Are volumes picking up again?

[gassedout2015]

My university hospital is starting to open up elective surgeries, imaging, and other services as of 5/15.

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[RM38]

Hospitals around here started opening things back up 2 weeks ago and it has definitely been picking back up. Some referral sources have not really started back yet. Hope to be back to normal by mid/end June. We will see how things go though.

 

[paindoc007]

We have started.. I had a completely full schedule last week and going forward. 6 weeks of nothing, so people were excited to get their procedures in and be scheduled for new consults again

 

[Laryngospasm]

Seems to be picking up. OR cases back to normal already, maybe down just a little. But easily 80% of previous numbers. I was doing 6-10 procedures a day last week in office. Quite a backlog.

 

[SSdoc33]

My university hospital is starting to open up elective surgeries, imaging, and other services as of 5/15.

You guys notice pain procedure volume picking up again?

wasnt that 2 days ago? of a friday?

 

[gassedout2015]

Yep, was just wondering what the volume is like for those whose hospitals has already resumed elective procedures

 

[lobelsteve]

Free Market Friday: Surgery bans damage lives and livelihoods | The Journal Record

One sobering aspect of governments’ responses to COVID-19 has been the insistence by some that governments are saving lives no matter how many people die or are harmed as a result of those government actions.

journalrecord.com

 

[SSdoc33]

Free Market Friday: Surgery bans damage lives and livelihoods | The Journal Record

One sobering aspect of governments’ responses to COVID-19 has been the insistence by some that governments are saving lives no matter how many people die or are harmed as a result of those government actions.

journalrecord.com

Bans were needed. Elective surgeries should be open everywhere now, but we still need to triage

 

[drusso]

Bans were needed. Elective surgeries should be open everywhere now, but we still need to triage

Except for in a few hot-spots please explain why elective surgeries needed to be banned? History will remember that banning elective procedures everywhere was misguided.

Moreover, imagine if we didn't. What would have happened?

 

[gaseous_clay]

Except for in a few hot-spots please explain why elective surgeries needed to be banned? History will remember that banning elective procedures everywhere was misguided.

Moreover, imagine if we didn't. What would have happened?

With the data they had at that time and seeing how Italy’s (and New York’s to a lesser extent) healthcare system was overrun, what did you expect them to do? They assumed that all resources and staff would be needed for the incoming deluge of COVID patients that never materialized. Hindsight is always 20/20.

 

[hyperalgesia]

Except for in a few hot-spots please explain why elective surgeries needed to be banned? History will remember that banning elective procedures everywhere was misguided.

Moreover, imagine if we didn't. What would have happened?

In hindsight, we could have done things more efficiently, like isolating only the very vulnerable. But we were looking at places like Italy, which was quarantining entire regions in panic. I think it was a reasonable but I guess we'll see how things go from here. History will judge.

 

[clubdeac]

We're back up to 75%

 

[SSdoc33]

Except for in a few hot-spots please explain why elective surgeries needed to be banned? History will remember that banning elective procedures everywhere was misguided.

Moreover, imagine if we didn't. What would have happened?

we dont know where we would be on may 18th if we didnt institute a blanket ban. remember, this was a consenus. all hospitals wanted to close. it is completely unreasonable to get a THA in the middle of a pandemic. that patient uses hospital resources, staff, and PPE. some of these patients absolutely would have contracted covid-19 AND DIED after an elective procedure. i submit that the social distancing and the rules imposed are the reason that we did not have overwhelming hospital numbers. as it stands, we have more cases than anywhere on the world by an order of 5.

it was a good judgement call at the time, but its now time to open the hospitals up. we can reasonably predict and see when there is a spike or new wave, and can then react accordingly if necessary.

 

[Ducttape]

the preliminary White House data stated that there was going to be 1 million deaths - one of of every 300 Americans were going to die. corroborated specifically from the mouth of one Peter Navarro. 80+ million Americans infected. worst case scenario by CDC and White House models were 214 million Americans infected and 2.2 million deaths.

initial estimates was that over 30,000 ventilators were needed in NYC alone.


if we hadn't instituted social distancing and stay at home orders, our current good but still horrible would have been much worse, and the spread even greater than it has been.

 

[SommeRiver]

Full

 

[SSdoc33]

the preliminary White House data stated that there was going to be 1 million deaths - one of of every 300 Americans were going to die. corroborated specifically from the mouth of one Peter Navarro. 80+ million Americans infected. worst case scenario by CDC and White House models were 214 million Americans infected and 2.2 million deaths.

initial estimates was that over 30,000 ventilators were needed in NYC alone.


if we hadn't instituted social distancing and stay at home orders, our current good but still horrible would have been much worse, and the spread even greater than it has been.

navarro is the anti-christ.

 

[lobelsteve]

the preliminary White House data stated that there was going to be 1 million deaths - one of of every 300 Americans were going to die. corroborated specifically from the mouth of one Peter Navarro. 80+ million Americans infected. worst case scenario by CDC and White House models were 214 million Americans infected and 2.2 million deaths.

initial estimates was that over 30,000 ventilators were needed in NYC alone.


if we hadn't instituted social distancing and stay at home orders, our current good but still horrible would have been much worse, and the spread even greater than it has been.

So yo u are saying Trump saved 900,000 to 2,100,000 deaths (based on end of May projections)?

 

[Ducttape]

nope.

I'm saying we saved 900,000-2,100,000 lives because of what we all did, through state guidance.

the states ordered the stay at home orders, not trump.

 

[Doctodd]

the preliminary White House data stated that there was going to be 1 million deaths - one of of every 300 Americans were going to die. corroborated specifically from the mouth of one Peter Navarro. 80+ million Americans infected. worst case scenario by CDC and White House models were 214 million Americans infected and 2.2 million deaths.

initial estimates was that over 30,000 ventilators were needed in NYC alone.


if we hadn't instituted social distancing and stay at home orders, our current good but still horrible would have been much worse, and the spread even greater than it has been.

based on Ferguson, who apparently hasnt been right about much

 

[lobelsteve]

nope.

I'm saying we saved 900,000-2,100,000 lives because of what we all did, through state guidance.

the states ordered the stay at home orders, not trump.

So your saying despite Trump running the country, the lives were saved despite Trump?

 

[lonelobo]

based on Ferguson, who apparently hasnt been right about much

Doesn't stop Trump from touting that we could of had 2.2 million deaths, IF not for HIS very Clear and concise messaging and leadership on this silent invisible killer

 

[SSdoc33]

Doesn't stop Trump from touting that we could of had 2.2 million deaths, IF not for HIS very Clear and concise messaging and leadership on this silent invisible killer

im still not convinced we wont have 1 mil dead when all is said in done. just b/c trump says there will be a vaccine by the end of the year doesnt make it true. in fact, it makes it almost certainly a lie. from what i hear, we are talking closer to the order of years than months.....

 

[Ducttape]

So your saying despite Trump running the country, the lives were saved despite Trump?

I'm saying that the actions of the various state governors and state governments acting flattened the curve.

even your governor did more than trump.

 

[SommeRiver]

Y'all are so ridiculous...

 

[clubdeac]

basically if there was any benefit from the gov't's actions it was due to the actions of individual states and governors. If there was harm, it was obviously due to Trump's incompetence. If you can't see that then you are a narrow minded, intolerant bigot (likely a privileged white male) who is putting millions of lives at risk because of your own selfish desire to act as you wish

 

[Eilat87]

Come on guys.. we are all physicians here.. people of science. Can we just not get at each other.. this virus is bringing out the ugly (political) in us.

 

[Doctodd]

It’s an election year. Meme wars with bad spelling.

 

[hyperalgesia]

basically if there was any benefit from the gov't's actions it was due to the actions of individual states and governors. If there was harm, it was obviously due to Trump's incompetence. If you can't see that then you are a narrow minded, intolerant bigot (likely a privileged white male) who is putting millions of lives at risk because of your own selfish desire to act as you wish

Yes but if the governor is republican and good things are happening, then it's because of the democrat mayor. You just go down the chain to the highest democrat to give credit. For every negative thing, you just blame Trump.

 

[lonelobo]

It’s an election year. Meme wars with bad spelling.
View attachment 306685

Please show me what source(facebook?) this is from...much of this with no context a quick google search shows this:


----Back in January, everything looked on track for California financially. The state was even looking at a $6 billion surplus and had accumulated a healthy "rainy day fund" of $18 billion.

That's all changed since the coronavirus swept around the world and decimated the economy. The state of California is now looking at a projected $54 billion deficit.

 

[Ducttape]

Yes but if the governor is republican and good things are happening, then it's because of the democrat mayor. You just go down the chain to the highest democrat to give credit. For every negative thing, you just blame Trump.

did I quote the political parties of the various governors?

you are injecting partisan politics in to this debate, where there is none. this is not a republican vs democrat problem, this is a trump run federal government vs state governments of both parties.

fwiw, please go back and read my post. its #23.

 

[Doctodd]

You want to nitpick at the budget numbers? Relax....it’s a meme. They can’t even spell mortality correctly. But there are some facts in it.....like we all know New York has the most cases.

 

[SommeRiver]

Strange times when the left argues in favor of states over the fed...

 

[lonelobo]

You want to nitpick at the budget numbers? Relax....it’s a meme. They can’t even spell mortality correctly. But there are some facts in it.....like we all know New York has the most cases.

Great... so you did get off facebook

 

[jsaul]

You want to nitpick at the budget numbers? Relax....it’s a meme. They can’t even spell mortality correctly. But there are some facts in it.....like we all know New York has the most cases.

Again typical response by doctodd. Once confronted with any facts your response is always "relax" or divert.
At least you are consistent in your inability to counter facts

 

[ateria radicularis magna]

Jack arses, please keep your BS political views that no one cares about in a special little thread that you can curate 24 hours a day while everyone else answers the OPs question.

I am back to nearly capacity, but referrals are still way down.

 

[thecentral09]

Jack arses, please keep your BS political views that no one cares about in a special little thread that you can curate 24 hours a day while everyone else answers the OPs question.

I am back to nearly capacity, but referrals are still way down.

Same. Referrals way down, but had a backlog of ~175 when electives reopened so that will keep me busy for a while.

 

[10KHertz]

There were many healthcare systems errors from WHO, CDC, HHS, to local government. Lack of supplies, to testing , to mechanical vents (ie NYC) to antibiotic shortages , etc.
This is due to multiple administrations and state deficiency supply and resource errors. We all know this...

The key is to learn from system errors and fix it, not to politicize it. You don’t like Tweety Trump great, fix the system basement Biden .

 

[pmrmd]

----Back in January, everything looked on track for California financially. The state was even looking at a $6 billion surplus and had accumulated a healthy "rainy day fund" of $18 billion.

That's all changed since the coronavirus swept around the world and decimated the economy. The state of California is now looking at a projected $54 billion deficit.

Any “surplus” was a mirage—their pension funds for workers and teachers are woefully underfunded to the tune of $200b.

 

[lonelobo]

Any “surplus” was a mirage—their pension funds for workers and teachers are woefully underfunded to the tune of $200b.

You might want to check Florida and Texas for same thing

How Big is Texas’ Pension Debt?

Answer: $86,109,622,354. That’s right, pension debt owed by Texas’ state and local retirement systems grew to more than $86.1 billion in February 2020, according the Pension Review Board’s latest actuarial valuation report. That’s a marked increase from the previous report (in October 2019) when...

www.texaspolicy.com

 

[pmrmd]

You might want to check Florida and Texas for same thing

Why bring up other states than the one you specifically mentioned?

There was so “surplus” in Cali and financially they aren’t “on track” and won’t be any time soon.

 

[hyperalgesia]

There were many healthcare systems errors from WHO, CDC, HHS, to local government. Lack of supplies, to testing , to mechanical vents (ie NYC) to antibiotic shortages , etc.
This is due to multiple administrations and state deficiency supply and resource errors. We all know this...

The key is to learn from system errors and fix it, not to politicize it. You don’t like Tweety Trump great, fix the system basement Biden .

I think the CDC testing flaws, and vent shortage and other things you mentioned were alarming because of what COULD have happened. But if we look back, I don't think any of these things changed the final outcome or death toll at all.

 

[lonelobo]

Why bring up other states than the one you specifically mentioned?

There was so “surplus” in Cali and financially they aren’t “on track” and won’t be any time soon.

look at chart Doctodd posted and you will answer your question

 

[10KHertz]

I think the CDC testing flaws, and vent shortage and other things you mentioned were alarming because of what COULD have happened. But if we look back, I don't think any of these things changed the final outcome or death toll at all.

I agree with you that the area under the curve, or Infection fatality rate (IFR) , was never going to reduce unless an antiviral or vaccine was created rapidly(too slow IMO due to lack of emphasis on innovation and more on affordability-another issue of course).
However, with our primitive tools of face masks, social distancing and last resort mechanical ventilation, it’s pretty scary that NYC was not prepared.... I mean shouldn’t major metropolitan cities expect a chemical warfare attack and need for vents and ICUs??

more on IFR:

Stanford study suggests coronavirus might not be as deadly as flu

The Stanford study suggests that COVID-19 might not, after all, be more deadly than flu — although, as Ioannidis notes, the profile is very different

spectator.us

 

[Ducttape]

interesting article, but more interesting supposition by the reporters - ie headline is misleading.

the original author did not suggest that it was more or less deadly than the seasonal flu.

he did suggest that the fatality rate appears lower than original predictions.

Conclusions The infection fatality rate of COVID-19 can vary substantially across different locations and this may reflect differences in population age structure and case-mix of infected and deceased patients as well as multiple other factors. Estimates of infection fatality rates inferred from seroprevalence studies tend to be much lower than original speculations made in the early days of the pandemic.

in terms of volume - I personally lost only a little volume, as I am not procedure heavy, and ended up using telemedicine a lot. had fewer no shows, because i had to wake up people for their telemed visit...

in a way, I'm glad back to seeing people in the office, so I don't have to see as many ppl in their "pajamas".

 

[GoSpursGo]

Please keep the arguing and political discussions in the private forum.

 

[clubdeac]

I agree with you that the area under the curve, or Infection fatality rate (IFR) , was never going to reduce unless an antiviral or vaccine was created rapidly(too slow IMO due to lack of emphasis on innovation and more on affordability-another issue of course).
However, with our primitive tools of face masks, social distancing and last resort mechanical ventilation, it’s pretty scary that NYC was not prepared.... I mean shouldn’t major metropolitan cities expect a chemical warfare attack and need for vents and ICUs??

more on IFR:

Stanford study suggests coronavirus might not be as deadly as flu

The Stanford study suggests that COVID-19 might not, after all, be more deadly than flu — although, as Ioannidis notes, the profile is very different

spectator.us

There was a stockpile for such a disaster that got used during Obama’s reign. He failed to restock it after H1N1 I believe.... sorry just now seeing the previous post. Disregard my comment

 

[BobBarker]

Got my reports in for April. We actually had the most office visits ever in my practice in April. I guess I was giving away 100 visits every month due to patient issues (sick, funeral, out of state) etc. I did several Telemed visits on patients that were in the hospital. I had about 10 patients that would have no showed Monday for instance (my staff didn’t give them their reminder call) that I was able to recapture with telemed.

 

[geauxg8rs]

interesting article, but more interesting supposition by the reporters - ie headline is misleading.

the original author did not suggest that it was more or less deadly than the seasonal flu.

he did suggest that the fatality rate appears lower than original predictions.




in terms of volume - I personally lost only a little volume, as I am not procedure heavy, and ended up using telemedicine a lot. had fewer no shows, because i had to wake up people for their telemed visit...

in a way, I'm glad back to seeing people in the office, so I don't have to see as many ppl in their "pajamas".

So you are not doing tele med visits anymore?

 

[SommeRiver]

Got my reports in for April. We actually had the most office visits ever in my practice in April. I guess I was giving away 100 visits every month due to patient issues (sick, funeral, out of state) etc. I did several Telemed visits on patients that were in the hospital. I had about 10 patients that would have no showed Monday for instance (my staff didn’t give them their reminder call) that I was able to recapture with telemed.

My April was bad...Really bad.

 

[Ducttape]

So you are not doing tele med visits anymore?

1/2 telemed, 1/2 actual visits now.

There was a stockpile for such a disaster that got used during Obama’s reign. He failed to restock it after H1N1 I believe.... sorry just now seeing the previous post. Disregard my comment

he did try to restock the stockpile. he asked. unfortunately, the Tea Party shot down his requests. he even reduced the sums that he requested in an attempt to get them to agree, to no avail.



warning - video is biased, but I posted this rather than the CNN speech, or the various 22 min speeches on youtube.