-
How can radiology help limit COVID-19 transmission?
-
ADHD, you are giving me hope. There are still a few of us out here that actually think, consider, wait, and then react with thoughtfulness. Bless you.
-
I will give more hope by saying the local world I inhabit is showing behaving closer to the ideal you mention IB. It’s the internet that is most depressing. Media reports take horrible local situations and make people feel like that is the norm. It is working to keep people at home and safe for the time being.
What will be interesting to see is when it is safe to go back to our business and everyone will need coaxing to get back out and spend. -
anyone else think adhd and ib should get a private (chat) room?
i partially agree with some sentiments that many reactions are overblown. but many reactions also aren’t enough. the NYT article posted by thread killer is thought provoking and hopefully we can [u][i][b]limit[/b][/i][/u] infection of hospital staff using methods that are proven to work.
but at the same time we must be careful to not rely too heavily on any single study or data point. just as it’s not reasonable to use the death rate from south korea because of their younger population it’s also not reasonable to use the death rate from italy with older population.
my point being..we can’t dismiss the very real risk of hospital staff becoming infected even though the NYT article says everyone will be just fine. we still need to do be very careful. patient and health first. economy be damned. that’s what people are trusting US to do.
once the pandemic is over people will return to their normal pattern and spend themselves into debt. long term i doubt this will change human nature or our consumer driven economy.-
The issue is understanding what works. Too many articles dismiss the danger as a big nothing – as do too many AM posters. Just because we got late into the game and the infection did not spread much yet is hardly assurance that it is a big “nothingburger.” It’s scored as if a sports game, who is ahead but hardly anything about why “who is ahead” and who is wayyy behind. There’s hardly any analysis comparing countries’ experiences and results. It’s mainly superficial. There is some, “Rah! Rah! GO AMERICA!” as if other countries don’t count and aren’t ahead of research and solutions. But rallies won’t solve the problem, troubleshooting and analysis will. But I’ve seen little discussion or links posted about how covid is acting differently, among countries, age groups, sexes, prior conditions, etc. Truth is that quite a few young and middle-aged people have required vents and even died due to covid.
[link=https://www.statnews.com/2020/03/20/understanding-what-works-how-some-countries-are-beating-back-the-coronavirus/]https://www.statnews.com/…-back-the-coronavirus/[/link]
[size=”0″][/size][size=”0″]With Europe and the United States locked in deadly battle with the coronavirus that causes Covid-19, a number of countries that were hit early by the virus are doing a far better job of beating it back.[/size]
China, which is now diagnosing more cases in returning travelers than in people infected at home, reported no new domestically acquired cases on Wednesday, for the first time in more than two months. South Korea, which had an explosive outbreak that began in February, is aggressively battering down its epidemic curve. Singapore, Hong Kong, and Taiwan have together reported only about 600 cases.
Singapore has seen [link=https://www.moh.gov.sg/covid-19]its numbers[/link] gradually tick up. But it hasnt had an explosion of cases, likely because it has aggressively tracked where the virus was circulating. Of the 345 cases it has recorded, 124 have recovered and 221 are considered active cases. [b]It has not yet recorded a death[/b].
Singapore has done everything right, said David Heymann, who led the World Health Organizations response to the 2003 SARS outbreak and now teaches infectious diseases epidemiology at the London School of Hygiene and Tropical Medicine. Theyve been openly communicating every day on whats going on. And theyve made it clear to the population and the population understands that they are not only to protect themselves but protect others.
[size=”0″][/size]
[link=https://www.webmd.com/lung/news/20200319/20-percent-of-us-covid-19-deaths-were-young-adults#1]https://www.webmd.com/lun…hs-were-young-adults#1[/link]A review of more than 4,000 U.S. patients who were diagnosed with novel coronavirus infection (COVID-19) shows that an unexpected 20% of deaths occurred among adults aged 20-64 years, and 20% of those hospitalized were aged 20-44 years.
The expectation has been that people over 65 are most vulnerable to COVID-19 infection, but this study indicates that, at least in the United States, a significant number of patients under 45 can land in the hospital and can even die of the disease.
[link=https://www.theatlantic.com/science/archive/2020/03/biography-new-coronavirus/608338/]https://www.theatlantic.c…ew-coronavirus/608338/[/link]
[size=”0″]For example, most respiratory viruses tend to infect either the upper or lower airways. In general, an upper-respiratory infection spreads more easily, but tends to be milder, while a lower-respiratory infection is harder to transmit, but is more severe. SARS-CoV-2 [/size][link=https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf]seems to infect both upper and lower airways[/link][size=”0″], perhaps because it can exploit the ubiquitous furin. This double whammy could also conceivably explain why the virus can spread between people before symptoms show upa trait that has made it so difficult to control. Perhaps it transmits while still confined to the upper airways, before making its way deeper and causing severe symptoms. All of this is plausible but totally hypothetical; the virus was only discovered in January, and most of its biology is still a mystery.[/size]
The immune system fights back and attacks the virus; this is what causes inflammation and fever. But in extreme cases, the immune system goes berserk, causing more damage than the actual virus. For example, blood vessels might open up to allow defensive cells to reach the site of an infection; thats great, but if the vessels become [i]too[/i] leaky, the lungs fill even more with fluid. These damaging overreactions are called cytokine storms. They were historically responsible for many deaths during the 1918 flu pandemic, H5N1 bird flu outbreaks, and the 2003 SARS outbreak. And theyre probably behind the most severe cases of COVID-19.
-
Well done Frumious. The last posting about cytokine storm is very important. Plaquenil is showing to be helpful here.
-
I’m wondering if it’s cytokine storm that’s killing disproportionately larger numbers of younger pts in the US.
-
Anecdotally our younger patients on the icu ventilator slate seem to be the lupus and sickle cell cohort
-
Quote from CaptainWaffles
Anecdotally our younger patients on the icu ventilator slate seem to be the lupus and sickle cell cohort
Yeah this doesn’t get reported in media. Only “young people also need the vents!”
Silent carriers are going to spread it everywhere as the authorities and hospital admins are condemning widespread facemask wearing.-
So start giving out N95 masks to everyone, tail.
Ummmm, where can you get them?-
Lets think about this. The doomsayers were predicting a collapse of the health care system because of treating this virus. Now that we are finally recognizing that even in the worst areas the number of deaths will not approach the horrific numbers predicted, what if the health care system collapses because there arent enough patients?
-
What are you talking about?
Look at Italy?
Are you serious
-
Quote from kpack123
What are you talking about?
Look at Italy?
Are you serious
Absolutely. Even in Italy the national health care system has not collapsed. But it is safer because it is mostly government controlled. Because we have a capitalist system it relies on being busy with patients to keep it solvent. Medical practices all over the country will be stressed in ways never seen before. Small and large groups are running on thin margins that rely on a steady income stream. Many if not most could become insolvent during this crisis. Clinics unable to meet staff and physician payroll etc. If we can safely see patients while using protocols established by places like Singapore and continue to take care of all of our patients that need care it would be better for the system as a whole with little impact on virus spread. -
Look, I know it is hard to read what I am saying if you don’t take the time to look at the numbers and think beyond the knee jerk reactions. I have been consistent with my predictions and the data continues to support them. Local flares like we are seeing in Italy and New York do nothing to change them. It is bad to reach capacity as we have seen in certain areas so we have to make tough decisions about who gets care. It’s a horrible choice to make. However, it’s does not mean the collapse of our health care system and it does not mean the world wide mortality numbers will be nearing the very high predictions based on basic math but the wrong numbers entered in the calculation.
-
Quote from ADHD
Local flares like we are seeing in Italy and New York do nothing to change them. It is bad to reach capacity as we have seen in certain areas so we have to make tough decisions about who gets care. It’s a horrible choice to make. However, it’s does not mean the collapse of our health care system and it does not mean the world wide mortality numbers will be nearing the very high predictions based on basic math but the wrong numbers entered in the calculation.
Much of the issue with capacity limitations can be addressed through judicious transfer of patients out of the hot-zone. France is currently shipping patients to bordering areas in germany, NY/NJ will be able transfer patients into PA and CT. Anyone who claims that our hospitals have no capacity to absorb additional sick patients is willfully blind to healthcare economics. Once you stop doing knee replacements, semi-elective back surgeries and semi-elective cardiac procedures, plenty of hospital and ICU beds open up.
It’ll be rough for a while. -
For sure we should be postponing the elective and semi-elective surgeries for a few weeks. If we do need more ventilators they can come more easily form OPS than a factory somewhere across the country. Space to keep different cohorts separated is also key and should be developed where it can be done.
Where I think the error is being made is the idea that social distancing by avoiding medical care is the right thing to do. It will potentially financially destabilize the system worse than being inundated with COVID patients. -
Politics and media infecting their lemmings is the real issue here. If you look at the numbers with sobriety, as I and ADHD have pointed out about 10x each at this point, and consistently — you see that this is in fact the biggest nothing bigger ever perpetrated on the global stage, comparing facts and the [i]actual policies[/i] enacted [b]due[/b] to the hysteria.
To recap, on the scale of viruses:
The R0 of this is VERY LOW to LOW. The last 3 news items (SARS, MERS, swine flu, etc) were all higher to much higher transmissibility.
The lethality [b]worldwide[/b] is not even NEAR THIS YEAR’S CDC death rate from influenza. Let alone previous years rates, which we didn’t shut down nearly all economic activity for (never forget the opportunity costs, that’s why we are even debating this)
Transmission is in sequestered places (hospitals), sickest people are in these places, they have many different diseases, and ONLY really old people are meaningfully tested and “dying” because they are in these very places!!! A random 40 year old somewhere reported to be dying is the same 40 year old any other year we’d be like “Yeah, he had some other issue, that’s not normal to just be healthy and drop dead from common flu”
And that’s not even really happening anywhere near the common flu reports!!! The evidence of nothing burger is totally staggering, our country is clearly declining and even faster than I thought if physicians are this brainless and politically driven.
-
Quote from Thread killer
Lets think about this. The doomsayers were predicting a collapse of the health care system because of treating this virus. Now that we are finally recognizing that even in the worst areas the number of deaths will not approach the horrific numbers predicted, what if the health care system collapses because there arent enough patients?
Doomsayers vs Pollyannas. Who is in the lead in this neck and neck race to the finish? Exciting race, folks!
This is really bizarre. We’re all supposed to be in the medical field?
Where are the facts of “will not approach the horrific numbers predicted?” Any data? All I am seeing is that we have not peaked and infected people are still being found. So how did so many get to Pollyannaville? Free margaritas from Margaritaville?
Or is this just cheerleading for the administration by medical supporters?
The data does not support Pollyanna predictions at this time. Nothing does. The data is both incomplete and being created as we post and the data is anything but optimistic.
Things will get worse before they get better. In that, the market is acting sane. -
Listen to the Italian doctors in Bergamo. There is interview online. We should take steps to avoid this here. Over used phrase nothing burger does not apply to that place.
I see someone saying yes but the economic harm is worse than the healthcare pain colleagues in Italy are seeing. They should just go back to work and let the hospitals drown further and then it’ll be over, back to business
But acting like it’s a non event is just strange.
-
Quote from touchingcotton
Listen to the Italian doctors in Bergamo. There is interview online. We should take steps to avoid this here. Over used phrase nothing burger does not apply to that place.
I see someone saying yes but the economic harm is worse than the healthcare pain colleagues in Italy are seeing. They should just go back to work and let the hospitals drown further and then it’ll be over, back to business
But acting like it’s a non event is just strange.
Also listen to the public health officials in south korea, singapore and germany. I for one never claimed that it was a ‘non-event’ and I am doing my small part in the management effort. But there is a large grey area between ‘nothingburger’ and ‘OMG, OMG we are all gonna die with painful boils’. -
Which begs the question, why the difference between countries in infected, rate of infection, severity of infection, casualties due to infection and what was done and when to mitigate the infection. Singapore did not forget it’s last experience while we dismissed our past experiences. Why are Germany’s results better than Italy’s? South Korea?
-
I think just about everything you mentioned can be explained by variations in testing.
Sure there are differences in demographics, comorbidities, and availability of healthcare. But I think its obvious that some are testing more thoroughly and quickly than others.
-
Quote from Jimboboy
I think just about everything you mentioned can be explained by variations in testing.
Sure there are differences in demographics, comorbidities, and availability of healthcare. But I think its obvious that some are testing more thoroughly and quickly than others.
Explain. Is this your opinion, your gut? Or looking at data?
-
^^ The fear of what will happen if you get it and shut down of society is almost as bad as painful boils you could argue.
-
Quote from Frumious
Quote from Thread killer
Lets think about this. The doomsayers were predicting a collapse of the health care system because of treating this virus. Now that we are finally recognizing that even in the worst areas the number of deaths will not approach the horrific numbers predicted, what if the health care system collapses because there arent enough patients?
Where are the facts of “will not approach the horrific numbers predicted?” Any data? All I am seeing is that we have not peaked and infected people are still being found.
No data? We have three months of data from two places where the virus ran out of control for a long time before social distancing was implemented. The first, China shows a total of 3,000 deaths a mortality curve that flattened in January. Now we have Italy, a perfect storm to set up for massive mortality with the aged population and communal living. It looks like the mortality rate is leveling off there. So we have a world wide mortality after nearly 4 months of this virus being unleashed on the population of just over 16K. That’s excellent data. The one thing we don’t have is the true infected rate. In the end this doesn’t really matter. If it is 10 or 100 times higher that is good news because the mortality rate is much lower than predicted. If it is not much higher than already measured than that is good news because it is not very contagious.
-
And BTW there is nothing Pollyanna about the analysis. We have already triggered a global depression the likes of which we have not seen in our lifetimes. This is horrible. Just not for the reasons everyone thinks.
-
Quote from Frumious
Quote from Thread killer
Lets think about this. The doomsayers were predicting a collapse of the health care system because of treating this virus. Now that we are finally recognizing that even in the worst areas the number of deaths will not approach the horrific numbers predicted, what if the health care system collapses because there arent enough patients?
Doomsayers vs Pollyannas. Who is in the lead in this neck and neck race to the finish? Exciting race, folks!
This is really bizarre. We’re all supposed to be in the medical field?
Where are the facts of “will not approach the horrific numbers predicted?” Any data? All I am seeing is that we have not peaked and infected people are still being found. So how did so many get to Pollyannaville? Free margaritas from Margaritaville?
Or is this just cheerleading for the administration by medical supporters?
The data does not support Pollyanna predictions at this time. Nothing does. The data is both incomplete and being created as we post and the data is anything but optimistic.
Things will get worse before they get better. In that, the market is acting sane.
This one really made me smile.
-
-
-
Quote from comet tail
Quote from CaptainWaffles
Anecdotally our younger patients on the icu ventilator slate seem to be the lupus and sickle cell cohort
Yeah this doesn’t get reported in media. Only “young people also need the vents!”
Silent carriers are going to spread it everywhere as the authorities and hospital admins are condemning widespread facemask wearing.
You seem to be fixated on this face mask issue.
Based on the data, spread by asymptomatic (or presymptomatic) individuals only accounts for a small percentage of cases. Not zero, but unless you are in an area of high prevalence of the infection, you walking around with a mask is not going to do much. Well, it may stop you from chewing your fingernails or sticking you pinky up your nose (and thats a good thing), as to preventing person-person spread from asymptomatic carriers its not likely to be of much help.
One of the main mechanisms of virus spread is the creation of droplets during coughing. So someone truly asymptomatic (by definition ‘not coughing’) is not going to spread it very effectively. A truly asymptomatic individual is just not going to create much in terms of droplets. They may have contaminated their hands and surfaces around them, but that chain is easily interrupted through the avoidance of handshakes and hand hygiene by everyone involved.
By all means, wear a mask if if it makes you feel better. Just dont expect that it confers much of a protective effect.-
Quote from fw
Quote from comet tail
Quote from CaptainWaffles
Anecdotally our younger patients on the icu ventilator slate seem to be the lupus and sickle cell cohort
Yeah this doesn’t get reported in media. Only “young people also need the vents!”
Silent carriers are going to spread it everywhere as the authorities and hospital admins are condemning widespread facemask wearing.
You seem to be fixated on this face mask issue.
Based on the data, spread by asymptomatic (or presymptomatic) individuals only accounts for a small percentage of cases. Not zero, but unless you are in an area of high prevalence of the infection, you walking around with a mask is not going to do much. Well, it may stop you from chewing your fingernails or sticking you pinky up your nose (and thats a good thing), as to preventing person-person spread from asymptomatic carriers its not likely to be of much help.
One of the main mechanisms of virus spread is the creation of droplets during coughing. So someone truly asymptomatic (by definition ‘not coughing’) is not going to spread it very effectively. A truly asymptomatic individual is just not going to create much in terms of droplets. They may have contaminated their hands and surfaces around them, but that chain is easily interrupted through the avoidance of handshakes and hand hygiene by everyone involved.
By all means, wear a mask if if it makes you feel better. Just dont expect that it confers much of a protective effect.
I disagree. If you are wearing a mask and the asymptomatic carrier is wearing as mask, then that would definitely be better than both individuals walking around without one.
Also, where is the data that asymtomatic people only account for a small percentage of cases? And regardless, Covid19 is so virulent that that small percentage will still balloon out to a substantial amount of people in a few weeks. It only takes one person to infect a whole city of people….
-
Quote from Theforce111
I disagree. If you are wearing a mask and the asymptomatic carrier is wearing as mask, then that would definitely be better than both individuals walking around without one.
It wouldn’t. The asymptomatic carrier would have been very unlikely to pass it on to you in a casual encounter without a mask and after you both wear a mask, he still would not have passed it on to you. It is not likely that it made a difference.
Arguably, the asymptomatic carrier would have had to don and doff the mask creating opportunities to contaminate his hands in the process and thereby creating another (known) avenue for spread. And unless you as the uninfected individual have access to multiple clean masks, disposable gloves and a handwashing facility for every occasion when you don or doff you mask, you are also likely to create contamination to your face from your hands that you would not have created without the mask.
Also, where is the data that asymtomatic people only account for a small percentage of cases?
Go look. The rates quoted are variable between 1-10%. The great majority of cases are transmitted by symptomatic individuals.
And regardless, Covid19 is so virulent that that small percentage will still balloon out to a substantial amount of people in a few weeks. It only takes one person to infect a whole city of people….
This is puzzling. We are supposedly on a forum of physicians here. Maybe they dont teach this in medical school these days, but none of this is a great secret if you can read the actual papers and research letters that are being published about this epidemic:
– SARS-CoV2 does not have an unusually high rate of transmission as respiratory viruses go.
– SARS-CoV2 is transmitted the same way as most other viruses in that family. Through droplet transmission, close contact and via contaminated objects.
– SARS-CoV2 is not particularly hardy in the environment. Yes, you can detect the DNA in the air up to 3 hours after you artifically created a 5μm aerosol, but there is no data to support that this is a significant mechanism of spread.
– Based on the data, Covid-19 causes more severe respiratory compromise than other viri in the same family yet it is far less aggressive than other coronavirus associated diseases that have come through over the years (SARS, MERS)
So no, this isn’t a gram of anthrax spores blown into the air supply at a basketball game. It doesn’t rapidly spread from one person to the whole city. There were numerous ‘escaped’ cases within china which were controlled locally through standard public health techniques. Most of the spread happened within families, among office-mates or to individuals using the same bathroom facility etc.
-
Quote from fw
It wouldn’t. The asymptomatic carrier would have been very unlikely to pass it on to you in a casual encounter without a mask and after you both wear a mask, he still would not have passed it on to you. It is not likely that it made a difference.
Arguably, the asymptomatic carrier would have had to don and doff the mask creating opportunities to contaminate his hands in the process and thereby creating another (known) avenue for spread. And unless you as the uninfected individual have access to multiple clean masks, disposable gloves and a handwashing facility for every occasion when you don or doff you mask, you are also likely to create contamination to your face from your hands that you would not have created without the mask.
I think that’s totally wrong. An asymptomatic person can still cough and sneeze independent to the virus and still spread their fomites. Why is the USA the only 1st world country that finds rationalizations not to use masks for the general populace?
I guarantee you masks still block large droplets and most importantly keeps you from touching your face…
If you watch every single nation that has done well with Covid (ie Taiwan, Singapore), the majority of their citizens are wearing masks… there is a reason for this.
Anyway, not sure why you are so anti-mask …if it even helps a little (and it does), we should be doing it.
-
Quote from Theforce111
I think that’s totally wrong. An asymptomatic person can still cough and sneeze independent to the virus and still spread their fomites.
If they cough and sneeze, they are by definition not asymptomatic. And read up on the definition of fomites*.
Why is the USA the only 1st world country that finds rationalizations not to use masks for the general populace?
The use of masks in most of those countries is not based on sound epidemiological reasoning but rather out of a desire to ‘do something’ and directed by social conformity.If you watch every single nation that has done well with Covid (ie Taiwan, Singapore), the majority of their citizens are wearing masks… there is a reason for this.
True, true unrelated.
Both of those countries did many other things to control the behavior of potentially infected people. Whether everyone and their brother walked around with a mask on their face likely had no significant effect on the evolution of the disease. Just a couple of things Taiwan did:
– screening all travelers
– quarantining everyone from a community transmission area (oh yeah, it was ‘voluntary’, right until the ‘neighborhood warden’ shows up and ushers you back into your apartment).
– prohibiting entry from mainland china
– intrusive data-mining to set up geo-fences for people under quarantine
.
.
.
This wasn’t their first rodeo.
Anyway, not sure why you are so anti-mask …if it even helps a little (and it does), we should be doing it.
I am not convinced that it does anything, at least in the way it is being practiced by the general public. As I said, if you want to wear it so you feel better, go ahead. I am not anti-anything.
Just to be clear:
If I get a covid patient for LP or any other procedure, I am going to be all suited up head to toe with disposable booties, eye-shield, respirator and bouffant cap. And that’s just because it is so damn hard to do a procedure while wearing a level-A hazmat suit.
* [size=”1″]just as a minor point, if not properly handled and discarded, your mask may well become a ‘fomite’.[/size] -
Quote from fw
* [size=”1″]just as a minor point, if not properly handled and discarded, your mask may well become a ‘fomite’.[/size]
I know what fomite means. I was talking about the trash the silent carriers may leave behind.
Ironically the major hospital systems around us just put out this text to all physicians: “[i]Effective immediately, all healthcare workers need to wear a mask in any hospital area, including both the inpatient and outpatient setting”[/i] so obviously they think masks work in some capacity and of course this translates to the general populace.
When we revisit this thread in 18 months after the virus has run it’s course, I’m sure masks will become as commonplace here as they are Asian countries during pandemics. We will see…
Anyway, it seems like we aren’t going to agree, and we have probably cluttered the thread enough going back and forth about masks, so I will end with I’m glad you are using masks and other PPE during the procedures. Stay safe and healthy. We are all in this battle together.
-
Quote from Theforce111
I disagree. If you are wearing a mask and the asymptomatic carrier is wearing as mask, then that would definitely be better than both individuals walking around without one.
Also, where is the data that asymtomatic people only account for a small percentage of cases? And regardless, Covid19 is so virulent that that small percentage will still balloon out to a substantial amount of people in a few weeks. It only takes one person to infect a whole city of people….
Masks in a pneumonia epidemic are just common sense no matter what circumlocution people use.
-
-
-
-
-
[link=https://www.france24.com/en/france/20200322-the-interview-we-hope-plaquenil-will-save-some-people-says-sanofi-s-olivier-bogillot]https://www.france24.com/…ofi-s-olivier-bogillot[/link]
[link=https://www.propublica.org/article/lupus-patients-cant-get-crucial-medication-after-president-trump-pushes-unproven-coronavirus-treatment]https://www.propublica.or…-coronavirus-treatment[/link] -
Quote from rayZor
I’m wondering if it’s cytokine storm that’s killing disproportionately larger numbers of younger pts in the US.
I think it’s a big part of the respiratory failure in all of the patients. My guess as to why there are relatively larger numbers of young people dying in the U.S. is there are many more infected than we realize. They were particularly interactive before the social distancing measures. In the U.S. our elderly are already distanced from the rest of us on a relative basis.
-
-
-
Quote from Frumious
[size=”0″]For example, most respiratory viruses tend to infect either the upper or lower airways. In general, an upper-respiratory infection spreads more easily, but tends to be milder, while a lower-respiratory infection is harder to transmit, but is more severe. SARS-CoV-2 [/size][link=https://www.medrxiv.org/content/10.1101/2020.03.05.20030502v1.full.pdf]seems to infect both upper and lower airways[/link][size=”0″], perhaps because it can exploit the ubiquitous furin. This double whammy could also conceivably explain why the virus can spread between people before symptoms show upa trait that has made it so difficult to control. Perhaps it transmits while still confined to the upper airways, before making its way deeper and causing severe symptoms. All of this is plausible but totally hypothetical; the virus was only discovered in January, and most of its biology is still a mystery.[/size]
The immune system fights back and attacks the virus; this is what causes inflammation and fever. But in extreme cases, the immune system goes berserk, causing more damage than the actual virus. For example, blood vessels might open up to allow defensive cells to reach the site of an infection; thats great, but if the vessels become [i]too[/i] leaky, the lungs fill even more with fluid. These damaging overreactions are called cytokine storms. They were historically responsible for many deaths during the 1918 flu pandemic, H5N1 bird flu outbreaks, and the 2003 SARS outbreak. And theyre probably behind the most severe cases of COVID-19.
I agree about the cytokine storms.
I also believe the most insidious thing about Covid19 is the large group of [b]silent carriers[/b] who probably are spreading the virus without even knowing it… that will probably be the biggest problem we didn’t tackle early enough in retrospect.
Most sick/symptomatic people are probably staying at home.. but these silent carriers are probably out and about getting everyone else sick…
-
Silent carriers of the “common cold” is not that far off, but no degree of reasonableness can abate this level of fear and propaganda.
-
-
-
-
-
What I have been saying for a while now will so obviously be right, I don’t know how anyone will take the chicken little’s seriously anymore; they cannot critcally think. They are disgusting, irresponsible media pawns. They know very little science, or what of it they know, they allow other fears or emotions swamp out.
ADHD can see this, I urge you to read his posts and mine in response, or that he refers to.
Once again, if you read all of my posts you will see that I was never against a 2 week phase of reasonable phase/disease reminder, strategy, organization, and precaution. The damage going longer than this is unbelievably irresponsible to every member of society. We can easily see that those in the ICU who suffer from OTHER, [b]very serious[/b] diseases are the only ones that have any issue with this supposed pandemic, and it is NO different ultimately than the common influenza.
What we have said from the beginning is: understand that those at risk are really a small, select number of popultion and mostly those who are already in the hospital with significant age and/or disease processes. Do something for them, the best way you can. Don’t shut down the livelihood of all people, and until an undetermined time, on the basis of fear alone, or power, or chaos.
Read that again, 3x — especially if your handle here starts with the letter F. -
Great. We all agree that isolation technique works best with an N95 mask.
Great idea for a business in the malls, the N95 store, selling just masks. We’ll be rich even selling them at non-inflated prices.
Now, will someone provide some information in where anyone can get them? I mean even hospitals can’t get them so how are civilians supposed to do that?
Oh yeah – China!
-
Yeah I know didn’t mean to tag you specifically. I just really hate the nothing burger ograse. If I ever say that it loud punch me
-
Quote from Intermittent Blasting
Politics and media infecting their lemmings is the real issue here. If you look at the numbers with sobriety, as I and ADHD have pointed out about 10x each at this point, and consistently — you see that this is in fact the biggest nothing bigger ever perpetrated on the global stage, comparing facts and the [i]actual policies[/i] enacted [b]due[/b] to the hysteria.
To recap, on the scale of viruses:
The R0 of this is VERY LOW to LOW. The last 3 news items (SARS, MERS, swine flu, etc) were all higher to much higher transmissibility.
The lethality [b]worldwide[/b] is not even NEAR THIS YEAR’S CDC death rate from influenza. Let alone previous years rates, which we didn’t shut down nearly all economic activity for (never forget the opportunity costs, that’s why we are even debating this)
Transmission is in sequestered places (hospitals), sickest people are in these places, they have many different diseases, and ONLY really old people are meaningfully tested and “dying” because they are in these very places!!! A random 40 year old somewhere reported to be dying is the same 40 year old any other year we’d be like “Yeah, he had some other issue, that’s not normal to just be healthy and drop dead from common flu”
And that’s not even really happening anywhere near the common flu reports!!! The evidence of nothing burger is totally staggering, our country is clearly declining and even faster than I thought if physicians are this brainless and politically driven.
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
to top it off you best your ignorance with a slather of self righteousness and condescension by labeling any physician with opposing opinions as “brainless and politically driven”-
From NYT:
There is little evidence that walking around in a flat surgical mask gives a healthy person much protection which is why many officials have said not to bother. But the experts Donald spoke to all agreed that it was important for all sick people to wear them to contain their coughs.How do you achieve that, if wearing a mask marks you out as infected? The lesson from Asia, the experts told Donald, is to make masks mandatory for everybody. Then the sick automatically have one on, and there is no stigma attached. The Asian approach is less about data than it is about crowd psychology, he writes.
-
I had to go in today. Seeing random people in the parking garage walking in with masks on.
-
The whole USA is making great sacrifices to slow down the rate of disease to flatten the curve , to not overwhelm the system and thus save lives. This of course is extremely costly economically and draws out the disease longer. The better thing to do is ramp up production – increase ventilator production and “ICU beds” across the nation which they think is too difficult but I think we can do it. They are already using navy ships to help out washington, california, new york city. You have auto makers all ready to switch production from cars to ventilators. You have old buildings being repurposed as hospitals by the military. You have the entire VA system to also repurpose as needed to help with the cause. You have military doctors and VA doctors that can be repurposed to deal with the surge. Maybe overseas doctors can come as well to help out. It would be much cheaper and faster to do it this way. No one is stopping the spread here by the shutdown measures, 30-70% is getting affected regardless. Let the whole USA get infected fast, get this done and over with fast. Maybe canadian doctors and mexican doctors can come and help if we need it. After we get done with this, we let another country like canada stop shutdown measures and help them with their surge in return. A lot of people who still arent taking this seriously really dont understand how exponential growth/spread works or simply dont care because they know personally they themselves wont die from this and thats all they care about.
-
Quote from striker79
The whole USA is making great sacrifices to slow down the rate of disease to flatten the curve , to not overwhelm the system and thus save lives. This of course is extremely costly economically and draws out the disease longer. The better thing to do is ramp up production – increase ventilator production and “ICU beds” across the nation which they think is too difficult but I think we can do it. They are already using navy ships to help out washington, california, new york city. You have auto makers all ready to switch production from cars to ventilators. You have old buildings being repurposed as hospitals by the military. You have the entire VA system to also repurpose as needed to help with the cause. You have military doctors and VA doctors that can be repurposed to deal with the surge. Maybe overseas doctors can come as well to help out. It would be much cheaper and faster to do it this way. No one is stopping the spread here by the shutdown measures, 30-70% is getting affected regardless. Let the whole USA get infected fast, get this done and over with fast. Maybe canadian doctors and mexican doctors can come and help if we need it. After we get done with this, we let another country like canada stop shutdown measures and help them with their surge in return. A lot of people who still arent taking this seriously really dont understand how exponential growth/spread works or simply dont care because they know personally they themselves wont die from this and thats all they care about.
Striker I applaud your conclusion that we would be better off letting this thing run its course and do our best to treat the very ill efficiently. I don’t think there is any doubt that this is the best advice to come out the back end with any semblance of a healthy economy. The only thing I find wrong with your idea is that we will need to ramp up ventilator production to meet your goal. If we do as you suggest we will see the peak of severe disease before the new ventilators are built and delivered. However, they wont be needed. There are plenty around to do the job if each community is smart about how they are accessed. Think of all of the outpatient surgery centers where they can be borrowed from. As you say there are plenty of places to set up short term care facilities.-
And here I thought rationing does not exist in America! I mean compared to those Socialist countries like Great Britain & Norway & Sweden & Finland & Denmark & Germany & France & so on & so on & so on.
Those fools in those Socialist countries like Singapore also are trying to keep their elders alive!
Idiots. Think of the money they could save.-
It was Striker’s idea! I’m just giving him props.
-
Quote from Thread killer
It was Striker’s idea! I’m just giving him props.
Then my response is to both.
-
-
-
-
Quote from striker79
The whole USA is making great sacrifices to slow down the rate of disease to flatten the curve , to not overwhelm the system and thus save lives. This of course is extremely costly economically and draws out the disease longer. The better thing to do is ramp up production – increase ventilator production and “ICU beds” across the nation which they think is too difficult but I think we can do it. They are already using navy ships to help out washington, california, new york city. You have auto makers all ready to switch production from cars to ventilators. You have old buildings being repurposed as hospitals by the military. You have the entire VA system to also repurpose as needed to help with the cause. You have military doctors and VA doctors that can be repurposed to deal with the surge. Maybe overseas doctors can come as well to help out. It would be much cheaper and faster to do it this way. No one is stopping the spread here by the shutdown measures, 30-70% is getting affected regardless. Let the whole USA get infected fast, get this done and over with fast. Maybe canadian doctors and mexican doctors can come and help if we need it. After we get done with this, we let another country like canada stop shutdown measures and help them with their surge in return. A lot of people who still arent taking this seriously really dont understand how exponential growth/spread works or simply dont care because they know personally they themselves wont die from this and thats all they care about.
For the 20th time, exponential spread only matters if coupled with lethality.
Please tell me, with numbers, how this possibly would overcome the already “20k who have died” this year from common flu. Or the 60-80k who died in the last several high flu seasons. In 2016, more people died in Italy from flu, not from covid, [i][b]and it wasn’t even close[/b][/i]. I wonder why there was no panic then, there were articles though. Go about your business people, unless we want to unleash the drones.
-
-
-
-
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
-
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
This is the 4th time I’ve seen this today. I love how these same people probably talk about “evidence based” blah blah blah here and there in their lives, too. What a world. -
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
exhausting
i didn’t call anyone names
and i don’t need to argue specific points. simply said – in case you missed it – i disagree with every point made and consider the claims both irresponsible and dangerous. we’re seeing a surge of patients sick and dying unlike anything in our lifetime and you’re pushing the agenda that this is nothing worse than any other viral event. disgusting.
and as for your rant:
“This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements.”
in my book = grade A you know what.-
Quote from callsucks
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
exhausting
i didn’t call anyone names
and i don’t need to argue specific points. simply said – in case you missed it – i disagree with every point made and consider the claims both irresponsible and dangerous. we’re seeing a surge of patients sick and dying unlike anything in our lifetime and you’re pushing the agenda that this is nothing worse than any other viral event. disgusting.
and as for your rant:
“This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements.”
in my book = grade A you know what.
Oh, I see you tried. Care to elaborate now?
-
-
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
Callsucks. Care to come back to the conversation?
-
-
-
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
Callsucks is spot on about cigar.
I am assuming you agree on all points cigar made then?
-
Quote from Frumious
Quote from ADHD
Quote from callsucks
i disagree with every point you make above. your claims are irresponsible and you’re pushing dangerous misinformation.
Come on. You can do better than that. Give him some data to support your claim. Argue the specific points. This sounds like all of the rest that just rail against things they don’t understand and make them feel uncomfortable. If you would go back and try to understand the logic it might make you feel better. It is hard though when you just don’t like the person making the statements. Much easier to call them names.
Callsucks is spot on about cigar.
I am assuming you agree on all points cigar made then?
Please, please, please again. Show me where the arguments are flawed. Show your own logic. Then we can have a discussion.
Look, I have seen things posted by IB before that really bother me. He comes from a level of conservatism that I don’t respect. However, in this discussion he has not made a point about the data that cannot be supported with reason. That’s why I respect him in this thread. Others have pointed out some of the ridiculous statements he has made in the past on this and other threads. Sure these are reasons to not like him, not want to spend time with him in person. Just don’t let that hatred cloud your judgement.-
Ah, hate.
You mean transference, dont you. After all, you said hate.
All I ever said was cigar has never said anything of importance or significance, including here, every sentence.
Perhaps you should explain why you agree with cigar here.-
You’d all love me in person, don’t sleep
-
Quote from Frumious
All I ever said was cigar has never said anything of importance or significance, including here, every sentence.
This is all you ever need to know about these people.
They are deranged.
Emotion, hatred and fear run in their brains daily. And they are unrepentant. They cause their own problems; if you can read you see this daily. This statement is one of a mad person that calls others mad because they aren’t like her. -
Quote from Frumious
Perhaps you should explain why you agree with cigar here.
I’m pretty sure this all started because he agreed with me. I have made a rational case for why the projected mortality numbers are way off base, even if we limit our social distancing practices. That’s it. IB chose to point out he thought my logic was sound. Now I am sucked into the BS yelling at each other because there are several of you that dislike him relating to other previous experiences. Fair enough. Keep yelling at him. I will only respond going forward to well thought out challenges to the data. Please prove me wrong. Maybe it would make me feel better about the extraordinary measures we are taking to unravel our economy and health care system.
For now I will be content to find solace in the experience of Ms. vos Savant.-
It’s more than just about who dies. Why do you suppose there is concern about overloading hospitals ICUs and with vents forcing triage. You said you support social distancing but how is social distancing supposed to work without affecting the economy?
I don’t yell at cigar, He’s beyond useless and has a years long history in AM under various names alwasy saying the same thing with the same attitude. Yelling is a waste of time. He’s a troll, nothing more. His posts are trolling posts, nothing more. If you like him, good for you. I just block him since I’ve never read a useful post. Nothing about facts, just how stupid everyone is other than him. If you are concerned with hating and “yelling”, speak to your boy first as he’s the 1st and best example of what you are complaining about.-
Our IR division down to using 1 mask per day if it is not soiled.
Use of PPE during other procedures being monitored b/c radiologists were starting to layer-up too much for cases on non-covid suspected pts.
Theft of masks and cleaning supplies rampant across the system. All now on lock down.
-
Quote from dergon
Our IR division down to using 1 mask per day if it is not soiled.
Use of PPE during other procedures being monitored b/c radiologists were starting to layer-up too much for cases on non-covid suspected pts.
Theft of masks and cleaning supplies rampant across the system. All now on lock down.
we had some personal hand sanitizers swiped. I had to come in yesterday and today we have no paper towels in the restroom even though we’ve called for them and I can tell you that’s not stopping people from using the restrooms.
-
My wife & I have some still but we’ve made our own using 99% isopropyl or Everclear.
-
Darn, at first I thought you said you had a home still! Perfect hobby for this outbreak. Nothing a little moonshine can’t cure.
-
Easily done. Coil of copper tubing, boiling vat, fermenting tanks & xtra fruits & potatoes & grains.
Viola!
-
One of our hospitals reportedly had ventilator theft.
-
One can’t even point to any real data regarding the “death rate” or lethality of Covid-19, yet they ask this ADHD guy and malign the blaster dude for pointing this out.
How can you make fun of “anti-vaccers” when you have exactly the same approach here = claims and fear in producing evidence? -
Jeez.So how does one sneak a vent out the door unseen? And who needs a vent to steal?
-
-
-
-
-
-
-
-
-
-
Quote from Frumious
I don’t yell at cigar, He’s beyond useless and has a years long history in AM under various names alwasy saying the same thing with the same attitude. Yelling is a waste of time. He’s a troll, nothing more. His posts are trolling posts, nothing more. If you like him, good for you. I just block him since I’ve never read a useful post. Nothing about facts, just how stupid everyone is other than him. If you are concerned with hating and “yelling”, speak to your boy first as he’s the 1st and best example of what you are complaining about.
Some people would say the same about you.-
“Many people” say I am a stable genius.
[:)][:)][:)][:)][:)]
-
-
take a pause… and a breath…
Face reality. US will surpass all countries for confirmed COVID cases. including China and Italy…. by this weekend. At least officially.
Do take note that both China and Italy’s numbers are too low because they didn’t test enough. Neither do we but we’re probably closer. Our death numbers are much lower. Which has me thinking. There is a good chance that fatality is sub 0.4-0.3%. If we count everyone, including kids. That’s getting awfully close to flu.
But Italy is about to have it under control. China may already, if it is to be believed. We still don’t. I just wanted people to realize that we have ways to go.
-
Nothing in recent history has strained ours and other nations ICU capacities to this extent. Also caused a severe shortage of PPE. Anyone calling this a nothing burger is nothing short of an idiot.
-
Quote from irfellowship2020
Nothing in recent history has strained ours and other nations ICU capacities to this extent. Also caused a severe shortage of PPE. Anyone calling this a nothing burger is nothing short of an idiot.
Shortage of PPE is a self-imposed problem. All of manufacturing is outsourced to China, and when the time was right, they nationalized all the factories. A lesson learnt.
ICU capacity is probably the only metric worth tracking. So long as we don’t overflow and start picking who’s going to live, we should be fine. It’s good to see WW2-style mobilization to increase capacity right now. -
Quote from irfellowship2020
Nothing in recent history has strained ours and other nations ICU capacities to this extent. Also caused a severe shortage of PPE. Anyone calling this a nothing burger is nothing short of an idiot.
THINK OUTSIDE THE BOX. Ever heard of a self fulfilling prophecy?
No data? Keep making outrageous claims and then say how you don’t need to reference data, which is,
“we’re seeing a surge of patients sick and dying unlike anything in our lifetime” by [i]callsucks [/i]above.
The data do not support this, anywhere. ICUs that are open will find a patient many times because of the hysteria. CYA and “we need to do all we can” is something we live every day with in medicine, now you have a political agenda so you don’t use your brain, yet blame those of us who know the data shows nothing of the sort.
[i][b]There is no excess mortality[/b][/i]. Repeat after me. It’s not there in the data. Period. If it is, produce it. You can’t, so you’ll post stupid responses after someone like ADHD asks you nicely, over 20 times. I think he can see why those of us who have had it trying to reason with you drones use the language we do.
-
-
Quote from Jimboboy
take a pause… and a breath…
Face reality. US will surpass all countries for confirmed COVID cases. including China and Italy…. by this weekend. At least officially.
Do take note that both China and Italy’s numbers are too low because they didn’t test enough. Neither do we but we’re probably closer. Our death numbers are much lower. Which has me thinking. There is a good chance that fatality is sub 0.4-0.3%. If we count everyone, including kids. That’s getting awfully close to flu.
But Italy is about to have it under control. China may already, if it is to be believed. We still don’t. I just wanted people to realize that we have ways to go.
0.4-0.3% is still more than 20x worse than the flu.
-
flu is 0.1%
-
Quote from Jimboboy
flu is 0.1%
I was going off your figure as percent of total population as a lot of people expect most people to get covid19 over the coming months (unlike the flu which I converted to as % of total popn). Not sure what # of people otherwise to estimate covid19 death from.-
Quote from ztune
Quote from Jimboboy
flu is 0.1%
I was going off your figure as percent of total population as a lot of people expect most people to get covid19 over the coming months (unlike the flu which I converted to as % of total popn). Not sure what # of people otherwise to estimate covid19 death from.
Please explain. The number is supposed to be the mortality rate from contracting the virus. It has been woefully underestimated to this point because of under testing which decreases the true number of the denominator. JBB is rightfully seeing this. Why are you mentioning total population?-
ER doctors in NYC describe pretty horrific conditions. Extremely sick patients that de-compensate quickly. Most clinical doctors are scared sheetless of this virus… that tells you a lot.
-
I am seeing some younger patients affected. Flu season comes and goes and I don’t see anything like what I am seeing on CT right now. The thing I am seeing is facilities not taking this seriously at first – not isolating, not using PPE until they realize the epidemic is in their hospital, putting staff and patients at risk. There is this strange ‘this isnt a big deal and we dont really need to prepare’ mentality out there. Its a something burger. I dont know if a total shitburger but definitely not a nothing burger, filling up our ICUs with ventilated patients.
-
[b]Trump Administration Froze Pandemic Models[/b][/h1] [b]
[/b]
The Department of Homeland Security stopped updating its annual models of the havoc that pandemics would wreak on Americas critical infrastructure in 2017, [link=https://www.politico.com/news/2020/03/24/dhs-pandemic-coronavirus-146884]Politico[/link] reports.
From at least 2005 to 2017, an office inside DHS, in tandem with analysts and supercomputers at several national laboratories, produced detailed analyses of what would happen to everything from transportation systems to hospitals if a pandemic hit the United States.
But the work abruptly stopped in 2017 amid a bureaucratic dispute over its value, two of the former officials said, leaving the department flat-footed as it seeks to stay ahead of the impacts the COVID-19 outbreak is having on vast swathes of the U.S. economy.
-
-
-
-
-
Quote from Jimboboy
flu is 0.1%
That is not a number comparable to the current corona numbers. The CDC arrives at that percentage indirectly based on looking at all ‘flu and pneumonia’ cases in conjunction with some measure of testing frequency they receive from the commercial labs. It is not a measured case fatality rate with a 1:1 releation to influenza A.-
Yes. It’s an estimate. Of the entire population. So flu case fatality is actually HIGHER because not everyone gets the flu.
-
[link=https://techcrunch.com/2020/03/25/twitter-federalist-coronavirus/]https://techcrunch.com/2020/03/25/twitter-federalist-coronavirus/
[/link]
[h1]Twitter Deletes Post From The [b]Federalist Proposing Chickenpox Parties to Deliberately Spread Coronavirus[/b][/h1]
A tweet by conservative online magazine The Federalist, which suggested people should deliberately infect themselves with the coronavirus strain COVID-19, has been pulled after it violated [link=https://crunchbase.com/organization/twitter]Twitters [/link] rules.
The infringing tweet, posted on Wednesday morning, said: It is time to think outside the box and seriously consider a somewhat unconventional approach to COVID-19: controlled voluntary infection.
A spokesperson for Twitter confirmed the tweet violated [link=https://techcrunch.com/2020/03/18/twitter-coronavirus-covid-19-misinformation-policy/]its new coronavirus-related rules[/link].
The article focuses on pox parties, where parents would historically gather their young children together in order to infect their children with the common childhood disease. The theory goes that the child obtains the immunity and doesnt suffer from the illness later in life, which can have far more serious medical implications. The article goes on to suggest this same principle should be used for the coronavirus strain, COVID-19, which to date has killed more than 20,000 people.
-
-
Quote from fw
Quote from Jimboboy
flu is 0.1%
That is not a number comparable to the current corona numbers. The CDC arrives at that percentage indirectly based on looking at all ‘flu and pneumonia’ cases in conjunction with some measure of testing frequency they receive from the commercial labs. It is not a measured case fatality rate with a 1:1 releation to influenza A.
I can’t go without applauding such a true statement. The question I have for you is what does it mean for the COVID number?
-
Quote from ADHD
I can’t go without applauding such a true statement. The question I have for you is what does it mean for the COVID number?
I dont know. One interpretation is that any attempt to diminish covid-19s significance by comparing it with the Flu is not valid.
This intro from an article proposing a different model to estimate influenza mortality rates describes the issue quite well:
[i]Estimation of the mortality burden associated with influenza relies on statistical association rather than on direct measurement of laboratory-confirmed deaths, both because it is expensive and clinically unnecessary to test all patients with respiratory symptoms, and because many sequelae of influenza that may lead to mortality (e.g. bacterial pneumonia) may be diagnosed only after influenza virus has become undetectable in the host.[sup][link=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3516362/#R1]1[/link][/sup] This paper describes a new statistical method for estimating influenza-related mortality.[/i]
Goldstein, E Epidemiology. 2012 Nov; 23(6): 829838
Its an entire subspecialty of epidemiology of exactly how to calculate the relationship between influenza cases and any observed excess mortality.-
[link=https://morningconsult.com/2020/03/25/coronavirus-national-quarantine-trump/?fbclid=IwAR2oXSh8NTc5-8i9bj9TElN2S_namxXI3YoCkeQplYPKtLpm-OL-JNWr8q8]https://morningconsult.com/2020/03/25/coronavirus-national-quarantine-trump/?fbclid=IwAR2oXSh8NTc5-8i9bj9TElN2S_namxXI3YoCkeQplYPKtLpm-OL-JNWr8q8[/link]
[b]Nearly 3/4 of Americans support a national quarantine[/b]
[ul][*] 74% of voters support a national quarantine, limiting activity except essential trips such as to the grocery store and the pharmacy.
[*] 1 in 5 voters think public activity will resume in the next month; 27% say two months.
[*] Majority of Republicans (56%) rate Trumps response as excellent, breaking from independents (16%) and Democrats (6%).
[/ul]-
Changing the tune a little bit – is anyone else getting blowback from their health system for limiting hospital rad staffing and having those rads read remotely? We still have someone in the department 24/7 and full IR staffing.
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
-
We got push back … and pushed back .. and did the right thing
anyone who *can* be remote *should* be remote -
Quote from raduser1
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
Maybe ADMIN. should be out there on the front lines, like Generals leading the way and rallying the troops for morale.-
Quote from IGotKids2Feed
Quote from raduser1
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
Maybe ADMIN. should be out there on the front lines, like Generals leading the way and rallying the troops for morale.
Unfortunately this is a difficult win. If the admin don’t see the sensibility, it’s an uphill battle. No other specialty will back you.
The only true sensible thing is to keep anyone not involved in direct patient care away. Including the rads. But that will sound self serving to them. Maybe appeal to a higher authority? Like state or county health authority.
-
-
Quote from raduser1
Changing the tune a little bit – is anyone else getting blowback from their health system for limiting hospital rad staffing and having those rads read remotely? We still have someone in the department 24/7 and full IR staffing.
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
No, not at all. Most of our specialists like urologists are doing telemedicine…-
Quote from raduser1
Changing the tune a little bit – is anyone else getting blowback from their health system for limiting hospital rad staffing and having those rads read remotely? We still have someone in the department 24/7 and full IR staffing.
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
Reminds me of Randy Newman
“I just want you to hurt like I do”[link=https://www.youtube.com/watch?v=KJGPv66Pc24]https://www.youtube.com/watch?v=KJGPv66Pc24[/link]
-
Exactly. What a sh-t show of envy medicine is, society is similar, but with physicians you’d think (though we know it ain’t this way) it would be just another office mentality of bitching and HR type crap.
-
Quote from dergon
Quote from raduser1
Changing the tune a little bit – is anyone else getting blowback from their health system for limiting hospital rad staffing and having those rads read remotely? We still have someone in the department 24/7 and full IR staffing.
We kind of thought it was a no brainer idea but our health system admin is basically calling us out and saying we are bailing on patients, colleagues, etc and we weren’t being a team player during the crisis.
Reminds me of Randy Newman
“I just want you to hurt like I do”
[link=https://www.youtube.com/watch?v=KJGPv66Pc24]https://www.youtube.com/watch?v=KJGPv66Pc24[/link]
First time I heard of this song. Thanks for sharing.
-
Do you think remote reading during COVID pandemic will change the paradigm? Will hospitals or groups become more accepting of the practice? I hear some PP are afraid to engage in it as they feel like they will be commoditized or lose presence. Are IR/mammo boots on the ground enough to hold down the fort?
-
Quote from ChuckI
Do you think remote reading during COVID pandemic will change the paradigm? Will hospitals or groups become more accepting of the practice? I hear some PP are afraid to engage in it as they feel like they will be commoditized or lose presence. Are IR/mammo boots on the ground enough to hold down the fort?
I said in another thread (or this one …. can’t recall) … that it will be hard to put the remote reading djinni back in the bottle.
-
Quote from Theforce111
No, not at all. Most of our specialists like urologists are doing telemedicine…
Just spoke to a neurologist friend who asked how this affects our volumes. He has switched to mostly tele encounters. Now that CMS allowed this, I expect that we will see a lot more tele in primary and patient care. If your IoT enabled blood pressure cuff and your IoT enabled glucometer have already uploaded their data to your ‘health managers’ cloud site, meeting him in person to get your BP and diabeetus meds adjusted seems anachronistic. -
[link=https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/]https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/
[/link][b]Doctors consider universal DNR on Cobid patients
[/b]
Hospitals on the front lines of the pandemic are engaged in a heated private debate over a calculation few have encountered in their lifetimes how to weigh the save at all costs approach to resuscitating a dying patient against the real danger of exposing doctors and nurses to the contagion of [link=https://www.washingtonpost.com/health/2020/02/28/what-you-need-know-about-coronavirus/?tid=lk_inline_manual_3&itid=lk_inline_manual_3]coronavirus[/link].
The conversations are driven by the realization that the risk to staff amid dwindling stores of protective equipment such as masks, gowns and gloves may be too great to justify the conventional response when a patient codes, and their heart or breathing stops.Richard Wunderink, one of Northwesterns intensive-care medical directors, said hospital administrators would have to ask Illinois Gov. J.B. Pritzker for help in clarifying state law and whether it permits the policy shift.
Its a major concern for everyone, he said. This is something about which we have had lots of communication with families, and I think they are very aware of the grave circumstances.
[/QUOTE]
-
I think the first order of business will be to get the spread of the virus under control and then resume economic activity Were not experts in pandemics over here. We dont get to make that decision. I would say though that we would tend to listen to the experts. Dr. Fauci said something like the virus is going to set the timetable and that sounds right to me.
Fed Chairman Jerome Powell, in a [link=https://on.today.com/2xtRH9X]NBC News[/link] interview.
-
The virus never sets the timetable, humans do, with clear thinking, or fear mongering. Only when Fauci shows clear thinking on the issue of death rate, not transmission (though that is important to an extent) should anyone take him seriously.
-
Quote from dergon
I think the first order of business will be to get the spread of the virus under control and then resume economic activity Were not experts in pandemics over here. We dont get to make that decision. I would say though that we would tend to listen to the experts. Dr. Fauci said something like the virus is going to set the timetable and that sounds right to me.
Fed Chairman Jerome Powell, in a [link=https://on.today.com/2xtRH9X]NBC News[/link] interview.
Two people working on wrong assumptions does not make a right.
-
The point is that we are nowhere near an inflection point where US leaders and experts believe that we are close to “reopening the economy”
Lots of people making public statements in that regard. -
Quote from dergon
The point is that we are nowhere near an inflection point where US leaders and experts believe that we are close to “reopening the economy”
Lots of people making public statements in that regard.
Correct. A few more weeks are prudent. But at some point it needs to opened and the data is starting to show it should be sooner than later. It can’t wait until “the virus is contained”. That is a meaningless end point for this virus that will end up killing fewer than the flu will even in this year.
If you are not ready to admit this will be the case right now I get it. There has to be a point where we recognize that fact and it better come soon or there is no coming back from the financial crisis for a very long time. In fact I think we are already past that point. -
Only hot spots need to be closed down – Majority of US should be open right now for business. Everyone everywhere should be practicing social distancing. We were beyond containment a long time ago, we should have known since asymptomatics spread this that it wouldnt be contained. The goal has been mitigation, and do that by aggressive testing, quarantines, and only closing down hot spots on a county by county basis. Too much of America has been shut down at the wrong time.
-
Quote from striker79
Only hot spots need to be closed down – Majority of US should be open right now for business. Everyone everywhere should be practicing social distancing. We were beyond containment a long time ago, we should have known since asymptomatics spread this that it wouldnt be contained. The goal has been mitigation, and do that by aggressive testing, quarantines, and only closing down hot spots on a county by county basis. Too much of America has been shut down at the wrong time.
The problem with that is you simply allow more place to become hot spots.
Take Louisiana …. wasn’t even on the risk radar just a short 2 weeks away and now …. boom.
If you take off the social distancing restrictions the virus is likely to take root there and become a hot spot.
And unless you put the national guard on the interstate highways and cordon off the hot spots then you’ll just keep getting reinfections. -
Do you have a maximum shutdown period endpoint, Three Amigos?
If you can’t answer this question, one can’t even have a discussion with you, let alone an argument. -
Quote from Castlevania
Do you have a maximum shutdown period endpoint, Three Amigos?
If you can’t answer this question, one can’t even have a discussion with you, let alone an argument.
It depends on how long it takes healthcare infrastructure to ramp up.
If we could get to adequate testing for asymmptomatic people and to PPE for both healthcare workers and the citizenry and get enough ICU beds /ventilators on-line in case there’s a second peak then we can start looking at broadly getting back to work.
(We *could* have been already 2 months into this process had the federal government responded decisively)
-
Quote from striker79
Only hot spots need to be closed down – Majority of US should be open right now for business. Everyone everywhere should be practicing social distancing. We were beyond containment a long time ago, we should have known since asymptomatics spread this that it wouldnt be contained. The goal has been mitigation, and do that by aggressive testing, quarantines, and only closing down hot spots on a county by county basis. Too much of America has been shut down at the wrong time.
I might argue that the hot spots should not be locked down anymore, at least internally. However if there is a draconian measure that makes sense it would be to lock them in. -
So a lockdown of 1 week and miracles already happened! for an incubation period for a virus of 14 days!
Yes, makes a lot of sense. We’re over the hump already after 1 week!
BTW ADHD, what state do you work in? What incidence of COVID have you seen there & for how long? -
Quote from Frumious
BTW ADHD, what state do you work in? What incidence of COVID have you seen there & for how long?
It makes absolutely no difference to me because I am not responding with a knee jerk reaction to every local anecdotal finding. I have been consistent with my analysis and predictions from the first time I started thinking about this. Nothing that has come along, even in the worst areas, is evidence that I am wrong.
Anyway, you would probably be surprised and I’m sure disappointed by the answer because it would be one more example of your flawed thinking. -
One of the three amigos gave an “it depends” to a YES/NO question above. The other cowards are pretending like they don’t see it, so as not to get exposed.
You proved Castle man’s point, dergon, in case you didn’t notice
It’s not possible to have a discussion with you. You can’t even give a totally outlandish answer like 1 year because that also traps you. You got pwned, just admit it. -
Quote from Frumious
So a lockdown of 1 week and miracles already happened! for an incubation period for a virus of 14 days!
Yes, makes a lot of sense. We’re over the hump already after 1 week!
Oh, I understand your hysteria now. Here’s the logic. The lock down has only been a week but given the hospital surge we can assume the virus is everywhere. It started weeks ago and was passed very easily in such a densely populated area. It was doubling every few days silently. The data is now showing an average incubation period of 5-7 days and people are passing it along before they are symptomatic.
Before surge numbers are seen aggressive social distancing has a chance of flattening the curve. Afterwards the lockdown will only cause those staying together at home to give it to each other if it hasn’t already happened. There are a lot fewer people left that are at risk by being out and about. It’s too late.
What is bad? Allowing all of those infected people to leave and bring it to less affected areas. That’s why I say lock them in not down. -
Quote from striker79
Only hot spots need to be closed down – Majority of US should be open right now for business. Everyone everywhere should be practicing social distancing. We were beyond containment a long time ago, we should have known since asymptomatics spread this that it wouldnt be contained. The goal has been mitigation, and do that by aggressive testing, quarantines, and only closing down hot spots on a county by county basis. Too much of America has been shut down at the wrong time.
I must say looking back you are an enigma Striker.
-
-
-
-
-
-
-
-
-
-
[b] [link=https://www.nytimes.com/2020/03/24/opinion/coronavirus-trump-lockdown.html]New York Times editorial board[/link] – All Americans Need to Shelter in Place[/b]
The [link=https://www.nytimes.com/2020/03/24/opinion/coronavirus-trump-lockdown.html]New York Times editorial board[/link] called for a national lockdown in the U.S. to combat the outbreak of the coronavirus.
The United States has passed the point where aggressive, targeted efforts at tracking and containment, like those pursued by South Korea, have a realistic chance of success. And calls for voluntary social distancing have had mixed results, as the photos of spring breakers crammed together on the Florida beaches last week made clear.
We are not suggesting that Mr. Trump has the authority to order a national lockdown, much less advocating that he attempt to enforce one. Instead, we are urging him to use the bully pulpit to put pressure on, and provide political cover for, governors to take the hard steps that are needed.-
The NYC editorial board is hoping to set national health policy now?
-
they’re just stating the obvious. There are still governors who think we can pray the virus away or like Dan Patrick who’s ready to sacrifice grandma for the Dow.
-
Correction. What seems obvious.
-
The truth is that protecting people and protecting the economy are not mutually exclusive. In fact, one depends on the other. We save our economy by first saving lives. And we have to do it in that order.
Ohio Gov. Mike DeWine (R)
-
Quote from dergon
The truth is that protecting people and protecting the economy are not mutually exclusive. In fact, one depends on the other. We save our economy by first saving lives. And we have to do it in that order.
Ohio Gov. Mike DeWine (R)That sounds really nice. How can you say no to that? But is it really? Note that I’m not saying we should abandon lives.
-
A global depression will kill a lot more people than this virus. His logic is backwards.
-
Quote from ADHD
A global depression will kill a lot more people than this virus. His logic is backwards.
Explain. Where is your data to come to that conclusion? Any models showing economy vs deaths?
And who dies? Who decides who dies? This is not a matter of letting God decide, this is a case of Man deciding what is a higher value and who is expendable.
How do you decide people are less important than money?-
There has been too much talk about flattening the curve, and not enough talk about exponentially increasing the supply side of this equation – Doctors, ICU beds, Ventilators, Protective equipment. Epidemiologists are leading the discussion assuming we can’t prop up the supply side of this equation. America is #1 when it comes to production – let america do what america does best, PRODUCE. Let everyone jump in on producing ventilators and protective equipment. Crank up utilization of mid levels to help manage this crisis, send doctors to areas that they are needed most. What America is finally getting to is this: Lockdown only areas where testing shows there are high numbers, rest of America continue working…which right now is most of America. Ramp up production of tests as well and test everyone to get a good idea of which localized areas need lockdown. Locking down all of America does not make sense. There is a way to save lives and keep the economy going – you have to be smart. You can’t be led by only one person Dr. Fauci who doesn’t have much experience with American economy, you also cannot be led by Mr. Trump who ONLY care about the American economy, stock market and how he is perceived in this crisis. This must be a team effort amongst infectious disease experts and economists and the solution I’ve outlined above seems like the obvious course.
1. Ramp up production: Ventilators – Car Makers and others who want to get into this and make some bank from the federal government, beds (repurpose old buildings or other facilities, utilize navy ships, utilize Veterans Affairs facilities), utilize department of defense doctors and staff (veterans affairs, military) or get help from retired staff or out of state staff; masks and protective equipment – let whoever wants to get in on this thats know how to do it, do it. lots of unemployed right now, let them get in on this and pay them
2. Lockdowns – Only lockdown areas that are really bad , in which your disease projection surpasses supply. The better you do at #1, the less you have to do of #2. Right now only New York City needs to be shutdown. Only shut it down for as long as the supply side of the equation does not meet demands. Aggressive testing will tell you which areas need to be shut down. Majority of USA should continue functioning business as usually, with simple social distancing measures. Keep restaurants and businesses open.
It is much better to boost supplies as this keeps the economy rolling. This also means the disease will spread faster and we will all be done with this much faster. The more you flatten the curve, the more you draw this out to 1 & 1/2 to 2 years. Also, by boosting supplies you will have a stockpile in reserve for future pandemics.
The American way/Capitalist way and BEST way to deal with this is to exponentiate the supply side of the curve to meet the exponential covid cases curve. Instead of acting like we are some communist country that cannot produce, and must flatten the curve otherwise we will be crushed. No one is talking about doing this, everyone is focused on flattening curves.
-
No argument there striker, but what’s happening? Cuomo is arguing just this, “Where are the supplies?”
To think we, the richest country in the world ran out of PPE? Things that cost <<$1 per mask & we have no supply?
To think that we had a government agency and plans for a pandemic that was ignored and dismantled. And not a peep from anyone about it.
And here we are with our pants down wondering how and why we are here and wondering why we are so slowly doing something about it while otehre call the whole thing a nothing burger conspiracy created for no reason than to make sure Trump is not re-elected?
Under “stupidity” in the dictionary, there is an illustration of America.
If we are so great, what happened? “scuse me while I wipe some egg off my American exceptional face.
-
-
-
-
Quote from Jimboboy
Quote from dergon
The truth is that protecting people and protecting the economy are not mutually exclusive. In fact, one depends on the other. We save our economy by first saving lives. And we have to do it in that order.
Ohio Gov. Mike DeWine (R)That sounds really nice. How can you say no to that? But is it really? Note that I’m not saying we should abandon lives.
It’s not remotely true in itself. Forgive me for stating the obvious and unpopular fact, but knocking off 70-90 year olds, as this virus supposedly does, would be the biggest win for the economy and insolvent issues the local, state and Fed governments could ever dream of. And it’s not even doing that, but it’s another example of how asinine that statement really is.
-
-
-
-
-
-
-
That’s cold. And not true. The effect of losing old people will be dire.
The enemy is the virus. Not old people.
-
Hmmmm, someone called me a liar for being mean to AM posters who are some physicians and some alleged physicians when I said some had no empathy or even wished for people dying.
I don’t see that person criticizing cigar/IB/Castlevania and a few others when they actually and explicitly proved my point that some should be “sacrificed,” that it would even be good for elder people to die. I am assuming those calling for, passively or actively, are convinced they themselves – and their loved ones (if they exist) will be the survivors of the pandemic.
Where are you? Am I the only bleeding heart calling these people out for their cold-bloodedness?
-
Frumi
Any doubts now that this isnt the same poster with 25 aliases?
-
Quote from kpack123
Frumi
Any doubts now that this isnt the same poster with 25 aliases?
Never had doubts that Castlevania=IntermittantBlasting=F@gar=cigar=who the fluck know who else. The poster with a thousand IDs who constantly complements himself and his posts using different IDs.
He is “I AM LEGION”
-
-
I just called one out.
Lets stick with reasoning and information. Not anecdotes, politics, and personal agenda.
-
When someone cheers the deaths of elders and thinks it a national good, that is NOT mere politics and personal agenda.
It is despicable.
And you weren’t the one telling me I was being mean to physicians on AM either in that earlier post on another thread.
-
No argument there
-
Quote from Jimboboy
No argument there
you forgot that this is my handle too, paranoid much?
-
-
-
-
-
-
Quote from Jimboboy
That’s cold. And not true. The effect of losing old people will be dire.
The enemy is the virus. Not old people.
The virus is an enemy like the flu, sure. I never said old people were an enemy. I defy you to tell me how losing the old people “will be dire,” economically. In every human plague (no one planned these) it was a huge win for everyone remaining, and it’s not even debatable. And don’t respond by saying I’m talking about “killing” old people, which I never did. The CCP that Frumi and kpack love so much might, but I wouldn’t and don’t encourage it. But the result of that action would help their nation too, it’s not even debatable. -
hear! hear!
-
Sometimes it takes a radiologist to first get Covid-19 and die from it, before real action to set up remote workstations can take place
-
We already had a pre-existing large foot print for remote reading …
50 PACS stations in radiologist homes …. transition has been simple. -
Quote from striker79
Sometimes it takes a radiologist to first get Covid-19 and die from it, before real action to set up remote workstations can take place
Or a radiologist is forced to self quarantine because he/she tests positive despite no symptom or family member falls ill. So the rad is sitting at home twiddling thumb because there is no workstation.
-
-
-
Mike DeWine, OH governor, anticipates that Ohio cases wont peak until may 1
-
Quote from dergon
Mike DeWine, OH governor, anticipates that Ohio cases wont peak until may 1
And is he the expert?-
ODH estimate
-
-
How do you prevent those places that are not hotspots from becoming hotspots? Dalai believes it can’t be done since Americans don’t know how to cooperate in social cohesion. That being the case, rural areas will see COVID hit at least as hard as present hotspots, just delayed. And their medical resources are even less than urban hotspots.
