Friday thread

[Fan_of_Meehl]

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I'm a convert to the "needing to get **** implemented NOW" crowd. We saw what happened in Italy when they failed to act. We'll be there within 4 weeks here. We need to be shutting things down yesterday. Non-urgent or non-emergent appointments should be canceled. Elective surgeries postponed. Inpatient units should be readied for an influx of critical care patients, and some wards should be converted to isolation areas for those who need acute medical care, but not necessarily critical vent care. We won't do this, of course, But, maybe we'll learn for when this happens again in the future. But, knowing people in this country, that is unlikely.

couldn't agree more. If they're going to implement this stuff, do it NOW due to the increased magnitude of delayed action (exponential). If we'd done containment two weeks ago, just think of how far ahead we'd be compared to implementing something in a couple weeks from now. IF we gonna do it, let's do it early/now.

 

[cara susanna]

We just got email to prepare to fill out HR paperwork on short notice so we can telework from home. Of course, they say it's only in the 'unlikely event' that we need to implement it (lol) but, trust me, it's happening in the next two weeks, probably early next week. You can see the cascade across society of things shutting down and events being canceled (they have even created the catchy phrase/ concept 'social distancing' (no doubt the PR/ branding experts are hard at work) to describe it.

Dude, I wish our HR would be doing that. Right now we're not telework eligible so that would, uh, create some problems.

I completely agree with both of you - we need to be doing this stuff now before our healthcare system gets overwhelmed. I am completely in favor of social distancing, which is why I'm calling all of my patients (some providers are triaging based on age etc).

 

[WisNeuro]

couldn't agree more. If they're going to implement this stuff, do it NOW due to the increased magnitude of delayed action (exponential). If we'd done containment two weeks ago, just think of how far ahead we'd be compared to implementing something in a couple weeks from now. IF we gonna do it, let's do it early/now.

If only we hadn't royally f'd up testing implementation. Man, really wish we actually had a pandemic containment team in the CDC... of wait, we used to!

 

[Sanman]

We just got email to prepare to fill out HR paperwork on short notice so we can telework from home. Of course, they say it's only in the 'unlikely event' that we need to implement it (lol) but, trust me, it's happening in the next two weeks, probably early next week. You can see the cascade across society of things shutting down and events being canceled (they have even created the catchy phrase/ concept 'social distancing' (no doubt the PR/ branding experts are hard at work) to describe it.

In the unlikely event? At our VA, moving sessions to telehealth has been announced as a forgone conclusion and work from home is being encouraged if you are the least bit ill. No mention of HR paperwork. I have already moved my sessions to telehealth/telephone and am working from home.

 

[Ollie123]

Off clinic today (was expecting to be at a conference anyways, didn't bother trying to get folks rescheduled once I decided not to go). Hoping we can get something sorted out before next Friday so I can do phone sessions. Seriously considering "calling in sick" if they legit want me to hold in-office sessions. We're 2 months into the year and I'm already almost 2 months ahead on RVUs so if they don't like it that is their problem. Several of our largest insurers here have already said they are suspending requirements for in-office visits and will allow everyone to bill telehealth as in-person while this process unfolds (cuz apparently therapy is cheaper than 3 months in the ICU...who knew?), so the only barrier is how fast we can scale.

 

[cara susanna]

In the unlikely event? At our VA, moving sessions to telehealth has been announced as a forgone conclusion and work from home is being encouraged if you are the least bit ill. No mention of HR paperwork. I have already moved my sessions to telehealth/telephone and am working from home.

You're HBPC, though, right? So I assume that your entire caseload is pretty much high risk?

@Fan_of_Meehl - are you in a county or state that has an outbreak or are they being more proactive? You can PM if you feel more comfortable.

 

[Sanman]

You're HBPC, though, right? So I assume that your entire caseload is pretty much high risk?

@Fan_of_Meehl - are you in a county or state that has an outbreak or are they being more proactive? You can PM if you feel more comfortable.

I am, so I was already setup for work from home/telehealth. However, all MH clinics are being encouraged to move to telehealth to reduce the possibility of transmission of the virus and the number of veterans coming to the hospital.

 

[Fan_of_Meehl]

You're HBPC, though, right? So I assume that your entire caseload is pretty much high risk?

@Fan_of_Meehl - are you in a county or state that has an outbreak or are they being more proactive? You can PM if you feel more comfortable.

In Louisiana. We've had some cases, but don't think we've had it too much worse than most other states so far. They're probably just being proactive, as you say.

 

[WisNeuro]

In Louisiana. We've had some cases, but don't think we've had it too much worse than most other states so far. They're probably just being proactive, as you say.

Don't you guys have >30, with confirmed cases on a sharp rise in the past 48 hours? At that rate, and based on only very limited testing, you already have community transmission.

 

[Fan_of_Meehl]

Don't you guys have >30, with confirmed cases on a sharp rise in the past 48 hours? At that rate, and based on only very limited testing, you already have community transmission.

You're right...looks like numbers just jumped this morning...most in New Orleans. Frankly, I think most/all areas of the country have probably had considerable community transmission for a while now. But I still (like you) think that containment measures should be implemented immediately to stop the rates of increase so that hospitals might be able to cope with the flow of critical cases.

 

[WisNeuro]

You're right...looks like numbers just jumped this morning...most in New Orleans. Frankly, I think most/all areas of the country have probably had considerable community transmission for a while now. But I still (like you) think that containment measures should be implemented immediately to stop the rates of increase so that hospitals might be able to cope with the flow of critical cases.

Indeed. I hope everyone is voicing their concerns. We actually have a (slim) chance of "flattening the curve," but are quickly losing that battle due o inaction and incompetence. We could have been like S.Korea, but will instead look like Italy in our response.

 

[ClinicalABA]

Yup, we're being asked to call patients to ask if they want to push back their appts or have their appt via video or phone instead. So that's what I'm doing in between appts today, haha. We've also cancelled some of our groups.

Yeah- I'm calling too to let them know to reschedule if your kid is or has been sick recently (which is pretty much EVERY toddler this time of year). These are families who have waited anxiously for up to 8-9 months for this appointment, so you can imagine there's a bit of malingering regarding the chil'ds runny nose. I will be letting them know that if they show up and they or the child are obviously sick that I will ask them to reschedule.

Also, asking to limit waiting area to just one parent and the child (rather than multiple siblings and generations, and only one staff from Early Intervention. As will most things in life, this will differentially negatively impact lower SES clients who don't have access to child care or rely on other for rides.

 

[WisNeuro]

Yeah- I'm calling too to let them know to reschedule if your kid is or has been sick recently (which is pretty much EVERY toddler this time of year). These are families who have waited anxiously for up to 8-9 months for this appointment, so you can imagine there's a bit of malingering regarding the chil'ds runny nose. I will be letting them know that if they show up and they or the child are obviously sick that I will ask them to reschedule.

Also, asking to limit waiting area to just one parent and the child (rather than multiple siblings and generations, and only one staff from Early Intervention. As will most things in life, this will differentially negatively impact lower SES clients who don't have access to child care or rely on other for rides.

Could you do some of the interviewing via telephone, so that when you reschedule for testing, you can schedule shorter appointments, and more within the week? Gonna be a mess more paperwork, but hopefully temporary-ish.

 

[ClinicalABA]

Could you do some of the interviewing via telephone, so that when you reschedule for testing, you can schedule shorter appointments, and more within the week? Gonna be a mess more paperwork, but hopefully temporary-ish.

Checking on that. We typically do a one hour intake which is primarily parent interview with some non-structured kiddo observations/interactions. Use that info to request testing auth (with testing usually scheduled 3-4 weeks out). Hope is that payers will accept a phone intake.

 

[WisNeuro]

Checking on that. We typically do a one hour intake which is primarily parent interview with some non-structured kiddo observations/interactions. Use that info to request testing auth (with testing usually scheduled 3-4 weeks out). Hope is that payers will accept a phone intake.

Reading reports that some are relaxing billing when it comes to telephone stuff, but it seems regional so far, haven't seen any national guarantees to that effect. It'd be nice if the Fed govt used emergency powers to enact a few of these.

 

[cara susanna]

Yeah- I'm calling too to let them know to reschedule if your kid is or has been sick recently (which is pretty much EVERY toddler this time of year). These are families who have waited anxiously for up to 8-9 months for this appointment, so you can imagine there's a bit of malingering regarding the chil'ds runny nose. I will be letting them know that if they show up and they or the child are obviously sick that I will ask them to reschedule.

Also, asking to limit waiting area to just one parent and the child (rather than multiple siblings and generations, and only one staff from Early Intervention. As will most things in life, this will differentially negatively impact lower SES clients who don't have access to child care or rely on other for rides.

Yeah, my testing patients that I reached did NOT want to reschedule. I'm gonna have to see them since we're being told that we can't cancel without patient agreement.

 

[WisNeuro]

Ah the good ol VA, where patient choice trumps patient and community safety 😉

 

[PsyDr]

I laughed at schools closed. I laughed when they closed events that don't interest me. I laughed when the church started limiting things. I laughed when toilet paper was limited, even though I have plenty.

I was concerned when the market tanked.

But, when they closed baseball and hot tubs... That, sir, is TOO FAR!

(it's also times like this, when the world is full of diarrhea and whatnot, that I am very happy I am not a physician).

 

[ClinicalABA]

Yeah, my testing patients that I reached did NOT want to reschedule. I'm gonna have to see them since we're being told that we can't cancel without patient agreement.

So far mine have been amenable to rescheduling (and the parents have indicated that children are sick). Looks like I'm finishing a bunch of reports next week. We have no set agency policy yet, but I expect one soon. The majority of my company's business is home-based ABA therapy, and that raises a whole bunch of issues (and vast majority of home-based therapist are FFS, so it's even more complicated for them).

 

[MAClinician]

I remember when 9/11 happened and air space came to a total shutdown for a week or so, sports events were canceled for 2 weeks (maybe 3?) and there was a sense of unity and somber ness. Never in my lifetime did I expect to experience a second and an even larger shutdown of events. It’s a good thing to be proactive rather than reactive to a virus with no treatment or vaccine approved yet. But still pretty wild.

 

[Ollie123]

The amount of paperwork, agencies and offices involved in saying "Hey - going to pause recruitment for a few week til things settle down folks. NBD - we'll start again asap" is utterly baffling to me.

I think the word count on all the emails and letters I have drafted in the last 48 hours is equivalent to like 4 R01s. Today was supposed to be a writing day, but this is not what I meant.

 

[AbnormalPsych]

I'm just here to say "Mandatory Volunteers" is the most VA thing ever.

My day today includes drinking enough coffee to get myself ready to engage in battle of the fittest: grocery store edition, then a few drinks to unwind after what I imagine that unnecessary chaos will be like.

 

[WisNeuro]

I'm just here to say "Mandatory Volunteers" is the most VA thing ever.

My day today includes drinking enough coffee to get myself ready to engage in battle of the fittest: grocery store edition, then a few drinks to unwind after what I imagine that unnecessary chaos will be like.

Hopefully you have enough toilet paper, good luck finding that today.

 

[AbnormalPsych]

I laughed when toilet paper was limited, even though I have plenty.

I imagined @PsyDr would have strong bidet game.

Hopefully you have enough toilet paper, good luck finding that today.

Protip: Cottonelle wipes

 

[WisNeuro]

I imagined @PsyDr would have strong bidet game.



Protip: Cottonelle wipes

I stocked up about 3 weeks ago. And we have a kid and a Costco membership. I'm set with everything for at least 3 months

 

[PsyDr]

@AbnormalPsych kinda weird that you imagine my bathroom habits....

 

[AbnormalPsych]

Friday threads are weird.

 

[Sanman]

@AbnormalPsych kinda weird that you imagine my bathroom habits....

I notice you didn't deny having a bidet...

 

[ClinicalABA]

For those who are into RPGs, there's an updated graphics version of Planescape: Torment (highly rated game from back in the day) available on Steam right now.

Cool. The original is a great game from that golden age of isometric RPGs (Fallout 1+2; Baldur’s Gate). Please review if you check it out.

I know these are serious time with major disruption but, microscopic common enemies bedamned, this is the Friday Thread! I’m currently eating popcorn, drinking a vodka sour, and watching a Harry Potter movie while the pizza dough proves.

 

[Justanothergrad]

with all the social distancing and canceled stuff, is every thread a Friday thread now?

ah well- today is a beer drinking kind of board game day. pandemic legacy, fallout, village attacks, burgle bros, and catan. I did fireball island this morning already- a fun game for kids and was a good laugh.

tomorrow its whiskey and some other games.

 

[WisNeuro]

Date night out of town last night, game night with some friends tonight. We have Pandemic and pretty much every expansion (wife's favorite game), so we may play something in that vein. Or, continue our Legacy: Betrayal. Maybe some whiskey. I do have some Pappy, but I am not opening that bottle unless I contract coronavirus and things aren't looking good for me.

 

[Fan_of_Meehl]

v

Cool. The original is a great game from that golden age of isometric RPGs (Fallout 1+2; Baldur’s Gate). Please review if you check it out.

I know these are serious time with major disruption but, microscopic common enemies bedamned, this is the Friday Thread! I’m currently eating popcorn, drinking a vodka sour, and watching a Harry Potter movie while the pizza dough proves.

Will do. I loved the Baldur's Gate series (which I played late 90's while in grad school). Laundry day for me.

 

[ClinicalABA]

with all the social distancing and canceled stuff, is every thread a Friday thread now?

ah well- today is a beer drinking kind of board game day. pandemic legacy, fallout, village attacks, burgle bros, and catan. I did fireball island this morning already- a fun game for kids and was a good laugh.

tomorrow its whiskey and some other games.

Nice! Started Final Fantasy XV this morning, which I played while my son was off taking the SATs!

 

[WisNeuro]

Nice! Started Final Fantasy XV this morning, which I played while my son was off taking the SATs!

Finished that one a few months back, not my favorite of the franchise, but entertaining.

 

[ClinicalABA]

Finished that one a few months back, not my favorite of the franchise, but entertaining.

Came as part and d a $20 4-pack with Monster Hunter World, Assassin’s Creed: something or other, and Modern Warfare Black Ops. Haven’t played a FF game since the first or second one on Super Nintendo. It’s goofy and a little slow, but it does what it needs to.

 

[Sanman]

It's Friday! Anyone with good weekend suggestions so that I can attempt to forget about COVID-19 for a weekend? I have a feeling booze and binging of some Netflix will occur

 

[WisNeuro]

It's Friday! Anyone with good weekend suggestions so that I can attempt to forget about COVID-19 for a weekend? I have a feeling booze and binging of some Netflix will occur

The Badlands is a decent post-apocalypse show. Slows down a little at the end. We're in isolation here with "potential symptoms." Apparently our state is no longer testing unless you need to be hospitalized. So, I now get time off, without having to use PTO. Apparently we are allotted 80 hours of employer paid leave for "Covid-leave."

 

[Fan_of_Meehl]

It's Friday! Anyone with good weekend suggestions so that I can attempt to forget about COVID-19 for a weekend? I have a feeling booze and binging of some Netflix will occur

Narcos: Mexico; Better Call Saul

 

[PsyDr]

Contagion.
Happy Valley
The Sinner
Ozark

Non Netflix:

the bridge
Mystery Team

 

[AbnormalPsych]

Narcos: Mexico; Better Call Saul

You have great taste. I was recently watching both of these.

 

[AbnormalPsych]

I hear Mcmillions is amazing

 

[LadyHalcyon]

I hear Mcmillions is amazing

It could have easily been 3 episodes. It kinda drags on....

I like the outsider

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[LadyHalcyon]

Contagion.
Happy Valley
The Sinner
Ozark

Non Netflix:

the bridge
Mystery Team

New Ozark next week!!

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[AbnormalPsych]

New Ozark next week!!

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FOR REAL!? Shelter in place just got 100000% better.

 

[cara susanna]

I enjoyed McMillions. Another suggestion for escapism is I'm Sorry on Netflix.

 

[Fan_of_Meehl]

FOR REAL!? Shelter in place just got 100000% better.

I'm about halfway through the '1917' movie and it's pretty good so far.

 

[WisNeuro]

"Working" from home today. Only have like 1.25 reports to write to be 100% caught up. I may bake a pie from scratch if I get really bored. Also, short run and a bodyweight/band workout should be on the docket. I think I miss my gym most of all.

 

[LadyHalcyon]

FOR REAL!? Shelter in place just got 100000% better.

Today is the day! Or, maybe it was yesterday..

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[thebalmofhurtminds]

"Working" from home today. Only have like 1.25 reports to write to be 100% caught up. I may bake a pie from scratch if I get really bored. Also, short run and a bodyweight/band workout should be on the docket. I think I miss my gym most of all.

We're doing the same workout today. I'll take some of the pie too.

 

[WisNeuro]

We're doing the same workout today. I'll take some of the pie too.

I must warn you, it is vinegar pie. I saw a recipe and was intrigued. As I have a metric ass-ton of flour, sugar, and other baking essentials, I figured I might as well use some of them.