MY house (all that matters)!  Someone PLEASE turn out the bat signal at night!  Every time we had to give prophylaxis injections everyone thought that they were still in the gut and brought a leather belt with them to bite down on.

Stay away from bats or this will be you!    

 

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2 minutes ago, GetMeOuttaThisMess said:

I haven't got time for this COVID mess (ABC World News, you're wearing me out with the same stories and video clips!).  We've had TWO bats test positive for rabies in my community, and they're getting closer to MY house (all that matters)!  Someone PLEASE turn out the bat signal at night!  Every time we had to give prophylaxis injections at my old gov't job everyone thought that they were still in the gut and brought a leather belt with them to bite down on.

wait, your house is in my country within several states! You have bats! I need to bat proof my property! 🙂

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Another wave is already forming. Flu will not help this. PLEASE let that vaccine be more effective than usual. 

Throw in a giant cloud of wildfire smoke and a patient population with 80%+ COPD - yay, disaster.

Add election/political fervor, nonsense, combativeness and my give a damn is pretty busted. I am so freaking tired of being yelled at or lectured at about this whole thing and who did what. And, NO, Bill Gates did not help create COVID..... dumbass.

Then, a group at work decided to have game night at someone's house - what could go wrong? - they are all coworkers.... yeah, well - our department was decimated for two weeks after someone was COVID + at game night. Try working with no staff in already challenging conditions. 

PPE is going to become an issue again.

I don't trust the CDC any longer.

I don't drink and right now cannot tell you why.

I just keep chanting the mantra in my head - SCIENCE IS REAL, MEDICINE IS AN ART, SCIENCE IS REAL

Deep sigh

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The good news is it looks like efforts related to COVID in the southern hemisphere did result in a pretty mild flu season. 

https://www.nbcnews.com/health/health-news/southern-hemisphere-covid-19-lockdowns-blocked-flu-will-work-north-n1238188

The bad news is there is model predicting a possible 400,000+ deaths before the end of the year.

http://www.healthdata.org/news-release/first-covid-19-global-forecast-ihme-projects-three-quarters-million-lives-could-be

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1 hour ago, EMEDPA said:

The other hysteria is XYZ pt "might have covid".  Nurse yesterday: He is short of breath, it might be Covid!!!. Me: I think more likely it is all the rib fx he sustained when he was assaulted and hit with a bat...

As sad as that is...I needed a good laugh, thank you.

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On 9/21/2020 at 3:52 PM, airslant said:

WE'RE ALL GOING TO DIE!! This is not a drill! Lose the optimism and panic. Quit your job and start digging your own grave today because you won't be able to afford the shovel tomorrow.



P.S. Donald Trump is a bad man who says mean things and lies. A lot.

Sent from my Pixel 3 XL using Tapatalk
 

Super insightful. Thank you 

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