Corona Virus: Idiot things people are doing

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It’s not that new...I’ve seen robots that deliver meds from the pharmacy to the floors...can’t be much different...they just have faces

I've never actually seen one go into a patient's room and deliver meds. Does it say something zingy, like 'It's a living!'. It'd be very creepy, and I think offensive to the patients (a human nurse or LVN doesn't have the time to round on you, so he's this nice robot).

I should not talk too much smack about the robots. . .they may be replacing us physicians very soon!

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I've never actually seen one go into a patient's room and deliver meds. Does it say something zingy, like 'It's a living!'. It'd be very creepy, and I think offensive to the patients (a human nurse or LVN doesn't have the time to round on you, so he's this nice robot).

I should talk too much smack about the robots. . .they may be replacing us physicians very soon!
no, I've seen the ones that deliver from the pharmacy to the medication room or to the pyxis...i don't think they interact with pts.
 
Corona Virus: Idiot things people are doing because of the COVID-19 Hysteria. [this should be documented, why not here?!]

- Fist bumping instead of shaking hands (b/c the virus hangs out on your finger tips, but not on your knuckles)
- Elbow bumping (even worse, b/c you've been coughing into your elbow all day)
- Banning large meetings, then having a meeting to discuss the ban.
- Having a large meeting outdoors, b/c somehow that's better.

Please add on !
I would add:

-healthcare workers having choreographed twerking and dancing on social media which is absolutely bizarre, tone deaf and distasteful to the public at large who have been hearing supposed news of hospitals being overwhelmed, facing deaths of loved ones and dealing with lockdown unemployment.





 
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I would add:

-healthcare workers having choreographed twerking and dancing on social media which is absolutely bizarre, tone deaf and distasteful to the public at large who have been hearing supposed news of hospitals being overwhelmed, facing deaths of loved ones and dealing with lockdown unemployment.

Yeah, that's a good one!
 
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Think this wins


Probably a disgruntled worker, who knows.

Anyone get COVID after they got vaccinated?

I did! About 10 days after. Mild symptoms though, very intermittent dry cough, which is hardly noticeable. And anosmia/aguesia (that is for real!). Nothing systemic (not a single fever, no chills, no sweats).
 
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Death penalty

If anything gets close to potential mass murder this about does it. He should be responsible for anyone that catches COVID and dies who got those bad vaccines or were slated to get those vaccines but couldn't. The harshest penalties should apply in this case. It's tantamount to poisoning the well.
 
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How are we going to open up our schools again, if every time there's a positive case in the school, they just shut it down again?!

Will no one realize that this virus is here to stay? It's too prevalent, and people are up and about too much (going to Costco, Target, etc) to prevent its spread.

Will anyone entertain the option of just opening up our society again---taking reasonable measures (social distancing where possible, wearing masks, getting vaccinated)--opening up our schools . . . and let the chips fall whichever way they may?!

Yes, people are going to die. But the overall mortality rate is < 2% , and that number approaches 0 in the non-comorbid population.

What's the alternative?!
 
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How are we going to open up our schools again, if every time there's a positive case in the school, they just shut it down again?!

Will no one realize that this virus is here to stay? It's too prevalent, and people are up and about too much (going to Costco, Target, etc) to prevent its spread.

Will anyone entertain the option of just opening up our society again---taking reasonable measures (social distancing where possible, wearing masks, getting vaccinated)--opening up our schools . . . and let the chips fall whichever way they may?!

Yes, people are going to die. But the overall mortality rate is < 2% , and that number approaches 0 in the non-comorbid population.

What's the alternative?!
Wait for people to get vaccinated and ban people who aren't from school/participating in public society. Wait until we see how much drift this virus has from year to year before giving up.

Alternatively let's convene some death panels so we can keep 75+ year olds with comorbidities and unrealistic goals with this out of the ICU and then I am all for it.
 
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Wait for people to get vaccinated and ban people who aren't from school/participating in public society. Wait until we see how much drift this virus has from year to year before giving up.

It might take us several years, maybe decades, to gain that understanding in a meaningful way. It took us a half century to come up with a good influenza vaccine.

Alternatively let's convene some death panels so we can keep 75+ year olds with comorbidities and unrealistic goals with this out of the ICU and then I am all for it.

They might just have to die. I'm sorry but it's true. Your reward for living a life of gluttony, smoking, sedentation, and medical mal-compliance is death by COVID. And saving those lives is not worth the economic destruction and the deprivation of good education for our kids, in my opinion.
 
How are we going to open up our schools again, if every time there's a positive case in the school, they just shut it down again?!

Will no one realize that this virus is here to stay? It's too prevalent, and people are up and about too much (going to Costco, Target, etc) to prevent its spread.

Will anyone entertain the option of just opening up our society again---taking reasonable measures (social distancing where possible, wearing masks, getting vaccinated)--opening up our schools . . . and let the chips fall whichever way they may?!

Yes, people are going to die. But the overall mortality rate is < 2% , and that number approaches 0 in the non-comorbid population.

What's the alternative?!
Your schools are stupid. Around here it takes a big number of positive cases to close a school.
 
To be fair california is in a very bad way. Anything that could make it worse should absolutely be avoided.

I agree with you in logic, but it's already worse, and I don't think there's anything we can really do about it. 'Stay at Home order', what a joke, everybody is up and about. Can't go to a gym or a school? Makes no difference if every grocery store and shopping outlet is still open.

There's really no exit strategy here, except to accept that the virus is here, let it equilibrate out in the population, take measures (vaccines, masks, etc), and then just let it be. Again I ask, what is the alternative exit plan?!
 
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I agree with you in logic, but it's already worse, and I don't think there's anything we can really do about it. 'Stay at Home order', what a joke, everybody is up and about. Can't go to a gym or a school? Makes no difference if every grocery store and shopping outlet is still open.

There's really no exit strategy here, except to accept that the virus is here, let it equilibrate out in the population, take measures (vaccines, masks, etc), and then just let it be. Again I ask, what is the alternative exit plan?!

It isnt about an alternative exit plan but trying to do anything to support the collapsing healthcare system. Tent hospitals being set up is a very bad sign, letting it loose without unshackling the ICU providers from triaging care is a recipe for a lot of avoidable deaths from easily survivable medical conditions in exchange for the half life that post-COVID people have.
 
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It isnt about an alternative exit plan but trying to do anything to support the collapsing healthcare system. Tent hospitals being set up is a very bad sign, letting it loose without unshackling the ICU providers from triaging care is a recipe for a lot of avoidable deaths from easily survivable medical conditions in exchange for the half life that post-COVID people have.

I especially agree with the bolded above. Sad that many beds are getting taken up by even the mild COVIDers (1-2L NC requirement). Earlier in the pandemic, we were sending these patients home with oxygen and home pulse ox, with instructions to monitor. That freed up a lot of beds. I guess there were some bad outcomes, and nobody wants to assume that liability. So now, even a mild O2 requirement with COVID keeps you in the hospital for 4-5 days. What a waste . . .
 
I especially agree with the bolded above. Sad that many beds are getting taken up by even the mild COVIDers (1-2L NC requirement). Earlier in the pandemic, we were sending these patients home with oxygen and home pulse ox, with instructions to monitor. That freed up a lot of beds. I guess there were some bad outcomes, and nobody wants to assume that liability. So now, even a mild O2 requirement with COVID keeps you in the hospital for 4-5 days. What a waste . . .
I read that 20% of covids were going to icu so I don't think it's mild illness that is the problem. The vented covids take weeks to extubate and months to rehab. In the meantime car accidents, septic appendicitis, mis, severe bacterial pneumonias etc will continue to occur and icu won't have any room.
 
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I read that 20% of covids were going to icu so I don't think it's mild illness that is the problem. The vented covids take weeks to extubate and months to rehab. In the meantime car accidents, septic appendicitis, mis, severe bacterial pneumonias etc will continue to occur and icu won't have any room.

quite true. even if that number was 5%, still too much. But what can we do? It's a virus that spreading and equilibrating out in the population, with a 2% mortality rate (<1% in the non comorbid).

No one's listening. People are still up and about, everyone's shopping, hanging out with each other, protesting, etc etc. The general population just wont listen.
 
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quite true. even if that number was 5%, still too much. But what can we do? It's a virus that spreading and equilibrating out in the population, with a 2% mortality rate (<1% in the non comorbid).

No one's listening. People are still up and about, everyone's shopping, hanging out with each other, protesting, etc etc. The general population just wont listen.
What’s the explanation for why case numbers and bed utilization so extreme in california vs other less restrictive states, like Florida (which also has an older population and higher pop density than CA), Georgia or Texas?
 
What’s the explanation for why case numbers and bed utilization so extreme in california vs other less restrictive states, like Florida (which also has an older population and higher pop density than CA), Georgia or Texas?
Florida doesn't have a higher population density than CA. CA is #3 behind NJ and NY.

CA also has the 3rd lowest hospital beds per capita (ahead of only Oregon and Washington state).

Those 2 together are the likely reason.
 
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Florida doesn't have a higher population density than CA. CA is #3 behind NJ and NY.

CA also has the 3rd lowest hospital beds per capita (ahead of only Oregon and Washington state).

Those 2 together are the likely reason.
California: population density 2018 | Statista


253 per sq mi in CA

397 per sq mi in FL

 
California: population density 2018 | Statista


253 per sq mi in CA

397 per sq mi in FL

Huh, I have no idea what the website I found was talking about then.

The hospital bed per capita is still pertinent as FL has literally double the beds/capita that CA does.
 
California: population density 2018 | Statista


253 per sq mi in CA

397 per sq mi in FL


Dividing the number of people by land mass is lazy and doesnt capture the actual risk. The prime example is Alaska--huge land mass but nobody lives in most of it making it seem like super low population density but in the few cities they have it isnt like people live miles away from each other. I imagine the sprawling urbanization of the bay area and Socal is relatively much more dense than Florida since the vast majority of the population is located along the northern and southern coasts rather than the desert.
 
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Dividing the number of people by land mass is lazy and doesnt capture the actual risk. The prime example is Alaska--huge land mass but nobody lives in most of it making it seem like super low population density but in the few cities they have it isnt like people live miles away from each other. I imagine the sprawling urbanization of the bay area and Socal is relatively much more dense than Florida since the vast majority of the population is located along the northern and southern coasts rather than the desert.
And in Florida the majority live along the coasts/major cities with farmland, wetlands, and forests in the middle.


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What’s the explanation for why case numbers and bed utilization so extreme in california vs other less restrictive states, like Florida (which also has an older population and higher pop density than CA), Georgia or Texas?

Several things:
-- Of course, large population, highly dense areas
-- CA is home to many minority ethnic groups, all of which have one thing in common: they like to socialize! Telling some people to refrain from having birthday parties, get-togethers, weddings, funerals . . . it's like telling them to jump off a bridge, it won't happen.
-- As liberal as people think CA is---and it certainly is, especially in LA/SF---much of CA can actually be quite conservative. We like our guns, ammo, and liberty just as much as our Texan brethren. And so people just don't listen. They wont 'self quarantine' or sequester, especially if they're asymptomatic. This has been true from Day 01 of the pandemic.
-- CA has a booming economy, still, and we don't want to see it get crushed (any more than it already has).

In any case, this horse is already out of the barn. The pandemic is raging here. We're in dire need of nurses (not doctors). Send some our way if you can.
 
Several things:
-- Of course, large population, highly dense areas
-- CA is home to many minority ethnic groups, all of which have one thing in common: they like to socialize! Telling some people to refrain from having birthday parties, get-togethers, weddings, funerals . . . it's like telling them to jump off a bridge, it won't happen.
-- As liberal as people think CA is---and it certainly is, especially in LA/SF---much of CA can actually be quite conservative. We like our guns, ammo, and liberty just as much as our Texan brethren. And so people just don't listen. They wont 'self quarantine' or sequester, especially if they're asymptomatic. This has been true from Day 01 of the pandemic.
-- CA has a booming economy, still, and we don't want to see it get crushed (any more than it already has).

In any case, this horse is already out of the barn. The pandemic is raging here. We're in dire need of nurses (not doctors). Send some our way if you can.
Traveling nurses shouldn't be an issue. Never was an issue here in NY in March/April/May. My gripe is my hospital having the budget to pay them 125/hr for these shifts but then not having budget to pay nurses now or get computers ****ing upgraded.
Also, now no beds for icu/ccu patients because 'no staff' due to 'budget'.
Last I checked, staying in the unit costs more than hiring another nurse.
 
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If you believe the currently available data (which you should, but also be open to it changing as we learn more), as a hospitalist, if your EM colleagues are doing their jobs, you shouldn’t be.

More infectious but less serious means COVID is finally moving to endemic/influenza/RSV status. A lot of people will get it, the smart/vaccinated will either avoid it or have minimal symptoms and only the unvaccinated and extremely medically vulnerable will wind up making it up to the floor.
 
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Though data suggests that omicron is less likely to lead to hospitalizations overall, that denominator (total infected) is going to be higher due to its higher transmissibility, and the net number of hospitalizations resulting from Omicron may be higher than Delta. I suspect we are going to see more hospitalizations in the US with time, as we are already seeing in other parts of the world.
 
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Though data suggests that omicron is less likely to lead to hospitalizations overall, that denominator (total infected) is going to be higher due to its higher transmissibility, and the net number of hospitalizations resulting from Omicron may be higher than Delta. I suspect we are going to see more hospitalizations in the US with time, as we are already seeing in other parts of the world.
Fair enough. Numerators AND Denominators are both important.

Also, can we finally start the MSE with vaccination status?

Vaccinated? Here’s the entire hospital and all of it’s resources

Not vaccinated? Here’s a referral for home O2. They should get to you by Monday.
 
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Fair enough. Numerators AND Denominators are both important.

Also, can we finally start the MSE with vaccination status?

Vaccinated? Here’s the entire hospital and all of it’s resources

Not vaccinated? Here’s a referral for home O2. They should get to you by Monday.
In my neck of the woods that would get you labelled as an anti-medical freedom nazi nanny state doctor followed by a bunch of jibberish about how patients need to talk to their personal physicians about the best decision for them which is ivermectin and prayer until sick enough to come to the inpatient side when their family can continue to decry us as nazis that wont let them visit or get ivermectin, both of which are apparently constitutional rights per my many discussions with these upstanding legal scholars.
 
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I'm more worried about the hysterical societal response, which has always had me more worried than the virus itself.

Can we stop testing the asymptomatic? What's the point? To catch people who might have the virus? we all have it. Fear of asymptomatic spread? If it's true that the virus can be so easily asymptomatically spread, then we all have it. We're all infected!
The Walking Dead Rick GIF by FOX International Channels
 
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I'm more worried about the hysterical societal response, which has always had me more worried than the virus itself.

Can we stop testing the asymptomatic? What's the point? To catch people who might have the virus? we all have it. Fear of asymptomatic spread? If it's true that the virus can be so easily asymptomatically spread, then we all have it. We're all infected!
I don't care about testing the asymptomatic. I care about reporting positive tests as a relevant statistic (it is not). Positive tests being admitted to the hospital/ICU? Totally relevant.
 
In my neck of the woods that would get you labelled as an anti-medical freedom nazi nanny state doctor followed by a bunch of jibberish about how patients need to talk to their personal physicians about the best decision for them which is ivermectin and prayer until sick enough to come to the inpatient side when their family can continue to decry us as nazis that wont let them visit or get ivermectin, both of which are apparently constitutional rights per my many discussions with these upstanding legal scholars.
I mean...that's cool. But I won't be their personal physician. Or their inpatient physician.

I'm down with being a nanny state doctor. If you come to me for my professional opinion, I will give it to you. if you are interested in following my recommendations, I'm happy to continue to care for you. If you choose not to, feel free to find someone else to care for you. It took me awhile, but I've gone down this route before COVID and outside of it. It's allowed me to be honest with my patients now. I now ask if my patients are vaccinated and tell them that it is irresponsible of me to give them cytotoxic or immunosuppressive/immunomodulating therapy if they are not vaccinated. I've gotten way more patients to agree to vaccination this way than I've lost. And the ones that I've lost haven't been much of a loss.
 
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Positive tests being admitted to the hospital/ICU? Totally relevant.

Well those are symptomatic patients (presumably).

The problem with testing the asymptomatic is that it leads to more hysteria, and school closures. My 11-yo got an extra weeks vacation tacked onto his winter break b/c 2 completely asymptomatic kids in his class tested positive. Of course he was thrilled. We are seriously screwing our kids.
 
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I mean...that's cool. But I won't be their personal physician. Or their inpatient physician.

I'm down with being a nanny state doctor. If you come to me for my professional opinion, I will give it to you. if you are interested in following my recommendations, I'm happy to continue to care for you. If you choose not to, feel free to find someone else to care for you. It took me awhile, but I've gone down this route before COVID and outside of it. It's allowed me to be honest with my patients now. I now ask if my patients are vaccinated and tell them that it is irresponsible of me to give them cytotoxic or immunosuppressive/immunomodulating therapy if they are not vaccinated. I've gotten way more patients to agree to vaccination this way than I've lost. And the ones that I've lost haven't been much of a loss.
It sounds like a good strategy everyone should follow. Unfortunately the icu patients don’t get to choose who their doctor will be so they get to do things my way or no way but definitely not the wanton ivermectin way.
 
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I mean...that's cool. But I won't be their personal physician. Or their inpatient physician.

I'm down with being a nanny state doctor. If you come to me for my professional opinion, I will give it to you. if you are interested in following my recommendations, I'm happy to continue to care for you. If you choose not to, feel free to find someone else to care for you. It took me awhile, but I've gone down this route before COVID and outside of it. It's allowed me to be honest with my patients now. I now ask if my patients are vaccinated and tell them that it is irresponsible of me to give them cytotoxic or immunosuppressive/immunomodulating therapy if they are not vaccinated. I've gotten way more patients to agree to vaccination this way than I've lost. And the ones that I've lost haven't been much of a loss.

We do that for all our HIV patients.
It's especially hilarious that they were okay getting PPSV, PCV, Influenza, etc vaccines but NOW they're hesitant about COVID. It's now become middle age/younger populations saying no because they feel they're young and not going to get sick. Aaaaand ENTER PEDS ICU filled with intubated kids!

It sounds like a good strategy everyone should follow. Unfortunately the icu patients don’t get to choose who their doctor will be so they get to do things my way or no way but definitely not the wanton ivermectin way.

I'm just glad the ICU Attendings are on the same page as ID. They don't bother us with COVID patients unless it's a really specific question about co-infection. I know it sucks being ICU at the moment and I'm sure it's even more annoying with the unvaccinated. So, we feel you.

Bc of omicron? Or just what you might expect in a winter surge?

Well, not sure how other hospital micro lab are doing things, but we don't necessarily test EVERY covid positive PCR for Omicron. 1 in 20 are sent to see if it's Omicron. Not because we don't want to but because it's the policy for our state. So, it's very premature for anyone in our region to say that we definitively don't have Omicron. We are seeing higher numbers, but we wager the Delta variant is the major player here.
 
I agree with you in logic, but it's already worse, and I don't think there's anything we can really do about it. 'Stay at Home order', what a joke, everybody is up and about. Can't go to a gym or a school? Makes no difference if every grocery store and shopping outlet is still open.

There's really no exit strategy here, except to accept that the virus is here, let it equilibrate out in the population, take measures (vaccines, masks, etc), and then just let it be. Again I ask, what is the alternative exit plan?!
I personally think that after next year we will just learn to live with it. Because if it’s still around to the same degree this time next year, then it will always be around. It may be that we just have a normalized vaccine schedule that everyone follows (every 6 months or a year) with the vaccines tweaked to the most prevalent variant. Also, while testing is good, it probably needs to be switched to symptomatic testing at some point. For the majority of the population that has been fully vaccinated and boosted, even if you get it, chances are it will not require hospitalization. The testing is creating mass hysteria. If we constantly tested for other types viral load on asymptomatic people every day, who knows what we would find.

I think if we can come up with a regular vaccination schedule, switch to symptomatic testing (and testing for high risk groups), and have a good supply of the treatment pills, we can be ok (and get back to a new “normal”). Also, I for one will continue to mask up, especially during winter or in crowded places probably for the rest of my life.
 
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