procedures

[Ducttape]

the Chinese government really effed up at least by hiding and downplaying the pandemic. not Dr. Li Wenliang...


but, much as he likes to think so, this does not obviate trump and his lack of response, particularly since multiple US intelligence sources were telling him that China was hiding information.

he needs to learn to believe American sources first over the specious statements by dictators.

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[pmrmd]

but, much as he likes to think so, this does not obviate trump and his lack of response, particularly since multiple US intelligence sources were telling him that China was hiding information.

he needs to learn to believe American sources first over the specious statements by dictators.

He should have been listening to Fauci who was saying as of February 29 we should not change our daily habits.

He should have listened to Biden and the Democrats and NEVER instituted that racist travel ban. He should have had a Support China rally instead.

He should have gone all dictator-like and revoked any and all authority of the CDC and FDA when it came to instituting safe testing for the U.S. No, he should not have listened to those American sources and leaders at all.

He should have revoked all civil liberties and ignored the Constitution and dictated behaviors in all the states.

 

[Agast]

Maybe I watch too much scifi but I would expect a manufactured virus to be a little more devastating. Like Ebola-level gross. An inconvenient flu that mostly kills old people is not exactly moustache-twirling.

 

[pmrmd]

It wasn't manufactured just grossly and incompetently mishandled.

 

[lonelobo]

Think he should just follow advice of the most respected doctors.....like Dr. Phil, Dr. Oz, Dr. J

 

[Laryngospasm]

Maybe I watch too much scifi but I would expect a manufactured virus to be a little more devastating. Like Ebola-level gross. An inconvenient flu that mostly kills old people is not exactly moustache-twirling.

The most virulent viruses are the ones that are the easiest to contain. Picture a virus that spreads quickly and kills everyone within 1 minute. This virus is precisely so devastating because the number of people who are asymptomatic, the long incubation period during which transmission is possible and the complete lack of immune resistance. As a microbiologist if you wanted to cause economic devastation this virus is almost perfect.

 

[Ducttape]

nice try playing devils advocate.

He should have been listening to Fauci who was saying as of February 29 we should not change our daily habits.

He should have listened to Biden and the Democrats and NEVER instituted that racist travel ban. He should have had a Support China rally instead.

He should have gone all dictator-like and revoked any and all authority of the CDC and FDA when it came to instituting safe testing for the U.S. No, he should not have listened to those American sources and leaders at all.

He should have revoked all civil liberties and ignored the Constitution and dictated behaviors in all the states.

I agree he has changed some of his statements on the travel ban.

but listen to his original statements in Feb 26. by the time trump put in the travel ban, he originally stated it was too late.

he should have recommended they put in a travel ban from everywhere back on Feb 26, especially Europe.




as to your last point, he is considering closing Congress... so not far from the truth.

 

[hyperalgesia]

Maybe I watch too much scifi but I would expect a manufactured virus to be a little more devastating. Like Ebola-level gross. An inconvenient flu that mostly kills old people is not exactly moustache-twirling.

And indiscriminately kills your own population as well. Great weapon guys.

 

[Piebaldi]

so, im thinking that we will start doing our shots pretty soon. i can reasonably tell a patient that they need to wait several weeks for an ESI or RF. i cant reasonably tell them they need to wait months and months with no end in sight. at some point, these "maintenance injections" do become a medical necessity. i am in a pretty hard hit state, but i think that by early-ish May, the shots will start to resume in earnest.....

that's what our state has said too - mid may is the target date to resume procedures

 

[Laryngospasm]

More and more data pointing to the virus coming from a lab..

 

[PAINISGOOD]

Texas just announced may go back to doing procedures (outpatient) if medically necessary on 4/22/2020.

 

[Piebaldi]

Texas just announced may go back to doing procedures (outpatient) if medically necessary on 4/22/2020.

Yep Tx is also planning on slowly opening businesses over the next week. Go Tx!

 

[BobBarker]

Will be able to go 4/24.

 

[10KHertz]

Orange man will not let China skate. Puff up his chest and take us to brink of WWIII.

I think China already caused a WWIII death count with this pandemic ...

 

[hyperalgesia]

If we don't see a spike in cases, I would attribute it to seasonal slowdown of the virus. In other words, luck.

I think the "curves" that we look at are mostly representations of lock down. The natural curve would resolve only with herd immunity.

 

[10KHertz]

If we don't see a spike in cases, I would attribute it to seasonal slowdown of the virus. In other words, luck.

I think the "curves" that we look at are mostly representations of lock down. The natural curve would resolve only with herd immunity.

Some recent articles question whether herd immunity is truly achievable, and that antibody formation only protects for a month or less. WHO unsure antibodies protect against COVID, little sign of herd immunity

 

[hyperalgesia]

Some recent articles question whether herd immunity is truly achievable, and that antibody formation only protects for a month or less. WHO unsure antibodies protect against COVID, little sign of herd immunity

I reject this utterly, based on my education and understanding of virology and the immune system. To me, it's the fog of war, the "enemy can walk through walls", "The enemy is invisible", etc.

Where is their evidence to make such an assertion?

 

[10KHertz]

I reject this utterly, based on my education and understanding of virology and the immune system. To me, it's the fog of war, the "enemy can walk through walls", "The enemy is invisible", etc.

Where is their evidence to make such an assertion?

You are preaching to the choir... I was hoping herd immunity was the initial answer(so did the Sweds). However, Sounds like one is only protected for 6-8weeks, maybe. WHO and some US/Australia labs are claiming this limited protection.
You ever get H Flu twice in a year?

 

[Jcm800]

i think the frustrating thing is, those that are trying to do the right thing, be as safe as possible for themselves and the community, are at a significant financial risk, compared to those who dont care and keep doing procedures etc, despite the recommendations, or THEIR interpretations of the recommendations. It just erases all of the intention and sacrifice by those doing the right thing. And it is all financially driven. some just dont care, and can justify everything. its a tough balance. nobody WANTS to be shut down... but this partial shutdown of half following the rules and the other half dismissing it, is what is so frustrating, and in the long term will be quite detrimental. and likely, delay a "full" opening...

 

[VA Hopeful Dr]

I reject this utterly, based on my education and understanding of virology and the immune system. To me, it's the fog of war, the "enemy can walk through walls", "The enemy is invisible", etc.

Where is their evidence to make such an assertion?

RSV is like that, so it can happen

 

[Ducttape]

I reject this utterly, based on my education and understanding of virology and the immune system. To me, it's the fog of war, the "enemy can walk through walls", "The enemy is invisible", etc.

Where is their evidence to make such an assertion?

but isn't it also true that we can get the seasonal flu yearly? there is a limit to our immune system, otherwise we wouldn't have to get the flu shot yearly (yea yea I know antigenic shifts, but still... if I got H1N1 once, I'm not immune the rest of my life...) nor could we get the flu more than once or twice our lifetimes...

 

[clubdeac]

but isn't it also true that we can get the seasonal flu yearly? there is a limit to our immune system, otherwise we wouldn't have to get the flu shot yearly (yea yea I know antigenic shifts, but still... if I got H1N1 once, I'm not immune the rest of my life...) nor could we get the flu more than once or twice our lifetimes...

The reason we get the flu shot annually is bc it mutates so quickly. That hasn’t been the case thus far with covid 19

 

[Ducttape]

see my comment about antigenic shifts.


the point is that while there are yearly variations of mutations, but you are getting yearly vaccines of the most common mutations. your immunity from the previous years vaccine or exposure does not give you lifelong immunity.

 

[DOctorJay]

For those of you doing procedures right now on urgent outpatients.

Are you wearing N95 masks or any other protective gear that you wouldn’t typically wear? Gowns, face shields, etc?


Sent from my iPhone using SDN

 

[drusso]

For those of you doing procedures right now on urgent outpatients.

Are you wearing N95 masks or any other protective gear that you wouldn’t typically wear? Gowns, face shields, etc?


Sent from my iPhone using SDN

N95, surgical mask, and face shield.

 

[vadim1980]

For those of you doing procedures right now on urgent outpatients.

Are you wearing N95 masks or any other protective gear that you wouldn’t typically wear? Gowns

Mask for me and if patient doesn’t come with a mask then we provide one for them

Sent from my iPhone using SDN

 

[SommeRiver]

Regular sterile precautions

 

[hyperalgesia]

see my comment about antigenic shifts.


the point is that while there are yearly variations of mutations, but you are getting yearly vaccines of the most common mutations. your immunity from the previous years vaccine or exposure does not give you lifelong immunity.

A vaccine should be discussed separately from exposure. It only targets a tiny part of a protein on the surface of a virus. A small mutation is all it takes to get around that.

In the course of natural exposure, immunological response, and successful clearing of a viral infection, your immune system is fully prepared to fight the same and similar viruses. There are exceptions. Young/developing immune systems, immunocompromised, old age, etc. And other exceptions that we obviously don't know about.

It's important for professionals to acknowledge we don't know everything. Fortunately, in the setting we are discussing this, alongside the Trump Show and other asinine topics, I am fully comfortable saying that, except in the obvious cases, I doubt there is any practical reason to worry about contracting the same virus again, after your immune system already defeated it. It's a done deal. If the virus ever makes the mistake of appearing in your body again, you won't even know about it. You can go back to worrying about more common viruses.

 

[clubdeac]

N95, surgical mask, and face shield.

drusso why are you wearing all that? You're certainly not performing an aerosol generating procedure and I would thus argue that the N95 is overkill. I'm wearing a surgical mask but that's it. Oh I guess I'm wearing sterile gloves too

 

[drusso]

drusso why are you wearing all that? You're certainly not performing an aerosol generating procedure and I would thus argue that the N95 is overkill. I'm wearing a surgical mask but that's it. Oh I guess I'm wearing sterile gloves too

I was able to source a bunch of N95 masks way back in early February when everyone thought that this was a hoax. I'll be good at least through the end of summer. A local sail factory stepped up and made face shields for us. We're also doing deep cleans every night with an electrostatic misting system with hospital grade disinfectant.

 

[cowboydoc]

I was able to source a bunch of N95 masks way back in early February when everyone thought that this was a hoax. I'll be good at least through the end of summer. A local sail factory stepped up and made face shields for us.

That doesn’t answer the question at all.

 

[drusso]

That doesn’t answer the question at all.

An ounce of prevention is worth a pound of cure.

 

[clubdeac]

I was able to source a bunch of N95 masks way back in early February when everyone thought that this was a hoax. I'll be good at least through the end of summer. A local sail factory stepped up and made face shields for us. We're also doing deep cleans every night with an electrostatic misting system with hospital grade disinfectant.

I do like the sound of that deep cleans with an electrostatic misting system with hospital grade disinfectant. We needs to get some of that

 

[SSdoc33]

That doesn’t answer the question at all.

he's a master of deflection

 

[Ducttape]

For those of you doing procedures right now on urgent outpatients.

Are you wearing N95 masks or any other protective gear that you wouldn’t typically wear? Gowns, face shields, etc?


Sent from my iPhone using SDN

not enough N95 masks available locally. fwiw, they should all be going to the various hotspots around the country for use in ER, inpatient COVID floors, etc.

A vaccine should be discussed separately from exposure. It only targets a tiny part of a protein on the surface of a virus. A small mutation is all it takes to get around that.

In the course of natural exposure, immunological response, and successful clearing of a viral infection, your immune system is fully prepared to fight the same and similar viruses. There are exceptions. Young/developing immune systems, immunocompromised, old age, etc. And other exceptions that we obviously don't know about.

It's important for professionals to acknowledge we don't know everything. Fortunately, in the setting we are discussing this, alongside the Trump Show and other asinine topics, I am fully comfortable saying that, except in the obvious cases, I doubt there is any practical reason to worry about contracting the same virus again, after your immune system already defeated it. It's a done deal. If the virus ever makes the mistake of appearing in your body again, you won't even know about it. You can go back to worrying about more common viruses.

first, vaccines are not infallible nor may they be as long lasting as we suspect:

Science | AAAS

www.sciencemag.org

in addition,

WHO probes reports of recovered Covid-19 patients being reinfected

The WHO says it's looking into reports of some Covid-19 patients testing positive after initially testing negative.

www.rnz.co.nz

 

[Ferrismonk]

For those of you doing procedures right now on urgent outpatients.

Are you wearing N95 masks or any other protective gear that you wouldn’t typically wear? Gowns, face shields, etc?


Sent from my iPhone using SDN

I wear a surgical mask like normal. Only difference is it's always on if I'm within 6 feet of someone (not necessarily inside the flouro suite.

I was able to source a bunch of N95 masks way back in early February when everyone thought that this was a hoax. I'll be good at least through the end of summer. A local sail factory stepped up and made face shields for us. We're also doing deep cleans every night with an electrostatic misting system with hospital grade disinfectant.

While I support free enterprise and good planning, that's irresponsible. We have hospital docs intubating COVID patients wearing the same N95 all day (all week some places) and you're stocked up until Fall in a low-risk situation. Shame on you.

 

[drusso]

I wear a surgical mask like normal. Only difference is it's always on if I'm within 6 feet of someone (not necessarily inside the flouro suite.


While I support free enterprise and good planning, that's irresponsible. We have hospital docs intubating COVID patients wearing the same N95 all day (all week some places) and you're stocked up until Fall in a low-risk situation. Shame on you.

Our hospital is not short PPE and donated tests. I don't know where you got your information.

 

[SommeRiver]

COVID-19 is a brightly-decorated stage for virtue signaling.

Neon lights. Massive speakers. Full audience. Television cameras.

 

[lonelobo]

...or maybe Vice signaling

 

[SommeRiver]

Cuomo says 13.9% of ppl in NY test positive for Ab...Open up America. We've been made to look like fools.

 

[paindoc007]

Cuomo says 13.9% of ppl in NY test positive for Ab...Open up America. We've been made to look like fools.

We’ve been made to look like fools by who?

 

[SommeRiver]

We’ve been made to look like fools by who?

...by ourselves...

 

[Ferrismonk]

Our hospital is not short PPE and donated tests. I don't know where you got your information.

Okay. Perhaps Oregon is different. In the Detroit area, this is what we've had to deal with.

 

[lonelobo]

Cuomo says 13.9% of ppl in NY test positive for Ab...Open up America. We've been made to look like fools.

49,000 dead in less than 2 months...

 

[lobelsteve]

49,000 dead in less than 2 months...

How much worse than a flu season is this on average?
How much worse is this than flu season this year?
How much better a flu season is this year compared to average?

 

[lonelobo]

How much worse than a flu season is this on average?
How much worse is this than flu season this year?
How much better a flu season is this year compared to average?

The old no worse than the flu argument....come on even Trump gave that one up

 

[clubdeac]

How much worse than a flu season is this on average?
How much worse is this than flu season this year?
How much better a flu season is this year compared to average?

Looks to be 2-3x worse than the average flu season, even with social distancing. Does that call for mass economic shut down and collapse? I don't think so.

 

[SommeRiver]

The old no worse than the flu argument....come on even Trump gave that one up

The economic cataclysm that we've inflicted upon ourselves will be much more severe and deadly than COVID-19.

 

[lonelobo]

Looks to be 2-3x worse than the average flu season, even with social distancing. Does that call for mass economic shut down and collapse? I don't think so.

Question is what it would be like without social distancing,

 

[paindoc007]

The economic cataclysm that we've inflicted upon ourselves will be much more severe and deadly than COVID-19.

Thank you Donald Trump.