CheGuevaraMD

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I've heard a few counties reclosing (4 out of 200+ in TX) or states pausing their reopenings, but I haven't heard entire states re-imposing stay-at-home orders? Which states have?
AZ just re-closed bars, gyms, movie theaters, and water parks for at least 30 days. Bars were just re-closed in 7 counties in CA, including LA. Stay-at-home orders were reimposed in 1 CA county.

Things are predictably trending backwards due to re-opening too quickly.
 

Birdstrike

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I honestly think the state governments and school boards are just mainly worried about the inevitable BS lawsuits they know will come from people that will claim "work gave them COVID" and sue to fleece the deep pockets of state governments. If it wasn't for that, I don't think they'd even be dragging their feet on any of this. They know these teachers aren't staying home 24/7 like hermits refusing to step outside and that if they can go to the grocery store, hair salon and restaurants, they can go to work.
 
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The American Academy of Pediatrics recommendation is going to be a death-blow to the teachers demands. They usually lead with "But we're doing it for the children," and that's now lost. I forwarded that along the the above back-to-school experience from Europe to my Governor, local school board rep and superintendent. I doubt I'll hear back from the governor's office but the response from the latter two, was surprisingly positive. Neither was aware of the AAP press release and were forwarding it to the state task force making these decisions.
I was planning on doing this tomorrow as well. Our school board is calling every parent in the county and doing a survey of their opinion on our kids going back. I’m going to email the article to the board, the principals and the governor.
 

Birdstrike

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I was planning on doing this tomorrow as well. Our school board is calling every parent in the county and doing a survey of their opinion on our kids going back. I’m going to email the article to the board, the principals and the governor.
Don't forget the one from Europe that shows teachers are incredibly low risk. I linked it a few pages up.
 
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Siggy

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How many of these cases could be linked back to protests though?
Not that many...

...on the other hand here's at least 85 linked to a single bar.

 

MixedAnimals77

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Not that many...

...on the other hand here's at least 85 linked to a single bar.

The bar&club incidents shouldn't come as any suprise though based on S. Korean information.
 

Birdstrike

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How many of these cases could be linked back to protests though?
I don’t know, MixedAnimals. I just know what I’ve been told. Which is, unless you’re an ignorant science denier, you’d know mass gatherings in support of Democrat causes, like rioting, eliminating police, arson, and virtue signaling to feel better about yourself, don’t spread the virus. Not only do they not spread it, they literally bend the curve to such an extent the virus stops spreading so much it goes off the news cycle for days at a time. Once such enlightened activities stop, the virus surges again like a wildfire, and back onto your screens.
 
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Mr. Hat

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I don’t know MixedAnimals. I just know what I’ve been told. Which is, unless you’re an ignorant science denier, you’d know mass gatherings in support of Democrat causes, like rioting, eliminating police, arson, and virtue signaling to feel better about yourself, don’t spread the virus. Not only do they not spread it, they literally bend the curve to such an extent the virus stops spreading so much it goes off the news cycle for days at a time. Once such enlightened activities stop, the virus surges again like a wildfire, and back onto your screens.

Looks like Chicago will be free of the virus soon! Maybe that’s the place to be!
 
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Rekt

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AZ just re-closed bars, gyms, movie theaters, and water parks for at least 30 days. Bars were just re-closed in 7 counties in CA, including LA. Stay-at-home orders were reimposed in 1 CA county.

Things are predictably trending backwards due to re-opening too quickly.
It's honestly shocking how ****ing dumb people are. I can't believe people think this does anything. This is literally going to do nothing. Hell, it might even increase mortality. Let's close gyms so people get fatter and increase their risk. They also closed tubing at rivers. What a joke.
 

Birdstrike

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It's honestly shocking how ****ing dumb people are. I can't believe people think this does anything. This is literally going to do nothing. Hell, it might even increase mortality. Let's close gyms so people get fatter and increase their risk. They also closed tubing at rivers. What a joke.
People are still deluding themselves into thinking shutdowns cure Coronavirus.
 

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The comments on this article are priceless in their honesty, and also show the issues teachers are facing. @Birdstrike may be comfortable with teaching in a crowded classroom, but many of these folks are not: Opinion | Remote School Is a Nightmare. Few in Power Care.

The (current) CDC guidelines recommend no more than 10 students per class; what school can afford to do that? Or has enough space? And what school will go against the guidelines?
 

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It's honestly shocking how ****ing dumb people are. I can't believe people think this does anything. This is literally going to do nothing. Hell, it might even increase mortality. Let's close gyms so people get fatter and increase their risk. They also closed tubing at rivers. What a joke.
I feel pretty confident saying that it will do more than "literally nothing".

I mean, we have pretty good data that bars are hotspots for this. Not sure about gyms, but I could see them being a problem for all the obvious reasons.

Outdoors stuff should be OK if kept from getting insanely crowded so closing all of that probably is overkill.
 

VA Hopeful Dr

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People are still deluding themselves into thinking shutdowns cure Coronavirus.
I'm sure some are, but I think most of us are still mainly worried about hospital capacity.

Our state, for instance, now was 1 in 7 beds being used by COVID patients. That's not a huge issue in itself. But we're still setting daily records for new cases. And this is summer, the historically lowest bed occupancy time of year in general. If this keeps up, flu season is going to be a huge problem.
 

Rekt

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I'm sure some are, but I think most of us are still mainly worried about hospital capacity.

Our state, for instance, now was 1 in 7 beds being used by COVID patients. That's not a huge issue in itself. But we're still setting daily records for new cases. And this is summer, the historically lowest bed occupancy time of year in general. If this keeps up, flu season is going to be a huge problem.
So just keep shutting down everything q2mo? For how long? Forever? Vaccine? If it even works? As soon as Texas/AZ open back up (and whatever other states decide to arbitrarily close random things to save face) cases will go right back up. So essentially all we're left with is Walmart and Amazon because nothing else can survive that.
 
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VA Hopeful Dr

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So just keep shutting down everything q2mo? For how long? Forever? Vaccine? If it even works? As soon as Texas/AZ open back up (and whatever other states decide to arbitrarily close random things to save face) cases will go right back up. So essentially all we're left with is Walmart and Amazon because nothing else can survive that.
Being a bit hysterical aren't you?

You must have been missing the parts for the last 2 months where I've been saying we need to start opening things back up.

But, we can also use some common sense with this. We're starting to get an idea of specific areas that cause more problems than others. Have plans in place for those if hospitals start getting overwhelmed. Doesn't have to be a shutdown. Require masks indoors since we know that makes a big difference.

With a little sense we can keep this manageable.
 
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The comments on this article are priceless in their honesty, and also show the issues teachers are facing. @Birdstrike may be comfortable with teaching in a crowded classroom, but many of these folks are not: Opinion | Remote School Is a Nightmare. Few in Power Care.

The (current) CDC guidelines recommend no more than 10 students per class; what school can afford to do that? Or has enough space? And what school will go against the guidelines?
The CDC and the AAP need to get together an issue a joint statement. Right now they’re saying two different things.
 
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Birdstrike

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I'm sure some are, but I think most of us are still mainly worried about hospital capacity.

Our state, for instance, now was 1 in 7 beds being used by COVID patients. That's not a huge issue in itself. But we're still setting daily records for new cases. And this is summer, the historically lowest bed occupancy time of year in general. If this keeps up, flu season is going to be a huge problem.
On the other hand, do we want to go into flu season with low community immunity? Think about that. Lockdown all summer and fall and get a big spike in Dec/Jan when pandemic flu hits, due to lack of COVID immunity? Or go into flu season with a portion of the community (likely) immune?

If we get a vaccine miraculously fast, it won’t matter. But if we don’t, could delaying the inevitable back fire?
 
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VA Hopeful Dr

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On the other hand, do we want to go into flu season with low community immunity? Think about that. Lockdown all summer and fall and get a big spike in Dec/Jan when pandemic flu hits, due to lack of COVID immunity? Or go into flu season with a portion of the community (likely) immune?

If we get a vaccine miraculously fast, it won’t matter. But if we don’t, could delaying the inevitable back fire?
I've been using a similar argument to really push flu/pneumonia shots.

Its infuriating how many people are still refusing them.

But to your actual point, I think you're missing my point. All I care about from a large scale perspective is not running out of ICU beds. That's why I don't care about the raw numbers by themselves and I pay close attention to both my hospital's and our state's bed reports.
 

Birdstrike

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I've been using a similar argument to really push flu/pneumonia shots.

Its infuriating how many people are still refusing them.

But to your actual point, I think you're missing my point. All I care about from a large scale perspective is not running out of ICU beds. That's why I don't care about the raw numbers by themselves and I pay close attention to both my hospital's and our state's bed reports.
I agree, watching ICU bed capacity is the most important thing to look at and preserve. Hospitalization information is also much harder to find.
 
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Birdstrike

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That would be a challenge. The CDC is concerned with everyone, the AAP is only concerned with children.
The CDC is concerned with health but not economics or other equally matters equally as important as health. If it was up to the CDC we'd have been on permanent lock-down since March until we get a vaccine, while they ignore people's incomes going to zero, getting evicted, growing homelessness, bread lines and suicides. One case of virus for the CDC is too many, and the statistics on everything else? Well, they don't look at them, because it's not their job to consider non-health matters. The CDC also happens to continue to get paid during the lock-downs they recommend, while everyone else goes bankrupt.
 
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Birdstrike

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Let me make this simple for y'all.

Against lock-down: Those who stop getting paid during lock-downs.
Pro lock-down: Those who continue to get paid to work during lock-downs.
Strongly pro lock-down: Those who get paid to stay home during lock-downs.
 

La Cumbre Lines

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@Birdstrike curious as to why you are expending so much time and internet bandwidth on what you consider a minimal threat? Why not ignore it, continue your procedures, and focus on what you deem to be more salient and impactful topics?
COVID is a threat, and deserves an appropriate reaction. Over-reaction and under-reaction, are also threats.
I think that there has been a lot of fear and a portrayal of panic by some during this pandemic. I do sometimes feel the “only thing we have to fear is fear itself.” Although, when you intubate (not always a benign and life saving intervention) someone with COVID-19, try to manage their multi-organ failure and then watch them die a miserable death alone in the hospital, it does make you have a little fear and respect for the fragility of life. I can’t say that I have felt that way in the past about viral illnesses in adults. It’s tough to definitely always say what constitutes an over or under reaction as it depends on the specifics. I’m not going to comment on the media’s influence on fear and panic as I don’t want this comment to come across as particularly political/partisan. We all have different concerns and comfort levels depending upon our individual risk factors and risk tolerance. I think we as society have really been wrestling with what is the most appropriate reaction. I also appreciate seeing other’s views even if I don’t always agree. There does come a point though where over communicating a message takes away from its persuasion and leads to listeners tuning out over time. This might be happening in this thread and also with the 24 hour news cycle. We need to pay intention, stay informed and critically analyze the data, but when we try too hard to persuade others to absolutely agree with our way of thinking we start putting up walls. Not specifically addressing these thoughts to the comments I quoted, but more in general to everyone. The intense polarization that has developed globally over the last decade is also playing out in our response to this virus. I think most of us agree on a lot more than we disagree, but we still are not very united in how we have been tackling this pandemic. I don’t have the solution and certainly wish I did. I’m a cog in the pit. I like to try to have a 10,000 foot high view though so I don’t get lost in the grind. My apologies if this is too philosophical. We all have too much time on our hands with everything being locked down ;)
 
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Birdstrike

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So ... AZ ... it’s not just that deaths lag hospitalizations lag cases - they also lag *reporting*.

The infrastructure is geared to set us up the bomb.

I don't see any matching of case curves to death curves. And where are the other states? You said sun belt "states."

Maybe you were replying to someone else on a different question, I don't know.
...Sun belt states look like their deaths are starting to curve upwards to match their cases...
 
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Let me make this simple for y'all.

Against lock-down: Those who stop getting paid during lock-downs.
Pro lock-down: Those who continue to get paid to work during lock-downs.
Strongly pro lock-down: Those who get paid to stay home during lock-downs.
Man, doesn't it make life so much easier to just box everyone into either 2-3 camps? You're either s strong brave independently thinking individual (who is probably stunningly good looking) or you're a cowardly "panic porn" craving dirtbag who wants to get paid to sit on their literal a$$.;)

Maybe lay down that broad brush my man. It's that mentality which leads to the level of divisiveness we've got these days.

My wife and I both teach on the side and we would kill to be back instructing in person. As would a large number of our colleagues.
 

Birdstrike

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Anyone work in Texas or heard of Complete Care free standing EDs?

Here’s an email from their Managing Partner, John Braxton Neiman, to reporter Alex Berenson ( ‪@AlexBerenson‬ on Twitter) about what he sees going on in Texas, with COVID. He says the reality may be very different than what you’re seeing and reading. I don't know if he's right or not. You decide. It's worth reading until the end.





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southerndoc

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Last week I went several shifts without seeing a single COVID patient. Sunday night I saw 3 or 4 positive tests (rapid tests) and another 3-4 that were possible cases pending testing. Last night, I saw at least 7 patients with positive rapid tests and another 4-5 that were likely.

Cases are starting to rise rapidly in my area... not looking forward to the second wave. This one is more steep than the first.
 

Birdstrike

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Last week I went several shifts without seeing a single COVID patient. Sunday night I saw 3 or 4 positive tests (rapid tests) and another 3-4 that were possible cases pending testing. Last night, I saw at least 7 patients with positive rapid tests and another 4-5 that were likely.
Of the confirmed positives, what were the ages, acuity levels and DNR status?
 

Mr. Hat

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Anyone work in Texas or heard of Complete Care free standing EDs?

Here’s an email from their Managing Partner, John Braxton Neiman, to reporter Alex Berenson ( ‪@AlexBerenson‬ on Twitter) about what he sees going on in Texas, with COVID. He says the reality may be very different than what you’re seeing and reading. I don't know if he's right or not. You decide. It's worth reading until the end.





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This guy needs to be de-platformed, doxed, fired, imprisoned, and possibly even executed.
 
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Siggy

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Man, doesn't it make life so much easier to just box everyone into either 2-3 camps? You're either s strong brave independently thinking individual (who is probably stunningly good looking) or you're a cowardly "panic porn" craving dirtbag who wants to get paid to sit on their literal a$$.;)

Maybe lay down that broad brush my man. It's that mentality which leads to the level of divisiveness we've got these days.

My wife and I both teach on the side and we would kill to be back instructing in person. As would a large number of our colleagues.
That's basically his view. Best thing that happened was when he reminded me that I could simply mute him and then I wouldn't have to constantly refute his points.

Every once in a while I'll look at his posts and it reaffirms that I did the right thing... like when he's posting length of stay information from an urgent care doc who is treating mild COVID with steroids. It reminds me of those 2 EM docs from California who complained that the lock down was ruining their free standing ED.

 
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Anyone work in Texas or heard of Complete Care free standing EDs?

Here’s an email from their Managing Partner, John Braxton Neiman, to reporter Alex Berenson ( ‪@AlexBerenson‬ on Twitter) about what he sees going on in Texas, with COVID. He says the reality may be very different than what you’re seeing and reading. I don't know if he's right or not. You decide. It's worth reading until the end.
I mean, other than what he's saying has showed up to his own FSED/UC everything is hearsay.

Hopefully he's right and everyone is a liar and things aren't that bad! Regardless of your views on a significant portion of the population I think the vast majority of folks would like to see people not dying from this.
 

Birdstrike

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I mean, other than what he's saying has showed up to his own FSED/UC everything is hearsay.
It's a credible named source, going on record for a reporter. How is that "hearsay," but when other reporters report information from a source it's "news"?
 

Mr. Hat

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Who me? If so, I need to know, because I'll have to endorse Joe Biden for my own safety.
Well I meant the Texas ED guy who dared question the severity of the second wave. But you know, since you posted it....
 
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Birdstrike

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Hopefully he's right and everyone is a liar and things aren't that bad!
I didn't read anywhere in his email saying, "Everyone is a liar." I interpreted what he was saying as simply giving his perspective on what he's seeing as a source to a reporter, like any other source that tells a report about something he saw that happened.

I think the vast majority of folks would like to see people not dying from this.
Then how come they get mad when someone posts raw data, not their opinion but raw data, showing less Americans have been dying from it every week for the past 10 weeks?
 

bravotwozero

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So, something went down between a mysterious meeting of all the hospital CEOs from the Texas Medical Center, and the governor, Greg Abbott. An article written in the Houston chronicle mentioned that Abbott, reportedly was not happy about hospital CEOs saying that their icus are filling up with COVID patients. In response, he also stated the he is going to shut down elective procedures, to keep more beds open. It did have a loophole though, which was 'if hospitals don't have enough capacity???' And man, the hospital ceos cling to that loophole for dear life, to maintain their cash cow. We started getting emails from Hospital brass about how statements were 'misinterpreted', that the hospital capacity is the same now as it was back in December, etc that what they really meant was that if we don't change our behavior now, then we will run out of capacity, etc.

Even more suspicious was the fact that the Texas Medical Center Website on COVID statistics wasn't updated for a few days, and they had a message on the website saying that some of the slides were 'inaccurate' and needed to be edited.

Almost as if there was some backroom power play between the Governor and the hospital executives. 'You want to shut things down, ok I'll cancel elective surgeries'. 'Noooo don't do that!'
 

Birdstrike

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So, something went down between a mysterious meeting of all the hospital CEOs from the Texas Medical Center, and the governor, Greg Abbott. An article written in the Houston chronicle mentioned that Abbott, reportedly was not happy about hospital CEOs saying that their icus are filling up with COVID patients. In response, he also stated the he is going to shut down elective procedures, to keep more beds open. It did have a loophole though, which was 'if hospitals don't have enough capacity???' And man, the hospital ceos cling to that loophole for dear life, to maintain their cash cow. We started getting emails from Hospital brass about how statements were 'misinterpreted', that the hospital capacity is the same now as it was back in December, etc that what they really meant was that if we don't change our behavior now, then we will run out of capacity, etc.

Even more suspicious was the fact that the Texas Medical Center Website on COVID statistics wasn't updated for a few days, and they had a message on the website saying that some of the slides were 'inaccurate' and needed to be edited.

Almost as if there was some backroom power play between the Governor and the hospital executives. 'You want to shut things down, ok I'll cancel elective surgeries'. 'Noooo don't do that!'
Let me make sure I follow. You’re saying the hospitals were allegedly inflating ICU numbers and when threatened with a possible forced shutdown of elective surgeries by the Governor, to open up beds, they then changed the numbers?
 

bravotwozero

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Let me make sure I follow. You’re saying the hospitals were allegedly inflating ICU numbers and when threatened with a possible forced shutdown of elective surgeries by the Governor, to open up beds, they then changed the numbers?
Honestly, I don't know what to make of it. ICU beds have been reaching capacity in the houston area, most of it isn't covid, but a sizable number. I know we've had ICU patients board in our ED for a while. But then not reporting the numbers, and backtracking on prior statements raises suspicions..
 
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GeneralVeers

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Honestly, I don't know what to make of it. ICU beds have been reaching capacity in the houston area, most of it isn't covid, but a sizable number. I know we've had ICU patients board in our ED for a while. But then not reporting the numbers, and backtracking on prior statements raises suspicions..
If it's not all COVID, is part of the increase explained by people with decompensated illness who put couldn't see a doctor or get elective procedures for almost two months in TX? Would be interesting to see percentage of ICU taken up by COVID patients.
 

Birdstrike

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Honestly, I don't know what to make of it. ICU beds have been reaching capacity in the houston area, most of it isn't covid, but a sizable number. I know we've had ICU patients board in our ED for a while. But then not reporting the numbers, and backtracking on prior statements raises suspicions..
Oh, so you think they might actually be reducing the ICU numbers, to avoid a shutdown?
 
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