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How can radiology help limit COVID-19 transmission?
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[b]Europe Condemns Trumps Travel Ban [/b]
[b][/b]
The European Union issued a scathing statement condemning President Trumps decision to ban most travel from Europe, the [link=https://www.nytimes.com/2020/03/12/world/coronavirus-news.html]New York Times[/link] reports.
From the statement: The coronavirus is a global crisis, not limited to any continent and it requires cooperation rather than unilateral action. The European Union disapproves of the fact that the U.S. decision to impose a travel ban was taken unilaterally and without consultation.
[link=https://www.washingtonpost.com/world/europe/europe-blindsided-by-trumps-travel-restrictions-with-many-seeing-political-motive/2020/03/12/42a279d0-6412-11ea-8a8e-5c5336b32760_story.html]Washington Post[/link]: Of all the slights between Washington and Europe in recent years, the new travel restrictions had all the makings of a historic rupture.-
[b]Pence Says Its Irresponsible to Downplay Outbreak[/b][/h1]
Vice President Mike Pence told [link=https://www.nbcnews.com/politics/white-house/pence-says-there-s-been-irresponsible-rhetoric-people-downplaying-coronavirus-n1156371]NBC News[/link] that there has been irresponsible rhetoric from people who have downplayed the seriousness of the U.S. coronavirus outbreak.
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[link=https://www.nytimes.com/2020/03/12/upshot/coronavirus-biggest-worry-hospital-capacity.html]Aaron Carroll[/link]: The ability of the American health care system to absorb a shock what experts call surge capacity is much weaker than many believe.
As a medical doctor who analyzes health issues for [i]The Upshot[/i], I strive to place your fears in context and usually tell you that you shouldnt be nearly as afraid as you are. But when it comes to the nations response to the new coronavirus, I cannot be so reassuring.
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Jimbo,
Can you feel it? Some distortion around the edges, a rising din in the background?
Keeping ones head is good. As new information becomes available, it should be assessed, processed and responded to appropriately.
One thing you may start to see and may need to resist are moral events. People will blame this NBA player, that coworker, this family member as being responsible for the disease because they joked about it, went on vacation, touched their nose, or a host of other reasons. That may then be used to justify why that person or persons is less worthy, or possibly less deserving of resources.
This is a human and common reaction to seek control of uncertainty.
Everyone deserves the best care possible.
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Quote from radgrinder
Jimbo,
Can you feel it? Some distortion around the edges, a rising din in the background?
Keeping ones head is good. As new information becomes available, it should be assessed, processed and responded to appropriately.
One thing you may start to see and may need to resist are moral events. People will blame this NBA player, that coworker, this family member as being responsible for the disease because they joked about it, went on vacation, touched their nose, or a host of other reasons. That may then be used to justify why that person or persons is less worthy, or possibly less deserving of resources.
This is a human and common reaction to seek control of uncertainty.
Everyone deserves the best care possible.
Yup. Can definitely feel the heat. Thanks for the moral support! Expected this but still does try the gut fortitude.
Too busy to mind my station today. But keeping an eye.
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My friend in Rome sent me this
This spreads so fast, and the problem is, it hits the weaker people and there are so many people going to the hospital and there arent enough intensive care units. Theyre at the point where they have to decide who’s going to die and whos not they have who theyre going to put on respirators and who theyre not. Thats the situation were in in Italy right now. And thats going to happen everywhere.
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I realize most of you rads are way late to this coronavirus and many have finally realized that coronavirus is for real. We are more like italy than China in how we are handling this situation. Be prepared for lockdowns, supply up on groceries and household goods. Get a home reading station if you dont have one.
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“For real”? You mean the hysteria is for real.
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The flat earther types are still spreading the hoax theories
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You keep saying meaningless stuff. Just stop posting, your posts don’t make any sense or have any real idea located therein.
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Quote from Castlevania
You keep saying meaningless stuff. Just stop posting, your posts don’t make any sense or have any real idea located therein.
This castlevania guy will be protected from COVID-19 under the rock he/she’s currently living under
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Seriously if we would of just confronted this problem honestly from the start we wouldnt see this panic know
Half the country believed us was a fake news CNN hoax until a day or 2 ago
This is an example of an unfit leader leading the country down a rabbit hole
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Quote from kpack123
My friend in Rome sent me this
This spreads so fast, and the problem is, it hits the weaker people and there are so many people going to the hospital and there arent enough intensive care units. Theyre at the point where they have to decide who’s going to die and whos not they have who theyre going to put on respirators and who theyre not. Thats the situation were in in Italy right now. And thats going to happen everywhere.
Is he a doctor? What is his vantage point?
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He owns a restaurant
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Quote from dergon
[link=https://www.nytimes.com/2020/03/12/upshot/coronavirus-biggest-worry-hospital-capacity.html]Aaron Carroll[/link]: The ability of the American health care system to absorb a shock what experts call surge capacity is much weaker than many believe.
As a medical doctor who analyzes health issues for [i]The Upshot[/i], I strive to place your fears in context and usually tell you that you shouldnt be nearly as afraid as you are. But when it comes to the nations response to the new coronavirus, I cannot be so reassuring.
And I think he is wrong. If we allow doctors to document their encounters on paper charts, stop doing elective surgeries, get away from calling pulmonology consults on every case of pneumonia and neurology for every headache, our hospitals can handle five times the patients they are rated for.-
Quote from fw
Quote from dergon
[link=https://www.nytimes.com/2020/03/12/upshot/coronavirus-biggest-worry-hospital-capacity.html]Aaron Carroll[/link]: The ability of the American health care system to absorb a shock what experts call surge capacity is much weaker than many believe.
As a medical doctor who analyzes health issues for [i]The Upshot[/i], I strive to place your fears in context and usually tell you that you shouldnt be nearly as afraid as you are. But when it comes to the nations response to the new coronavirus, I cannot be so reassuring.
And I think he is wrong. If we allow doctors to document their encounters on paper charts, stop doing elective surgeries, get away from calling pulmonology consults on every case of pneumonia and neurology for every headache, our hospitals can handle five times the patients they are rated for.
I don’t know about “5 times” … but I agree in principle. —
We should already be halting elective procedures and converting ORs to ICUs etc
A federal waiver on all medical billing related to the virus would also help.
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Not a solution, fw. Elective surgeries are just that, elective. By both the patient and the surgeon. Not sure how elective surgeries are interfering with healthcare response to the public. They will be stopped once a level is reached.
Paper charting? OK, let’s recreate and open medical records departments handling paper again. Not exactly an overnight effort.
As for consults interfering with COVID patients, I think first we need to actually know who is infected other than them coming into EDs with severe SOB and high fever. We need testing kits to test people to get a handle on how big the problem is, who is infected, who can home-quarantine and who needs a respirator in an ICU, recovery times and outcomes. Other than data from other countries, this data is thin in USA.
Right now a lot of this is spinning allowing some to dismiss COVID as a big nothing cold or flu.-
[b]How Right-Wing Pundits Are Covering Coronavirus[/b][/h1]
[link=https://www.nytimes.com/2020/03/11/us/politics/coronavirus-conservative-media.html?utm_source=The+Bulwark+Newsletter&utm_campaign=afd153d4d0-EMAIL_CAMPAIGN_2020_03_11_06_29&utm_medium=email&utm_term=0_f4bd64ac2e-afd153d4d0-79506957]New York Times[/link]: Sean Hannity used his syndicated talk-radio program on Wednesday to share a prediction he had found on Twitter about what is really happening with the coronavirus: Its a fraud by the deep state to spread panic in the populace, manipulate the economy and suppress dissent.
As the coronavirus spreads around the globe, denial and disinformation about the risks are proliferating on media outlets popular with conservatives Where doctors and scientists see a public health crisis, President Trump and his media allies have seen a political coup afoot.-
They try to deny it now
But a few weeks ago Trump tried to label (or brand) this as a democratic hoax
Sometimes truth and reality can bite you in the arse
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Quote from Frumious
Not a solution, fw. Elective surgeries are just that, elective. By both the patient and the surgeon. Not sure how elective surgeries are interfering with healthcare response to the public. They will be stopped once a level is reached.
That’s what I am saying. Elective surgeries consume hospital resources, resources that we may have to use on sick patients. That knee replacement can wait 6 months, same for the gastric bypass for ‘too much twinky disease’. That private room with the pull out couch for visitors can hold two patients. The gowns and face-shields used for an ortho case can be better used for a bronch.
Paper charting? OK, let’s recreate and open medical records departments handling paper again. Not exactly an overnight effort.
5,000 ‘Classification folders with fasteners’, three reams of copy paper, a photocopier and a big room in the hospital basement, and I can stand up a provisional paper records department overnight. After everything is done and over, we scan the hand-charts and catch up on the coding. I have done this before on a smaller scale. Its not hard.
I watch our hospitalists spend 15-20 minutes slogging through the multiple screens on the EMR it takes to document a straightforward inpatient encounter. In the days of paper charts, you jotted a soap note on a pink sheet of lined paper and whoever came after you the next day, knew how the patient was doing the day before by looking at your note. Now we have pages upon pages of word vomit that exists for one reason only: to comply with byzantine medicare billing rules. Oh, and we have pages upon pages of nursing ‘narrative’ that tells me absolutely ****ing nothing.[i] ‘Patient returned to room from Cat scan. Writer confirmed integrity of the patients integuement and socio medical socio frugal well being by conducting a supportive interview blablablablaah'[/i] Let the nurses do nursing things and the doctors do doctor things and a hospitalist can carry 30 or 40 patients.
As for consults interfering with COVID patients,
The CYA medicine has become an impediment to patient care. Every consult puts the patient into a waiting loop until a decision can be made. Hospitals are part of that. You can’t order bronchodilators without pulmonology getting involved, you can’t order antibiotics without ID etc.
I think first we need to actually know who is infected other than them coming into EDs with severe SOB and high fever. We need testing kits to test people to get a handle on how big the problem is, who is infected, who can home-quarantine and who needs a respirator in an ICU, recovery times and outcomes. Other than data from other countries, this data is thin in USA.
According to our director of lab services, testing is available through a commercial lab. Just order it as ‘misc sendout’ and call the lab to arrange for a courier. Now if you want the state health department laboratory to do the test for free, you need to call the local health department, the mayor, the county roads commissioner and you have to fax a request to the state. Only when the state has accepted the case and sends back a mounted messenger with the gold sealed acceptance letter, you are allowed to send the sample to the lab. Without the accompanying ream of approvals, they will discard it.
We are lacking ‘capacity’ because we are standing in our own way due to medicolegal and government requirements. Without those impediments, we could ramp up the capacity to triage and dispo patients to a multiple of the rates we have right now. It wouldn’t be pretty and maybe we’ll have to skip the visit of the ‘child life specialist’, the ‘smoking cessation counselor’ and the ‘nutritional counseling’, but we’ll get the job done.-
Speaking of flattening the curve under healthcare system capacity, why is our capacity so low?
[link=https://data.oecd.org/healtheqt/hospital-beds.htm]https://data.oecd.org/healtheqt/hospital-beds.htm[/link]
[link=https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?end=2015&start=2015&view=map][link]https://data.oecd.org/healthres/doctors.htm[/link][/link]
Perhaps a century-long Flexner lobbying to keep physician supply low, midlevel scope of practice restricted, and new hospital construction blocked through “certificates of need” wasn’t such a good idea for our nation?
Imagine Chinese government trying to build a makeshift hospital in Wuhan, but then being denied by a local group of physicians concerned about increased competition and requiring the government to spend a few years working around a “certificate of need” instead.
Let’s see how truly useless our leaders are in the times of crisis. I’m watching every “emergency” bill very carefully to see if there’s even a slim hint of trying to unblock the healthcare provider supply.-
Gov DeWine:
Mass gatherings are prohibited in Ohio…anything over 100 persons, auditoriums and stadiums; indoor or outdoor
Election Day March 17 will go on as planned
Does not include immediate family members of participants
Does not include religious gatherings, funerals or weddings
Anna Staver@AnnaStaver
Ohio @GovMikeDeWine
just banned mass gatherings in the state of 100 or more people. It does not include grocery stores, airports, malls or places were more than 100 people are “passing through.”-
All Ohio schools closing for 3 weeks starting Monday.
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[link=https://thehill.com/homenews/campaign/487278-biden-rolls-out-plan-to-combat-coronavirus]https://thehill.com/homen…-to-combat-coronavirus[/link]
[b]Biden rolls out plan to combat coronavirus- [/b]
Former Vice President Joe Biden rolled out his plan to combat the COVID-19 coronavirus on Thursday as it rapidly spreads throughout the United States.
Biden’s plan calls for a number of measures, including the establishment of an effective national response to the virus through making testing free and widely available, as well as the establishment of 10 mobile sites and drive-thru facilities per state.
The former vice president also called on greater transparency from the White House in terms of how many individuals have been tested.
The plan also called for an economic response to the outbreak, which includes emergency paid leave for all those affected by the outbreak. The response would also work to aid workers, families and small businesses affected by the outbreak.
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Its time to jet the A team take over
This reality star is out of his league
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In light of sudden finding of new positives, Hizzoner DeBlasio announcing NYC restricting large gatherings and projecting maybe for 6 mos at least.
[/h3]Heres what you need to know:[/h3] [link=https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-york-update.html#link-28dbd12c]New York bans most gatherings of more than 500 people. N.Y.C. declares a state of emergency.[/link] [link=https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-york-update.html#link-28fd84b8]Rumors are spreading about a total city shutdown. Theyre not true.[/link] [link=https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-york-update.html#link-5e39dad9]New York City canceled school activities, and closed some schools for the first time.[/link] [link=https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-york-update.html#link-1798bb66]The New York Archdiocese will close schools for 19,000 students.[/link] [link=https://www.nytimes.com/2020/03/12/nyregion/coronavirus-new-york-update.html#link-245dce0]The Met Museum, the Metropolitan Opera and others will close in response to the virus.[/link] [/ul]
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Quote from fw
That’s what I am saying. Elective surgeries consume hospital resources, resources that we may have to use on sick patients. That knee replacement can wait 6 months, same for the gastric bypass for ‘too much twinky disease’. That private room with the pull out couch for visitors can hold two patients. The gowns and face-shields used for an ortho case can be better used for a bronch.
I don’t think we fundamentally disagree.
Quote from fw
5,000 ‘Classification folders with fasteners’, three reams of copy paper, a photocopier and a big room in the hospital basement, and I can stand up a provisional paper records department overnight. After everything is done and over, we scan the hand-charts and catch up on the coding. I have done this before on a smaller scale. Its not hard.I watch our hospitalists spend 15-20 minutes slogging through the multiple screens on the EMR it takes to document a straightforward inpatient encounter. In the days of paper charts, you jotted a soap note on a pink sheet of lined paper and whoever came after you the next day, knew how the patient was doing the day before by looking at your note. Now we have pages upon pages of word vomit that exists for one reason only: to comply with byzantine medicare billing rules. Oh, and we have pages upon pages of nursing ‘narrative’ that tells me absolutely ****ing nothing.[i] ‘Patient returned to room from Cat scan. Writer confirmed integrity of the patients integuement and socio medical socio frugal well being by conducting a supportive interview blablablablaah'[/i] Let the nurses do nursing things and the doctors do doctor things and a hospitalist can carry 30 or 40 patients.
“Downtime procedure.” Yes, of course it can be done and should already be written as a policy procedure. But it becomes someone else’s manual labor to file/copy to the EMR. All doable but there are no shortcuts.
Medical staff should be raising hell with C-Suite and vendors for the lousy UI of the EMR. I do mean raising hell. C-Suite has advantage of not having to live with their decisions, that’s for the “little people” and that bothersome medical staff. Help them live with their decisions.
Bad UI’s are nothing new. My wife is an RN and knows her charting. 10 years ago at her job then management decided to move to computer charting. She found that computer charting added an hour or more to her day just getting through screens. She is not & was not computer illiterate. Like C-Suite “decision makers,” programmers often do not have to live with their designs and too often it sucks. While developing they have a limited DB file for testing & all the time in the world for testing. They don’t get the real world & often people, even customers do not hold their feet to the fire.
Sorry for the short rant, but poor medical software design is a sore subject for me too. But moving back to paper is only a short term solution was my major point.Quote from fw
The CYA medicine has become an impediment to patient care. Every consult puts the patient into a waiting loop until a decision can be made. Hospitals are part of that. You can’t order bronchodilators without pulmonology getting involved, you can’t order antibiotics without ID etc.CYA medicine is hardly new. It’s existed before the 1970’s when I first started in healthcare. It’s a mindset. As for orders requiring ID, again procedures that need to streamline while being accurate & accountable.
None of this is overnight solutions as they are longstanding and cannot be allowed to interfere with COVID and any other response.Quote from fw
According to our director of lab services, testing is available through a commercial lab. Just order it as ‘misc sendout’ and call the lab to arrange for a courier. Now if you want the state health department laboratory to do the test for free, you need to call the local health department, the mayor, the county roads commissioner and you have to fax a request to the state. Only when the state has accepted the case and sends back a mounted messenger with the gold sealed acceptance letter, you are allowed to send the sample to the lab. Without the accompanying ream of approvals, they will discard it.We are lacking ‘capacity’ because we are standing in our own way due to medicolegal and government requirements. Without those impediments, we could ramp up the capacity to triage and dispo patients to a multiple of the rates we have right now. It wouldn’t be pretty and maybe we’ll have to skip the visit of the ‘child life specialist’, the ‘smoking cessation counselor’ and the ‘nutritional counseling’, but we’ll get the job done.
I don’t know about those medico-legal requirement getting in the way so much. Again, these examples are long-standing annoyances at best but cannot be allowed to interfere with care. And resolving them will not happen before COVID is a problem because we are already in the deep muddy.
From what I’ve read regarding COVID testing, we got in our own way with bad reagents in the 1st kits.
[link=https://www.businessinsider.com/us-coronavirus-testing-problems-timeline-2020-3#a-problem-with-one-ingredient-in-the-us-tests-caused-more-than-half-of-state-labs-to-receive-inconclusive-results-7]https://www.businessinsid…inconclusive-results-7[/link]
[link=https://www.propublica.org/article/cdc-coronavirus-covid-19-test]https://www.propublica.or…onavirus-covid-19-test[/link]
And IMHO, we need to stop disabling government’s ability to respond. CDC missteps are one thing but by defunding the CDC and other government department/agencies we are creating our own problems. Such as what happened in May 2018 regarding the structure set up to address ebola. Dismantling prior successful efforts to “save money” does not help. I mean, really? Explaining budget cuts to the CDC because someone doesn’t like to see “doctors standing around doing nothing?” Because this person is a “businessman” who knows how to make these decisions?
Yes, we are in deep sh1te when this excuse is acceptable.
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Many hospitals are suspending elective surgeries in preparation of needing resources for virus.
[link=https://www.msn.com/en-us/health/medical/ny-hospitals-pitch-tents-nix-surgeries-to-prepare-for-influx/ar-BB11c05e]https://www.msn.com/en-us…for-influx/ar-BB11c05e[/link]-
We don’t exactly have our act together testing and treating cover patients.
[link=https://www.npr.org/2020/03/15/816174103/former-coronavirus-infected-patient]https://www.npr.org/2020/…virus-infected-patient[/link]-
Our numbers at 3000 are very high given that testing it extremely limited still. Until the screening opens up to the general population, it will remain extremely under diagnosed. Right now you have to have URI symptoms, fever, AND been in contact with someone who has COVID 19 or travelled to a high risk area. Meanwhile if you just have a URI (minor URI is probably how this affects majority of people), that does not qualify you for testing. If you are severely ill like in the ICU you can also get tested at that point (without having known contact with someone infected or travel to high risk area).
Once screening opens up at your local walgreens, target, walmart – look for numbers to shoot up to over 50,000.
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White House economic adviser Larry Kudlow told Republicans the President may sign a disaster declaration under the Stafford Act on Thursday afternoon, [link=https://www.cnn.com/2020/03/12/politics/trump-disaster-declaration/index.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+rss%2Fcnn_allpolitics+%28RSS%3A+CNN+-+Politics%29]CNN[/link] reports.
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But I thought it was a hoax that would magically disappear because our president had a hunch?????
Maybe science is actually something to be believed….. occasionally
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But I thought it was a hoax that would magically disappear because our president had a hunch?????
Maybe science is actually something to be believed….. occasionally
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[link=https://thehill.com/homenews/state-watch/487221-seattle-mayor-warns-protective-gear-running-low]Seattle mayor warns that protective gear is running low[/link]
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I wonder when the SHTF if there will be health care worker protests. The administrators can just sit at home safe on their computers and order their workers into the hospitals.
So far I’ve only seen mask fittings as preparation for the rad techs and there seems to be an undercurrent of uncertainty and discontent.
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US mortality figures
Today 2.6%
Yesterday 2.9%
Day before 3.5%Because we’re testing more. Expecting continuing decline.
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Welcome to the fog of war. Realize that for an as-yet determined amount of time, a lot more of ones life will be defined by uncertainty and ambiguity.
One can control how one deals with uncertainty.
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In the movies maybe.
Be happy we are still in a position to believe we can control uncertainty. That could dramatically change.-
[link=https://www.npr.org/2020/03/12/814881355/white-house-knew-coronavirus-would-be-a-major-threat-but-response-fell-short]https://www.npr.org/2020/03/12/814881355/white-house-knew-coronavirus-would-be-a-major-threat-but-response-fell-short[/link]
[b]Trump put Re-election ahead of Coronavirus Response as early as January [/b]
“In the case of Alex Azar, he did go to the president in January. He did push past resistance from the president’s political aides to warn the president the new coronavirus could be a major problem. There were aides around Trump – Kellyanne Conway had some skepticism at times that this was something that needed to be a presidential priority.
But at the same time, Secretary Azar has not always given the president the worst-case scenario of what could happen. My understanding is he {President Trump} [b]did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear – the lower the numbers on coronavirus, the better for the president, the better for his potential reelection this fall.”[/b]-
Quote from dergon
[link=https://www.npr.org/2020/03/12/814881355/white-house-knew-coronavirus-would-be-a-major-threat-but-response-fell-short]https://www.npr.org/2020/03/12/814881355/white-house-knew-coronavirus-would-be-a-major-threat-but-response-fell-short[/link]
[b]Trump put Re-election ahead of Coronavirus Response as early as January [/b]
“In the case of Alex Azar, he did go to the president in January. He did push past resistance from the president’s political aides to warn the president the new coronavirus could be a major problem. There were aides around Trump – Kellyanne Conway had some skepticism at times that this was something that needed to be a presidential priority.
But at the same time, Secretary Azar has not always given the president the worst-case scenario of what could happen. My understanding is he {President Trump} [b]did not push to do aggressive additional testing in recent weeks, and that’s partly because more testing might have led to more cases being discovered of coronavirus outbreak, and the president had made clear – the lower the numbers on coronavirus, the better for the president, the better for his potential reelection this fall.”[/b]
Note to forum members: the quoted poster seems to have a troubling tendency to post characterize opinion as fact. See quoted text for example. There is no proof provided for the first line after the link.
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So Trump lies to the camera about the testing being performed. He didnt want the cruise ship because the numbers would go up. Had the CDC stop publishing testing numbers. Says all sorts of BS. Maybe Im missing something but it sure seems like hes trying to cover up reality.
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….. and because he downplayed everything
The market goes into free fall as his base slowly realized they have been lied to
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All schools in Ohio closed as well as movie theatres and social gatherings. Good job Ohio in trying to flatten the curve. Is Ohio the only state smart enough that understands how to deal with this? Most other states are ignoring the experts and simply waiting for the numbers to go up? Do they not already know that numbers are low because testing is low? You must flatten the curve so that our health resources can deal with this, that is the key to all of this. This should have been the 1st lession taught to Trump and the #1 agenda pushed forth on a federal level. Some states on the local level I guess are realizing that Trump is failing and cannot be relied upon, certainly not to be trusted. Trump has gauranteed himself a loss come election time based solely on the extremely poor handling of this pandemic.
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Quote from kpack123
….. and because he downplayed everything
The market goes into free fall as his base slowly realized they have been lied to
Because shutting down the border to Chinese nationals over 3 weeks ago is “downplaying”. Your ilk yelled at him for that. Now he doesn’t do enough. Choose one, liar.-
Quote from Intermittent Blasting
Quote from kpack123
….. and because he downplayed everything
The market goes into free fall as his base slowly realized they have been lied to
Because shutting down the border to Chinese nationals over 3 weeks ago is “downplaying”. Your ilk yelled at him for that. Now he doesn’t do enough. Choose one, liar.
I happen to give Trump a C+ for the handling of this, but criticisms from kpack123 have as much value as that of a three-dollar-bill. Like Bill Maher, he delights in America’s pain simply because it can be used to jab at Trump.
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Hes getting on TV and spouting out non-truth. Like everyone coming from overseas is being tested. Uh….no theyre not. Theyre being screened.
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There are parallels to 9/11. The world shifts due to a new and unexpected threat that hits the country and forces a sudden change in the way people across the country go about their daily lives and particularly their travel.
People are afraid and uncertain of what happens next, just as they were then. People overreact, errors are made, most everyone is figuring things out as they go along.
It is interesting to note the differences in reactions between the events. It is good to see people pulling together at both times. It is also good to see Congress passing supportive funding so quickly.
To a large extent, we are all soldiers in this situation, particularly we healthcare workers. Good to review the ACR’s guidance.
[link=https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection]https://www.acr.org/Advocacy-and-Economics/ACR-Position-Statements/Recommendations-for-Chest-Radiography-and-CT-for-Suspected-COVID19-Infection[/link] -
Questions for IR and Flouro rads in harder hit areas of the USA.
Are you using N95 masks when performing cases/interacting with sick patients now? -
The numbers in Italy went up dramatically.
About 2 weeks ago Italy had around 322 confirmed cases.
Last week the number jumped to around 2,500.
This week it went to over 10,000 cases.
Over 1,000 deaths reported.Some hoax.
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Trump Ad-Libbed In Oval Office Address[/h1]
In the most scripted of presidential settings, a prime-time televised address to the nation, President Trump decided to ad-lib and his errors triggered a market meltdown, panicked travelers overseas and crystallized for his critics just how dangerously he has fumbled his management of the coronavirus, the [link=https://www.washingtonpost.com/politics/trump-coronavirus-teleprompter-speech/2020/03/12/81bc8a3a-647a-11ea-acca-80c22bbee96f_story.html]Washington Post[/link] reports.
Even Trump a man practically allergic to admitting mistakes knew hed screwed up by declaring Wednesday night that his ban on travel from Europe would include cargo and trade, and acknowledged as much to aides in the Oval Office as soon as hed finished speaking.
Futures for the Dow Jones industrial average fell in real time with virtually each word Trump uttered.
Trump who believed that by giving the speech he would appear in command and that his remarks would reassure financial markets and the country was in an unusually foul mood and sounded at times apoplectic on Thursday as he watched stocks tumble and digested widespread criticism of his speech.
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Amateurs …. they’re all in way over their head.-
Ohio health officials estimate 100,000 cases in the state.
Bad news? That would be… …FANTASTIC!!!
The reason being, if there were that many, mortality will come out to 0.001% !!!! Way better than the seasonal flu which is 0.1%.
But I really doubt it. Reverse engineering the numbers would indicate there are about 6,000 cases in the US.
1,600 test confirmed cases so far.
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[link=https://www.bloomberg.com/news/articles/2020-03-12/coronavirus-can-live-in-patients-for-five-weeks-after-contagion]https://www.bloomberg.com…-weeks-after-contagion[/link]
Coronavirus Can Live in Patients for Five Weeks After Contagion
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Quote from Jimboboy
Ohio health officials estimate 100,000 cases in the state.
Bad news? That would be… …FANTASTIC!!!
The reason being, if there were that many, mortality will come out to 0.001% !!!! Way better than the seasonal flu which is 0.1%.
But I really doubt it. Reverse engineering the numbers would indicate there are about 6,000 cases in the US.
1,600 test confirmed cases so far.
You use strange math.
100k cases in Ohio alone?
But 6,000 in USA?
But only 1,600 confirmed in USA?
Therefore = REAL mortality rate of 0.001%???
???? Show me the equation for that please.
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Quote from dergon
[link=https://www.bloomberg.com/news/articles/2020-03-12/coronavirus-can-live-in-patients-for-five-weeks-after-contagion]https://www.bloomberg.com…-weeks-after-contagion[/link]
Coronavirus Can Live in Patients for Five Weeks After Contagion
Herpes and HPV live in you for … LIFE
#nothingburger
#did you go to med school even?-
Never forget.
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[link=https://pbs.twimg.com/media/ES9B5tAXQAEsUaC?format=jpg&name=medium]Never forget[/link]
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The US must take the Chinese coronavirus as a prompt to completely decouple from China. Start making our own electronics and antibiotics. Stop the infiltration of our universities by Chinese assets. Etc.
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Quote from Frumious
Quote from Jimboboy
Ohio health officials estimate 100,000 cases in the state.
Bad news? That would be… …FANTASTIC!!!
The reason being, if there were that many, mortality will come out to 0.001% !!!! Way better than the seasonal flu which is 0.1%.
But I really doubt it. Reverse engineering the numbers would indicate there are about 6,000 cases in the US.
1,600 test confirmed cases so far.
You use strange math.
100k cases in Ohio alone?
But 6,000 in USA?
But only 1,600 confirmed in USA?
Therefore = REAL mortality rate of 0.001%??????? Show me the equation for that please.
My point is that the 100,000 in Ohio is way overestimated. I will show you the math.
The official threw that number out assuming that 1/100 of the Ohioans might be currently infected. In a state of 10million, she reasoned, that works out to 100,000.
If that were true, does that mean 4 million are infected in the US? US population being 400M.
As of last night, US deaths from coronavirus was 40. 40 deaths divided by 4M infected is 0.00001, or mortality rate of 0.001%. That would be fantastic if it were only true. If only.
————Now to the more plausible math via reverse engineering.
The more accurate mortality is probably around 0.7%, based on South Korean figures. They were more thorough in their screening so it can be reasoned that the numbers are more accurate. And they had about 70 deaths out of 10,000 confirmed cases, which equals 0.007, In other words 0.7%
US as of last night had 40 deaths. Assuming a similar mortality, 40 divided by 0.007 equals 5714, or about 6000 infections.
All very “back of the napkin” but 6000 is probably the closest estimate of the current US infection. More if you consider leadtime from infection to death.
Against a backdrop of 1600 testing positive so far.
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At least this morning Trump is taking decisive action …
…. by tweeting about how it’s all Obama’s fault and that “Sleepy Joe” was worse with the swine flu.
True leadership!!-
He is incapable of true leadership
He is a second guesser….. a guy who always could have done it better and tried to judge everyone else from the grandstands
He cannot solve problems
He has to try to create a boogeymen to have a fake fight with
But thats not going to cut it this time
The jig is up….,. He Fd this up royally
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Can we talk about these papers who recommend ct as an initial screening test for covid? Ya it’s pretty sensitive, anyone with acute resp problems probably has some groundglass or airspace disease.
Getting all kinds of questions about like standard patterns of ground glass if it’s covid. Don’t really think we’re helping anyone and I’ve seen a variety of patterns that end up being covid.
I think clinical history and symptoms are going to be way more specific than our ct.
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Quote from IR27
Can we talk about these papers who recommend ct as an initial screening test for covid? Ya it’s pretty sensitive, anyone with acute resp problems probably has some groundglass or airspace disease.
Getting all kinds of questions about like standard patterns of ground glass if it’s covid. Don’t really think we’re helping anyone and I’ve seen a variety of patterns that end up being covid.
I think clinical history and symptoms are going to be way more specific than our ct.
If a clinician is concerned enough about Covid to ask about the CT results then that patient needs to be tested….
with the widely available tests than anyone who wants one can get.-
Quote from dergon
Quote from IR27
Can we talk about these papers who recommend ct as an initial screening test for covid? Ya it’s pretty sensitive, anyone with acute resp problems probably has some groundglass or airspace disease.
Getting all kinds of questions about like standard patterns of ground glass if it’s covid. Don’t really think we’re helping anyone and I’ve seen a variety of patterns that end up being covid.
I think clinical history and symptoms are going to be way more specific than our ct.
If a clinician is concerned enough about Covid to ask about the CT results then that patient needs to be tested….
with the widely available tests than anyone who wants one can get.
CT can give you findings to confirm viral pneumonia in 20min. The test for the virus still has a turn-around of 6hrs or more. It’s not 100% as there are test positive patients who had a negative CT, but neither is the DNA based test.
And sure, it’s not specific. Our ER docs already scan every abnormal CXR and i can’t say that I see that pattern (e.g.in adeno) all that often.
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Not to mention, the coronavirus test is still in short supply across the nation. So they are forced to ration it’s use. Whereas CT is readily available. The clinical colleagues have their hands tied.
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The way the moron nps where I work are quarantining people with very questionable histories from the ER, I think CT is far better than their clinical acumen.
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Problem is
How quickly can you clean/sanitize your CT?
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Have your NPs decided on their own to quarantine? Or are they working under some sort of supervision?
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If it’s not specific it’s not confirming anything. Tons of patients with SOB have ground glass.
It’s nearly pointless.
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Many are estimating 30-70% of the population is going to get this – They key is spreading/slowing the disease out over a long period so that our healthcare can cope with it. For every 3 posters on here, at least 1 of you is going to get this.
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Striker is most likely correct. Our herd will build its immunity. The goal is to avoid incapacitating too many people during one time period.
Hmm. Telemedicine seems a good method. How much medicine can be accomplished by FaceTime? Quite a lot.
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Quote from IR27
If it’s not specific it’s not confirming anything. Tons of patients with SOB have ground glass.
It’s nearly pointless.
If you see those patterns published out of the chinese outbreak on a routine basis, you practice in an environment very different from mine.
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Mortality figure for US cumulative
2% as of today
2.4% yesterday
3% day before
3.6% before that… because we’re testing more.
Latency is not a big factor. Typical time to death is only little over a day from onset of symptoms. Probably similar to time of presentation for testing
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We have seen a group of cases in my practice already, and they all look remarkably similar and similar to the published literature: ground glass opacities, peripheral, usually greater in the lower lungs and bilateral, and often with sub pleural sparing. It almost looks like COP, and definitely doesn’t look like a typical pneumonia.
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Quote from LuckyStrike
We have seen a group of cases in my practice already, and they all look remarkably similar and similar to the published literature: ground glass opacities, peripheral, usually greater in the lower lungs and bilateral, and often with sub pleural sparing. It almost looks like COP, and definitely doesn’t look like a typical pneumonia.
Would be helpful if you can publish that local experience quickly. A ‘Research Letter’ in the grey journal for example.
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[link=https://reason.com/2020/03/13/america-doesnt-have-enough-hospital-beds-to-fight-the-coronavirus-certificate-of-need-laws-are-one-reason-why/]https://reason.com/2020/03/13/america-doesnt-have-enough-hospital-beds-to-fight-the-coronavirus-certificate-of-need-laws-are-one-reason-why/[/link]
America Doesn’t Have Enough Hospital Beds To Fight the Coronavirus. Protectionist Health Care Regulations Are One Reason Why. -
Quote from avocado
[link=https://reason.com/2020/03/13/america-doesnt-have-enough-hospital-beds-to-fight-the-coronavirus-certificate-of-need-laws-are-one-reason-why/]https://reason.com/2020/03/13/america-doesnt-have-enough-hospital-beds-to-fight-the-coronavirus-certificate-of-need-laws-are-one-reason-why/[/link]
America Doesn’t Have Enough Hospital Beds To Fight the Coronavirus. Protectionist Health Care Regulations Are One Reason Why.
The non CON states are not going to have a shortage of ortho and cardiac beds.
But yes, CONs are a problem. We have a growth area where the hospital routinely has hour long waits in the ER and has to go on bypass yet the CON buerocracy wont allow expansion.
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Hour long wait in the ED? ED patients around here would be very happy to have a hour long wait. There are times (once triage has seen you) it is as long as 4- 7 hours. Patients leave because they waited so long. A good part of the reason is ED abuse by the patients that should not even be there.
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This is why ER medicine is the most overrated specialty in medicine.
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We agree that at tumor board we are impressed by knowledge of surgeons radiation oncologists and medical oncologists.
When was the last time a radiologist was impressed by an ER doctor?
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When they came to help me during rapid response in CT room.
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About once every week or so. I tend to chat them up on occasion and am impressed by the sense many of the older and mid career ER docs acquire to know when a patient is about to get in trouble.
Theres an element of bias in that we as rads dont see the patients they choose not to scan. We only see the ones they do. On the whole, they are scanning more, but in my neck of the woods it isnt due to laziness, incompetence or a desire to make the rads life harder.
The communication also leads to a mutually beneficial detente.
For instance, they usually do their own LPs and so when they call a member of our group for an after hours LP, its almost always a hard stick and the patients condition is genuinely concerning. In exchange, we dont hem or haw or give them crap. We roll up, do it, and go back to bed.
Its a decent enough working relationship, and Ive read enough posts here not to take it for granted.
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Quote from Ixrayu
There are times (once triage has seen you) it is as long as 4- 7 hours. Patients leave because they waited so long.
Works as expected. Teenagers getting high on weed coming to ER, sitting in line alone for 7 hours, regaining consciousness and heading home. Win-win for everyone. Except the surprise $8000 bill. -
Quote from LuckyStrike
We have seen a group of cases in my practice already, and they all look remarkably similar and similar to the published literature: ground glass opacities, peripheral, usually greater in the lower lungs and bilateral, and often with sub pleural sparing. It almost looks like COP, and definitely doesn’t look like a typical pneumonia.
how are they peripheral with sub-pleural sparing? that is an oxymoron
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notice how the ACR specifically says don’t use chest CT to screen for COVID
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Quote from IR27
notice how the ACR specifically says don’t use chest CT to screen for COVID
Yeah, that’s a headscratcher not supported by the data that has come out so far. I mean does everyone here see epidemics of adenovirus ? Or those extensive GGOs on patients who get scanned for respiratory problems ?
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Do not put Corona virus patients or suspected Corona virus patients on your scanner. The findings are non specific and do not change management. If you do, you may need to take your scanner down for up to an hour for proper cleaning
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We had two suspected covid patients in the scanner, took almost an hour to clean each time.
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Anyone changing their practices and working remotely? How about Flouro and IR?
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IR27, peripheral with subpleural sparing is not an oxymoron. The opacities are in the periphery of the lungs, but often the 1-2mm subpleural surface will be spared.
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Removed due to GDPR request
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Quote from 67ED5CC042435
How do I get over the jitters of getting this? I don’t want a viral pneumonia or anything that comes with it.
Just be proactive and try to work from home.
If you get it, it’s not the end of the world. You will most likely have mild symptoms. Be glad you aren’t ER.
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Quote from Jimboboy
My point is that the 100,000 in Ohio is way overestimated. I will show you the math.
The official threw that number out assuming that 1/100 of the Ohioans might be currently infected. In a state of 10million, she reasoned, that works out to 100,000.
If that were true, does that mean 4 million are infected in the US? US population being 400M.
As of last night, US deaths from coronavirus was 40. 40 deaths divided by 4M infected is 0.00001, or mortality rate of 0.001%. That would be fantastic if it were only true. If only.
————Now to the more plausible math via reverse engineering.
The more accurate mortality is probably around 0.7%, based on South Korean figures. They were more thorough in their screening so it can be reasoned that the numbers are more accurate. And they had about 70 deaths out of 10,000 confirmed cases, which equals 0.007, In other words 0.7%
US as of last night had 40 deaths. Assuming a similar mortality, 40 divided by 0.007 equals 5714, or about 6000 infections.
All very “back of the napkin” but 6000 is probably the closest estimate of the current US infection. More if you consider leadtime from infection to death.
Against a backdrop of 1600 testing positive so far.
Come on jimbo, you were trained in disease science but somehow can’t wrap your head around the latency period of exposure, infection, symptoms? Especially for a new virus that you have insufficient testing for so all calculations are back of the napkin guesstimates?
Well my training tells me you make no firm conclusions until you have the tested data. All of our data now is from other countries since we have insufficient data to make any firm conclusions for USA for who is exactly infected and infectious even with no symptoms. Thus we cannot determine mortality. Only guess and cross fingers. Right now you are assuming a very optimistic outlook but you have no data to back it up.
Forget Fox & Rush. They have a political agenda. We are supposed to be in healthcare science.
Let’s take that 10 million population in Ohio. You are blindly accepting a 100,000 infected figure based on nothing. Yet you have Italy with a population of 60 million with confirmed infection of 10,000 cases as of a couple of days ago. Immediately your blind acceptance of 100,000 infected in Ohio for a population that is 1/6 of Italy’s is suspect.
Your math and assumptions are off from GO.
We need more testing. You cannot make conclusions of anything with collecting data and right now we have little data. And there are still many areas and populations of the US that remain uninfected. Is that because the virus isn’t dangerous? Of maybe exposure is still down and mitigating factors like people using good hygiene and limiting exposure themselves?
You have insufficient data to conclude anything. It’s all guesswork and crossed fingers at this point.
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What? I just said 100,000 estimate in Ohio cannot be accepted. It is way too much and makes the mortality figure ridiculously rosy.
And I told you that latency will bring the figure above 6000. If I had to guess, we’re probably closer to 10k infected in the US.
If that 100,000 Ohio# was true, that would mean 4M are infected in the US. applying 0.7 % mortality would mean 28k deaths in about a week. Ridiculous.
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That’s the key, if you “had to guess…”
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Better than accepting what people in ohio tells you.
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Frumious,
If the infection was that high (100k in ohio, 4M in US), that would be fantastic. We’ve only seen 40 or so deaths so far. Probably 100 by next week.
That is so much better than even the mildest flu. Talk about nuthinburger… if it were only true.
But it’s not. Do the math yourself instead of claiming its impossible. Even a rough calculation is very informative. Instead of listening to the talking heads.
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Removed due to GDPR request
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Adahn,
The testing can run on existing systems in the US, and the company is based in Switzerland.
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It’s not as easy as applying data from South Korea to the USA. They test 20k people a day whereas the US has tested a little over 10k people total. They also report about 5x more hospital beds per person (~ 12 versus ~3 beds per 1k people) compared to the USA.
The real problem with the virus is not the mortality rate of the virus. The problem will be the effects of saturating our hospitals. South korea tested aggressively early and are showing signs of containment. Look at Italy on the other hand. They are warning us that they are reaching a point where they will need to decide on who gets as ventilator and who doesn’t.-
Yes. but still instructive. Better than panicking any-which-way from the molotov cocktails lobbed by the talking heads. The quoted mortality of 3-4% is clearly incorrect. Sub 1%. Probably even sub0.7% because the koreans couldn’t have counted every case. They probably didn’t test most of the nonsymptomatic cases.
The country situation is indeed different. But not so much that we can’t use rough generalizations.
We cannot use Italy for comparison though Because they tested even less. That’s clear. They have 1000 deaths. 15,000 confirmed cases. Their infected is probably closer to 120,000!!!
And yes, mortality cannot assertain hospital bed utilization. But unfortunately that data is even less available.
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Some may find this useful:
[link=https://www.linkedin.com/content-guest/article/notes-from-ucsf-expert-panel-march-10-dr-jordan-shlain-m-d-/?fbclid=IwAR3VZfoZbQuW7VqpHXgdb3CHk-1jOMTZgayc8bqiqmsmuCb4yX2-1VVqNE8]https://www.linkedin.com/…bqiqmsmuCb4yX2-1VVqNE8[/link]
….with notes on testing capacity.
[link=https://www.linkedin.com/pulse/doctors-clinical-people-dr-jordan-shlain-m-d-?trk=related_artice_For%20Doctors%20and%20Clinical%20People_article-card_title]https://www.linkedin.com/…ple_article-card_title[/link]
And this one goes into the weeds on clinicals -
Who cares about true mortality rates? Our lives are changed – All major social events/gatherings cancelled, sporting events cancelled, and most people will not take leisure trips. Most people are going to stay socially withdrawn and indoors. There will be global recession and no one is out doing things and spending money. Airlines will need to be bailed out, smaller ones may go bankrupt. The bigger issue with this virus is the spread of it, every 1 person infected gives it to 2 or 3 people. Just because you don’t die doesnt mean you may not get sick enough to tie up valuable hospital resources. We could be dealing with this social isolation for a year. COVID 19 has already done a lot more damage than most people thought, and extremely more damage than most radiologists posting on these forums thought. You cannot just look at total deaths when assessing this, you have to look how it has changed everybodys way of life around the world and the economic repercussions as well.
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Serious stuff.
As for radiology, we need to expedite remote reading.
Suspend credentialing so resources can be allocated where needed.
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Maybe this will help.
[link=https://www.washingtonpost.com/opinions/global-opinions/with-so-few-coronavirus-tests-america-has-been-flying-blind-into-a-storm/2020/03/12/71e32206-6487-11ea-845d-e35b0234b136_story.html]https://www.washingtonpos…35b0234b136_story.html[/link]
As Jeremy Samuel Faust, an emergency physician at Brigham and Womens Hospital, [link=https://www.washingtonpost.com/opinions/2020/03/11/useful-covid-19-testing-we-need-think-outside-box-outside-er/?tid=lk_inline_manual_4&itid=lk_inline_manual_4]wrote in a Post op-ed[/link], this is for two reasons. First, identifying even mild cases of the infection that are now going uncounted would yield a more accurate picture of the lethality of the disease.
Second, Dr. Faust explained, the discovery of mild and symptom-free cases may lower the number of serious cases over the course of the outbreak, and might even save lives. This is partly because treatment (short of cure) can be effective, and partly because isolation of asymptomatic patients would slow the spread of infection. But those patients arent going to self-quarantine if they dont know theyre sick.
South Koreas experience supports this argument. Regulators there [link=https://www.cnn.com/2020/03/12/asia/coronavirus-south-korea-testing-intl-hnk/index.html]approved[/link] a new diagnostic test by a private company in a weeks time. South Korea is [link=https://www.bbc.com/news/world-asia-51836898]testing[/link] 20,000 people a day, and it now has drive-through testing and the infection rates are not climbing sharply.
The United States record is sadly different.
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A colleague in IM saw a patient with viral pneumonia and a CT compatible with what we know to be the pattern for covid. Getting the state lab to accept the sample required the threat to involve the governor’s office.
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[link=https://www.wsj.com/articles/fda-grants-new-coronavirus-test-emergency-approval-11584090078]https://www.wsj.com/artic…y-approval-11584090078[/link]
The FDA is allowing a private corporation to produce testing that will allow its systems to greatly increase the testing capacity in the US. Good. They are wisely dissolving the red tape in recognition of the situation and the significant benefit this can bring the country.
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Quote from radgrinder
[link=https://www.wsj.com/articles/fda-grants-new-coronavirus-test-emergency-approval-11584090078]https://www.wsj.com/artic…y-approval-11584090078[/link]
The FDA is allowing a private corporation to produce testing that will allow its systems to greatly increase the testing capacity in the US. Good. They are wisely dissolving the red tape in recognition of the situation and the significant benefit this can bring the country.
A day late and a dollar short.
We know our federal government is inept. Why anyone expected the CDC to be the lead in disseminating a test is a mystery to me. Korea rolled out mass testing in January and we are now in the middle of March.
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Americans don’t realize that amongst 1st world countries, USA is ranked last in healthcare. Perhaps with how we are handling this COVID pandemic, they will now be able to understand why. The richest country with the brightest minds in the world, provides the worst healthcare. Testing has been very low for good reason, we are USA and we stink when it comes to healthcare. We spend the most on it, make the most off of it, but the end product – health itself to the average citizen is behind everyone else. We are going to be like Italy, picking which people to let die and which ones to let live because we dont have enough icu beds, ventilators, and other equipment.
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Most all manufacturing is in the far east, and they aren’t sharing. Ramping up test production is hindered in this regard. And there is no cure.
5 million chinese fled Wuhan when the government announced its travel lockdown. The US State Department was sneaking US nationals out and back here. The smart move, given the level of uncertainty, would have been to lock down *all* travel originating from China, through anywhere, into the US right then and there. No President, past or present, would have been able to swim upstream against howls of ‘the economy’ and ‘that’s racist’. The Chinese are fighting this in a manner not too dissimilar to containing a livestock epidemic. And it’s working, to a degree, insomuch that any information coming from their government can be trusted, and it can’t. The WHO had its pants around its ankles as well. Everybody did.
Welcome to globalism. I hope all that cheap crap was worth it.
I read recently that the average age of nurses in the US is 50. It’s probably older for doctors. -
Cleveland Clinic finds 5 cases of coronavirus on first day of internal testing.
[link=https://www.clevescene.com/scene-and-heard/archives/2020/03/13/cleveland-clinic-discovers-five-new-cases-of-covid-19-in-first-day-of-internal-testing?fbclid=IwAR3QVTJ3ad3rtLpNFNOsoeyHMMZw61tuCewlf1Tjx4X26KH3Ii1ki_UCNkI]https://www.clevescene.co…1Tjx4X26KH3Ii1ki_UCNkI[/link] -
US is behind. But you have to realize. Places like Korea, Hong Kong, Taiwan, Australia had practice with SARS in 2003. If not for that, they’d be looking just as flat-footed.
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*Not* Firing the US pandemic response team might have help too.
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Quote from dergon
*Not* Firing the US pandemic response team might have help too.
We don’t want to pay physicians for standing around doing nothing, do we. We can hire them back on a per diem basis as needed, then let them go again, right?
Think of all the money saved. That’s planning ahead.-
Back to the original question – What can radiology do to limit the spread of covid 19?
Same thing as everyone else – Work from home remotely. Stay away from other people, wash hands every hour. If it were free to work from home remotely, I imagine most of us would be doing that. Given that this may last for a year, companies and groups may want to consider moving existing workstations home temporarily for up to 1 year and working remotely with minimal in house staff for procedures. -
Fw,
This may sound odd, but bear with me. It is much much better to do the correct thing eventually than never at all. There will still be a significant benefit from the mass production of testing materials by private corporations.
In addition, there is now a precedent for the FDA loosening or suspending certain regulatory requirements in emergent situations. These are common sense adaptations that will be useful both now and the next time.
An analogy (which is by no means perfect) which builds upon the 9/11 comparison is that the correct thing would have been to eliminate bin Laden and al Qaeda years beforehand and to screen airline passengers for things that could be used as weapons. We learned. Now terrorists tend to get droned into oblivion regularly and we use metal detectors at the airport.
Similar societal and travel measures are being implemented now that will be used in the future. This event will be studied in microscopic detail, and in the future travel to areas will be shut down at the whiff of a new disease.
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One piece of interesting news. Apple is reopening its stores in China. Closed them in February.
So, in the epicenter of a pandemic, one of the smartest companies in the world thinks its safe enough to open back up for business. Closed about 6 weeks there, which again, was the epicenter of the problem.
It doesnt prove anything of course. But its interesting to see what kind of timeframe a return to daylight would look like in the place hardest hit thus far.
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[b][i]Similar societal and travel measures are being implemented now that will be used in the future. This event will be studied in microscopic detail, and in the future travel to areas will be shut down at the whiff of a new disease. [/i][/b]
I hope you are correct. Stop worrying that this will be construed as a racist or xenophobic. Shut it down as soon as this situation shows again and get under control quickly.
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Honestly I’m not chalking it up to panic at this time. I’ve been shopping over past couple of days & no one seemed panicky at all. Concerned, yes. Stocks of items depleted or low, yes. I think people are just stocking up because of the unknown of the impact of the virus. Something like milk running out of blizzard days – when we used to have them anyway.
The only panic I see so far is in the markets. That’s where the real disaster movies are being filmed.
“WE’RE ALL GOING TO DIE!” followed by, “Oh there’s the sun.” followed by “OMG! WE’RE GOING TO DIE” The world of PONG.
Even in communities being restricted I see no panic, just concern about tomorrow & how long this is going to last and what impact it’s going to have on all of us.
Also have not yet heard of any delays in deliveries of goods except those manufactured in China. But food seems OK so far. We are stocked as of now.
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It wouldnt have been a panic all of a sudden if the trumpers didnt downplay it from the beginning
Hoax
15 cases soon to be zero
Will magically disappear
Just another flu
A lot of this panic could have been avoided if it was handled honestly dying the start
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Interesting article in NYTimes about how Singapore, Hong Kong & Taiwan handled things without the draconian. Basically they addressed the issue when the news came out of China & did not wait until someone showed symptoms.
[link=https://www.nytimes.com/2020/03/13/opinion/coronavirus-best-response.html]https://www.nytimes.com/2…rus-best-response.html[/link]
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And so Singapore, Taiwan and Hong Kong might be more instructive examples. All three places were especially vulnerable to the spread of the infection because of close links with mainland China especially in early January, as they were prime destinations for Chinese travelers during the upcoming Lunar New Year holiday. And yet, after all three experienced outbreaks of their own, the situation seems to have stabilized.
As of midday Friday, Singapore had [link=https://www.moh.gov.sg/news-highlights/details/three-more-cases-discharged-twelve-new-cases-of-covid-19-infection-confirmed]187 cases confirmed and no deaths [/link](for a total population of about 5.7 million), Taiwan had [link=https://www.cdc.gov.tw/En]50 confirmed cases including 1 death[/link] (for a total population of about 23.6 million) and Hong Kong had [link=https://chp-dashboard.geodata.gov.hk/covid-19/en.html]131 confirmed cases including 4 deaths[/link] (for a total population of about 7.5 million).
Since identifying the first infections (all imported) on their territories on Jan. 21 in [link=https://www.cdc.gov.tw/En/Bulletin/Detail/pVg_jRVvtHhp94C6GShRkQ?typeid=158]Taiwan[/link] and on Jan. 23 in both [link=https://www.chp.gov.hk/files/pdf/local_situation_covid19_en.pdf]Hong Kong[/link]and [link=https://www.moh.gov.sg/news-highlights/details/confirmed-imported-case-of-novel-coronavirus-infection-in-singapore-multi-ministry-taskforce-ramps-up-precautionary-measures]Singapore[/link] all three governments have implemented some combination of measures to (1) reduce the arrival of new cases into the community (travel restrictions), (2) specifically prevent possible transmission between known cases and the local population (quarantines) and (3) generally suppress silent transmission in the community by reducing contact between individuals (self-isolation, social distancing, heightened hygiene). But each has had a different approach.
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Not what I’d advise. But wonder if the dread of getting it is more detrimental to our well being than actually getting it. At least you can get it over with and not worry about it for rest of the pandemic. And you can actually do your job and not worry about contracting it.
In essence, build an army of the immune who can then take care of the sick.
Easier said than done, but maybe quarantine away all the elderly and people with comorbidities in their own domiciles. Then let the virus spread amongst the healthy. Achieve herd immunity.
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^^ There will be a small % of young healthy who will die or come close to it. No way of knowing in advance.
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Some data that helps:
[link=https://www.scientificamerican.com/article/which-groups-are-most-at-risk-from-the-coronavirus/]https://www.scientificame…-from-the-coronavirus/[/link]
The vast majority of cases in China87%were in people ages 30 to 79, the China Center for Disease Control [link=http://weekly.chinacdc.cn/en/article/id/e53946e2-c6c4-41e9-9a9b-fea8db1a8f51]reported[/link] last month based on data from all 72,314 of those diagnosed with Covid-19 as of Feb. 11. That probably reflects something about biology more than lifestyle, such as being in frequent contact with other people. Teens and people in their 20s also encounter many others, at school and work and on public transit, yet they dont seem to be contracting the disease at significant rates: Only 8.1% of cases were 20-somethings, 1.2% were teens, and 0.9% were 9 or younger. The World Health Organization mission to China found that 78% of the cases reported as of Feb. 20 were in people ages 30 to 69.
The death toll skews old even more strongly. Overall, China CDC found, 2.3% of confirmed cases died. But the fatality rate was 14.8% in people 80 or older, likely reflecting the presence of other diseases, a weaker immune system, or simply worse overall health. By contrast, the fatality rate was 1.3% in 50-somethings, 0.4% in 40-somethings, and 0.2% in people 10 to 39.
The age-related death risk probably reflects the strength, or weakness, of the respiratory system.
[link=https://www.scientificamerican.com/article/how-does-the-coronavirus-test-work-5-questions-answered/]https://www.scientificame…-5-questions-answered/[/link]
[link=https://www.scientificamerican.com/article/researchers-rush-to-test-coronavirus-vaccine-in-people/]https://www.scientificame…rus-vaccine-in-people/[/link]
[link=https://www.scientificamerican.com/article/why-deaths-from-coronavirus-are-so-high-in-italy/]https://www.scientificame…-are-so-high-in-italy/[/link]
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There is a potential for some d!(khead young person to move ahead in their own self interest. So I say this with trepidation. But times like this calls for thinking outside the box. And its not like other people aren’t thinking the same thing. The fact that there is such a sharp age cutoff can be used strategically. If containment fails.
Perhaps set up a 3-4wk spa in the middle of the desert. Rotate a bunch of young healthcare workers. Sort of like a chickenpox party where they can build immunity.
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