live and let die?

[Zarniwoop]

Any country declaring victory at this point is a having a George Bush "Mission Accomplished" moment. The ballgame is only in the first inning. If the UK and USA had done a better job with long term care facilities, numbers would look a lot better. An older lady at work lost both of her parents in a nursing home to Covid.

Instead, we are more worried about NBA players and athletes getting tests each day. Too bad we weren't this vigilant with workers and residents in high risk facilities.

The employees at high risk facilities like nursing homes are often restricted by their employers (nursing home employers are notoriously cheap) from working full time to cut costs on benefits, etc. As a result, these people typically have second jobs to make ends meet. In the process, they have that many more opportunities to contract COVID and bring it into the nursing home and wreak havoc.

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[Allegri]

I probably suffer from a degree of TDS and am the last to defend the guy, but that NEJM editorial was irritating in the way it holds up China and New Zealand as meaningful comparisons to the US. If they're going to decide to take the extraordinary step of doing a political piece, do a better job of it.

 

[WEBB PINKERTON]

I probably suffer from a degree of TDS and am the last to defend the guy, but that NEJM editorial was irritating in the way it holds up China and New Zealand as meaningful comparisons to the US. If they're going to decide to take the extraordinary step of doing a political piece, do a better job of it.

No doubt. Meanwhile, they offered no details for what should have been done. Just more USA hatin. I'm over these stupid liberals. Go to another country if you so miserable. Apparently New Zealand will take you.

I am still very skeptical of the data. How many are dying of the virus vs dying with the virus?

I know my friend's wife was not counted in the Chinese stats even though she likely had the virus.

 

[Med Director New England]

I would argue that this was not partisan. What was the federal plan? What was the federal response? That's right- no plan, no response. Obscuring reality to fit a political goal hoping reality would not set in was the only plan I saw.
The buck was passed to the states, without means or expertise, and no coordination.
Not sure where you see we did better than western Europe excluding NYC... we had our worst day in terms of infections... yesterday. Most states are currently still heading in the wrong direction.

Are we reading the same editorial!? This is as partisan as it gets. Why do you think CNN has highlighted this (multiple times) as an endorsement of the Biden ticket by the general medical community.

 

[bosco77]

TDS is real.

Trump is currently in a state of dexamethasone induced-mania, that is the real TDS.

This is clearly a scared, sick old man who knows prison awaits him if he relinquishes power.
Hopefully we make it through the next few months without him burning it all down.

 

[gbwillner]

But wait- there's more:

'It is a slaughter': Public health champion asks CDC director to expose White House, orchestrate his own firing

A public health titan wrote a private letter to CDC Director Robert Redfield asking him to expose interference in the COVID-19 response and leave his post.

www.usatoday.com

 

[Vicinal]

Trump is currently in a state of dexamethasone induced-mania, that is the real TDS.

This is clearly a scared, sick old man who knows prison awaits him if he relinquishes power.
Hopefully we make it through the next few months without him burning it all down.

Yes unlike Pelosi, an 80 year old narcissist that has made millions as a career politician and Biden 80 year old empty vessel. These are the ones that are willing to burn it all down to hold power with the help of an unelected entity (media: social and otherwise). This is epic Theranos type gaslighting. They must have the same lawyers and consultants.

 

[Vicinal]

Are we reading the same editorial!? This is as partisan as it gets. Why do you think CNN has highlighted this (multiple times) as an endorsement of the Biden ticket by the general medical community.

CNNs monicker should become CCP.

 

[Thr0mbus]

Yes unlike Pelosi, an 80 year old narcissist that has made millions as a career politician and Biden 80 year old empty vessel. These are the ones that are willing to burn it all down to hold power with the help of an unelected entity (media: social and otherwise). This is epic Theranos type gaslighting. They must have the same lawyers and consultants.

Dementia Joe resigned from the 1988 election in disgrace caught red handed for plagiarism. Yet here he is again. Probably doesn’t even remember what he did.

 

[Vicinal]

Dementia Joe resigned from the 1988 election in disgrace caught red handed for plagiarism. Yet here he is again. Probably doesn’t even remember what he did.

If they lose the Democratic Party will have to split because you can’t put a moderate mask on an entity that has its face shoved against the far left wall. Frame shift mutation. In my day liberals fought for freedom of speech, due process of the law, and a quest for truth. This is a whole other manipulative monster. This new entity is not liberals but reinvented Jacobins that may unintentionally kill the goose that laid the golden egg for one deranged meal of revelry.

 

[Vicinal]

‘Worst in the state’: S.F. sales tax data show likely population decline

Sales tax data show San Francisco’s population probably declined during the coronavirus...

www.sfchronicle.com

 

[Vicinal]

New York and San Francisco Can’t Assume They’ll Bounce Back

America’s big cities were beginning to struggle even before the pandemic led some residents to flee.

www.bloomberg.com

 

[gbwillner]

Wtf has happened to this thread? I thought we were talking about the Coronavirus and the government response to it.

 

[Vicinal]

Better than expected in a constitutional democracy during an insanely partisan time. I am impressed that we didn’t go monolithic and there was a spectrum of responses between states. Would have hated to see federal troops going door to door enforcing masks and using cell phone IMEI numbers to track people and then handing out immunity cards or some bs dystopian vision.

 

[esob]

This is a friendly reminder to please keep the discussion on-track and civil. There have been several reports about this thread in the past 24 hrs.

 

[WEBB PINKERTON]

Wtf has happened to this thread? I thought we were talking about the Coronavirus and the government response to it.

Says the dude who throws a few partisan punches and stands back. LOL.

I think at this point, the strategy is herd immunity. They will claim it isn't but what else would it be?

 

[WEBB PINKERTON]

This is a friendly reminder to please keep the discussion on-track and civil. There have been several reports about this thread in the past 24 hrs.

Several reports? Tell em to get an emotional support animal. Maybe I should post videos here of me neutering and slaughtering animals on the farm. That would toughen em up.

 

[Med Director New England]

Agree ^^ maybe straying a bit off topic like many threads do, but certainly civil.

 

[gbwillner]

Yet another liberal hit piece by the socialist mouthpiece, the Wall Street Journal, describing how the CDC was hamstrung by White House interference and meddling, in addition to its own mistakes.

A Demoralized CDC Grapples With White House Meddling and Its Own Mistakes

Trump advisers made line-by-line edits to official health guidance, altering language written by scientists on church choirs and social distancing.

www.wsj.com

 

[Vicinal]

“Clowns to the left of me,
Jokers to the right, here I am,
Stuck in the middle with you”

 

[LADoc00]

This is a friendly reminder to please keep the discussion on-track and civil. There have been several reports about this thread in the past 24 hrs.

Im being 100% serious: what are the "several reports" exactly saying?

Im curious. Im always very weary of silencing discourse even when I disagree with it.

Dont need to call out who is reporting who, but perhaps some redacted HIPAA compliant snippets? Would be fascinating to dive into this.

 

[esob]

Im being 100% serious: what are the "several reports" exactly saying?

Im curious. Im always very weary of silencing discourse even when I disagree with it.

Dont need to call out who is reporting who, but perhaps some redacted HIPAA compliant snippets? Would be fascinating to dive into this.

We don't spell out the content for obvious reasons and normally we would let your mod handle this but they haven't been around for a couple of weeks, so I get to handle the pushback. I honestly loathe moderating the physician forums anyway given the free-for-all nature of subforum culture, so, if y'all want to have at one another, you won't get any further flack from me.

 

[LADoc00]

We don't spell out the content for obvious reasons and normally we would let your mod handle this but they haven't been around for a couple of weeks, so I get to handle the pushback. I honestly loathe moderating the physician forums anyway given the free-for-all nature of subforum culture, so, if y'all want to have at one another, you won't get any further flack from me.

Fascinating, which are more civil subforums? Vet students? Folks we may have a potential American Journal of Psychiatry article on our hands here.

Im thinking "The psychopathology of physician engagement on social media and its impact on medicine and health outcomes." Or something similar erudite and impactful.

 

[esob]

Fascinating, which are more civil subforums? Vet students? Folks we may have a potential American Journal of Psychiatry article on our hands here.

Im thinking "The psychopathology of physician engagement on social media and its impact on medicine and health outcomes." Or something similar erudite and impactful.

It's an interesting question, actually. Off the top of my head, of the high volume forums, the one's with the least reports are probably the non-trad premed forums. To be fair, y'all pathologists are pretty docile compared to some of the other physician subforums, lol. Anesthesia and EM are no man's land. I once saw a neuro resident wander into EM and, well....it wasn't pretty

The truth is, however, it really depends on your forum mod, which is why most of us steer clear of the physician forums. You'll have to consult yaah to find out what crosses the line.

 

[LADoc00]

Interesting. It appears we need step up our game. I would have guessed Anesth and EM would be salty and likely general surgery.

Has anyone interacted with a premed recently?? Its crazy, they are in this mystical magical world of their own imagination. I forgot what they were like until recently when my mom repeatedly asked if I could help a young premed with some course planning and when I showed up:

Clueless would be an upgrade for these folks. I sat at a coffee shop at my alma mater staring in total amazement at this premed telling me she was going to save the world (and go to Harvard on the way).

They are so lost in idealism and romanticizing a career in healthcare, its like they are on an incredibly powerful and long acting hallucinogen.

 

[y2k_free_radical]

Wtf has happened to this thread? I thought we were talking about the Coronavirus and the government response to it.

What hubris.Your posts had no political overtones ??????????????????????

 

[WEBB PINKERTON]

Interesting. It appears we need step up our game. I would have guessed Anesth and EM would be salty and likely general surgery.

Has anyone interacted with a premed recently?? Its crazy, they are in this mystical magical world of their own imagination. I forgot what they were like until recently when my mom repeatedly asked if I could help a young premed with some course planning and when I showed up:
View attachment 320601
Clueless would be an upgrade for these folks. I sat at a coffee shop at my alma mater staring in total amazement at this premed telling me she was going to save the world (and go to Harvard on the way).

They are so lost in idealism and romanticizing a career in healthcare, its like they are on an incredibly powerful and long acting hallucinogen.

I miss those days. Ignorance is bliss!

 

[gbwillner]

It's an interesting question, actually. Off the top of my head, of the high volume forums, the one's with the least reports are probably the non-trad premed forums. To be fair, y'all pathologists are pretty docile compared to some of the other physician subforums, lol. Anesthesia and EM are no man's land. I once saw a neuro resident wander into EM and, well....it wasn't pretty

The truth is, however, it really depends on your forum mod, which is why most of us steer clear of the physician forums. You'll have to consult yaah to find out what crosses the line.

Dude, this is just you getting old and crotchety... soon you'll be yelling at clouds like thrombus.

All new med students are like this. They always have been. You were probably like this too.

I remember MS1 a poll of my class showed ~95% of my class at a top institution was going to go into primary care. Looking at match rates MS4 it was like 15%.

 

[pathslides]

I remember MS1 a poll of my class showed ~95% of my class at a top institution was going to go into primary care. Looking at match rates MS4 it was like 15%.

Primary care blows. I remember during med school interviews, you just tell them all you want to do primary care because that’s what they want to hear. Anytime I feel overworked or tired, I just imagine doing primary care for 1 week, and I instantly appreciate my job and salary so much more.

 

[Thr0mbus]

I would need to see a shrink for the rest of my life if I did Primary Babysitting. TRAUMATIC!!

 

[LADoc00]

Sigh...you guys dont play enough 3D Chess to see nearly every sub-specialty of medicine CAN be extremely lucrative. Some require more TLC to build wealth, but if I went into primary care I can guarantee I wouldnt that much worse off than I am now.

I know broke plastic surgeons, CT surgeons who are leveraged to the hit with zero savings, orthopods riding bicycles to work to save money and I know pediatricians who are worth 10 million+.

Never tell me the odds.

 

[KeratinPearls]

Sigh...you guys dont play enough 3D Chess to see nearly every sub-specialty of medicine CAN be extremely lucrative. Some require more TLC to build wealth, but if I went into primary care I can guarantee I wouldnt that much worse off than I am now.

I know broke plastic surgeons, CT surgeons who are leveraged to the hit with zero savings, orthopods riding bicycles to work to save money and I know pediatricians who are worth 10 million+.

Never tell me the odds.

Some people love to spend money or fool around and get divorced or have kids from different wives. That’s why they are broke.

 

[LADoc00]

Im starting to feel like society at large now views healthcare as something they own, like we are all slaves manning oars on a giant ship they can dictate the course and speed for.

Doctors are now getting the police treatment, despised, vilified yet demanded to perform like circus animals until we collapse. How long til we hear the chorus "Defund the Doctors!" or are we already at this point??

 

[octopusprime]

Im starting to feel like society at large now views healthcare as something they own, like we are all slaves manning oars on a giant ship they can dictate the course and speed for.

Doctors are now getting the police treatment, despised, vilified yet demanded to perform like circus animals until we collapse. How long til we hear the chorus "Defund the Doctors!" or are we already at this point??

Starting to feel this way?? We're well past that point. The "medicare for all" chants have been getting louder every year for a long time. I feel next in line on Steve Buscemi's list.

Combined with CMS's "budget neutrality" that robs Peter to pay Paul (Peter is a radiologist/pathologist/surgeon/et al specialist, Paul is an E&M-coding primary care doc), I only see my income increasingly whittled away until the cuts & inflation & private insurance rate leveling prompt me to venture back into the military version of indentured servitude in the hopes there is an opening in an a half-way decent duty station (like not Bragg or Ft. Sam)....or maybe the VA.

 

[Vicinal]

“Press the Meet”. Jeffrey Toobin’s new show on CNN

 

[deleted941485]

Im starting to feel like society at large now views healthcare as something they own, like we are all slaves manning oars on a giant ship they can dictate the course and speed for.

Doctors are now getting the police treatment, despised, vilified yet demanded to perform like circus animals until we collapse. How long til we hear the chorus "Defund the Doctors!" or are we already at this point??

We are ahead of the police Dept as we have been steadily defunded for years now. But doctors will continue to show up for work and honestly they don’t have many options. Unless they are willing to walk away and let people suffer nothing will change.

 

[Zarniwoop]

Sigh...you guys dont play enough 3D Chess to see nearly every sub-specialty of medicine CAN be extremely lucrative. Some require more TLC to build wealth, but if I went into primary care I can guarantee I wouldnt that much worse off than I am now.

I know broke plastic surgeons, CT surgeons who are leveraged to the hit with zero savings, orthopods riding bicycles to work to save money and I know pediatricians who are worth 10 million+.

Never tell me the odds.

Seeing orthopods dumpster diving in trailer parks is primary care's schadenfreude - like seeing a former TV child star punching a time card at Walmart.

I do believe that LA could turn anything into diamonds - but I also think that this attitude is undeservedly shared by most pathologists in private practice who are financially successful. A few made it happen like LA, but most benefited by luck and timing.

 

[WEBB PINKERTON]

What makes me mad is that we have been helping primary care docs make money through client billing schemes for years. We do our part to help augment their income so they shouldn't be cutting us. We are getting hit twice.

 

[Zarniwoop]

What makes me mad is that we have been helping primary care docs make money through client billing schemes for years. We do our part to help augment their income so they shouldn't be cutting us. We are getting hit twice.

No good deed goes unpunished?

 

[WEBB PINKERTON]

We get screwed from all sides....Throw us a freaking bone and outlaw ALL forms of client billing and other inducements if you want to take 10 percent from us. We are already augmenting family doc salaries. FLEE PATHOLOGY NOW!!

 

[KeratinPearls]

We get screwed from all sides....Throw us a freaking bone and outlaw ALL forms of client billing and other inducements if you want to take 10 percent from us. We are already augmenting family doc salaries. FLEE PATHOLOGY NOW!!

Webb=Thombus=Thr0mbus=MagIcMan72?

 

[Vicinal]

No Standard Cycle Threshold Value!!!!!!!

Cycle Threshold Value Missing in CCP Virus Case Numbers: Experts

www.theepochtimes.com

Conservative publication but important consideration. Been asking about this all along.... how do you come up with the Ct value in different platforms? The manufacturer sets it is the answer I get. But how does it correlate to viral load and infectivity? I ask..... Crickets

 

[Lawpy]

The failure to appreciate the potential economic price of the short and longterm morbidity of this disease is incredibly shortsighted. Sure the immediate economic pain of shutdowns are real and excruciating, but the morbidity costs secondary to a large number infected due to letting this spread largely unchecked would likely be far more devastating. Just in a more drawn out and subtle way. Healthcare costs, productivity costs due to workers out weeks maybe months, loss or out of commission critical and hard to replace healthcare workers and downstream effects of that and so on.

The disorganized shutdowns could've been easily prevented. What should've been done was fast, immediate targeted lockdowns at high risk/highly infectious areas with covid centers rapidly built to help prevent hospitals from being swamped. Then provide these lockdown regions with basic incomes and heavy stimulus benefits to avoid economic collapse.

Somehow many governments worldwide messed up on all regards.

 

[Vicinal]

The disorganized shutdowns could've been easily prevented. What should've been done was fast, immediate targeted lockdowns at high risk/highly infectious areas with covid centers rapidly built to help prevent hospitals from being swamped. Then provide these lockdown regions with basic incomes and heavy stimulus benefits to avoid economic collapse.

Somehow many governments worldwide messed up on all regards.

The opposite of what the governors of NY and NJ did

 

[bauber]

The opposite of what the governors of NY and NJ did

Well their fractured, non-uniform response was a direct result of little to no coordination or instruction from the federal level. You could even make an argument that the feds actively hampered state responses to the initial outbreak - hoarding supplies and eliciting bidding wars between states. There should have been a centralized, firm, top down response but instead we got a fractured mess with lots of denial and obfuscation from the feds.

We heard a lot about the defense production act but there are still shoratages of PPE across the country.

 

[Vicinal]

Well their fractured, non-uniform response was a direct result of little to no coordination or instruction from the federal level. You could even make an argument that the feds actively hampered state responses to the initial outbreak - hoarding supplies and eliciting bidding wars between states. There should have been a centralized, firm, top down response but instead we got a fractured mess with lots of denial and obfuscation from the feds.

We heard a lot about the defense production act but there are still shoratages of PPE across the country.

Sorry I disagree big time. Both states were run by incompetent partisan local governments. Federal govt is not the parent to come in and manage incompetence at the local level. DeBlasio never shut down public transport and Cuomo et al has been riding his fathers coat tails but he fell far away from the tree. NYC has been through 9/11 and has managed local major disaster so it should have learned something. The local hospitals in Queens and other sites and many local schools are run like crap and are fading fast. It is easy to blame to feds and the confused white coat incompetent CDC and FDA and the executive branch. But this has been a purely partisan hack job and locally elected government would rather be woke with their mouthpieces in CNN than to care about their constituents. They had plenty of PPE and help but hoarded and acted like unvirtous partisan hacks. Not that the other side did things perfectly by any stretch but we are not a monolithic system with top down nanny state like control. Some people would like that but it’s not how our nation works. Just look at how well the EU worked. Barely lasted 20 years before Brexit. They were lucky because the US had historically clothed, fed, and protected them since WW2. No one knows including the purported scientists what is really going on with COVID in terms of true epidemiological data. It’s a **** show and comedic that one side is supposedly listening to science. What a farce.

 

[octopusprime]

One side is listening to science with regard to mask wearing: any kind of vapor barrier that will limit the expulsion (via nose or mouth) of droplets containing viral particles will limit the likelihood of infection. This has been fairly extensively studied (plenty of recent studies on air travel with infected patients), and is the basis for surgeons wearing masks in the OR. It doesn't definitively protect the wearer, but when adopted by a large group of people the risk of transmission is greatly reduced. The anti-mask crowd is just as hysterically ignorant as the anti-vax crowd, and they'll let you know it too. I and other family members have been accosted on several occasions by people claiming knowledge that the whole thing is a joke or plot or fake. It's just amazing. And I am a dyed-in-the-wool Edmond Burkian conservative (that's read 'conservative', not 'Republican', not 'GOP', definitely not 'Trump supporter).

I think the statistics are still off for mortality--all our stats on mortality for other viruses, say influenza, include statistically theorized asymptomatic caseloads, statistically theorized numbers of patients that did not seek care, etc. Most of the COVID stats are just raw data comprised of positive & negative tests and deaths. People claim large numbers of asymptomatic or subclinical undocumented, but they haven't been factored into the current stats.

And you always have to consider the varying degree of experience people have, because people do experience vastly different symptoms. Yes, odds are in your favor like any other illness, but until you have a friend, family member or colleague die after an extensive battle in the ICU, there's a good chance you won't take it as seriously as someone that has.

 

[gbwillner]

No Standard Cycle Threshold Value!!!!!!!

Cycle Threshold Value Missing in CCP Virus Case Numbers: Experts

www.theepochtimes.com

Conservative publication but important consideration. Been asking about this all along.... how do you come up with the Ct value in different platforms? The manufacturer sets it is the answer I get. But how does it correlate to viral load and infectivity? I ask..... Crickets

You do it by establishing analytical validity and clinical validity of the test. You only need to establish the clinical validity on one platform, then the analytical validity can be determined in multiple platforms by measuring ct via the same validation set of samples.

 

[Vicinal]

You do it by establishing analytical validity and clinical validity of the test. You only need to establish the clinical validity on one platform, then the analytical validity can be determined in multiple platforms by measuring ct via the same validation set of samples.

What is the clinically valid Ct?

 

[Dave CX]

Sigh...you guys dont play enough 3D Chess to see nearly every sub-specialty of medicine CAN be extremely lucrative. Some require more TLC to build wealth, but if I went into primary care I can guarantee I wouldnt that much worse off than I am now.

I know broke plastic surgeons, CT surgeons who are leveraged to the hit with zero savings, orthopods riding bicycles to work to save money and I know pediatricians who are worth 10 million+.

Never tell me the odds.

This is correct. A bit of creativity, chance taking and luck makes a difference. I make twice now what I did in my hospital private practice since I starting working in office GI