procedures

[SommeRiver]

Thank you Donald Trump.

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[lobelsteve]

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

I am asking questions, not offering theories or insights.
I think until we see how many extra deaths occurred from 2/1/20 to 6/30/20 as compared to the 5 year average, we are only part of the problem.
What if there is no excess death from COVID? What if the same people are dying from COVID who would have died from flu, MI, CVA? It is still a terrible thing.

I know the media overblows everything. But by how much? We will know in a few months.

 

[10KHertz]

Swedish epidemiologists: “Tsunami of a mild” disease. Death rate 0.2% or less.(H Flu 0.1%)

Do we agree with this assessment??

 

[clubdeac]

Swedish epidemiologists: “Tsunami of a mild” disease. Death rate 0.2% or less.(H Flu 0.1%)

Do we agree with this assessment??

Yes the death rate will be far less than 1%. It'll probably be somewhere b/w 0.2-0.5%. We'll see in a few months. But that's where I'm putting my money.

 

[drusso]

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

Marriott Rolls Out ‘Hospital-Grade Disinfectant’ In Hotels For Next-Level Cleanliness

Amid the COVID-19 pandemic, hotel brands are upping their hygiene game.

www.forbes.com

 

[hyperalgesia]

I am asking questions, not offering theories or insights.
I think until we see how many extra deaths occurred from 2/1/20 to 6/30/20 as compared to the 5 year average, we are only part of the problem.
What if there is no excess death from COVID? What if the same people are dying from COVID who would have died from flu, MI, CVA? It is still a terrible thing.

I know the media overblows everything. But by how much? We will know in a few months.

Ducttape posted this in the other thread. NYT looked exclusively at average death rates and it's significantly higher around the workd.

This is nothing like the plague but it's real. I think politicians play it up because it's the only way to get people's attention and wash their disgusting hands. And of course the media is having a field day with it because they are a bunch of amateur entertainers.

I can't believe I'm citing Ducttape and NYT.

The Pandemic’s Hidden Toll: Half a Million Deaths (Published 2020)

Far more people died in 2020 during the pandemic than have been officially reported, a review of mortality data in 35 countries shows.

www.nytimes.com

 

[Ducttape]

I am asking questions, not offering theories or insights.
I think until we see how many extra deaths occurred from 2/1/20 to 6/30/20 as compared to the 5 year average, we are only part of the problem.
What if there is no excess death from COVID? What if the same people are dying from COVID who would have died from flu, MI, CVA? It is still a terrible thing.

I know the media overblows everything. But by how much? We will know in a few months.

flu deaths are reported separately from COVID deaths by the CDC and these other sources.

this year has apparently been a typical year. 2018-2019 saw 61,000 seasonal flu deaths. the CDC preliminary number shows an estimate of between 24,000 and 62,000 deaths thus far from seasonal flu. we did have 168 pediatric flu deaths, which apparently is average. around the US, flu is mostly done.

on top of that are the 50,000 coronavirus deaths. we may be reaching or have reached the peak death rate for this wave.

 

[lonelobo]

We do have to realize that these Flu numbers for Mortality and Morbidity are all just estimates with significant limitations

 

[drusso]

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.....

I encourage everyone to organize efforts and form coalitions to re-open our health care system.

The Portland Clinic_Social - TPC_04232020

This is "TPC_04232020" by CMD on Vimeo, the home for high quality videos and the people who love them.

vimeopro.com

 

[clubdeac]

Got 15 on the schedule for tomorrow!

 

[hyperalgesia]

I'm hoping our modern understanding of hygiene, testing and isolation will allow us to fare better than in past epidemics.

 

[Ducttape]

I'm not sure we learned lessons from 1918.

case in point - reopening early.

this article notes that those cities that reopened early had much greater issues with the second wave than those that kept restrictions in place until much longer.

INSIDER TODAY: What happens if we reopen too early? Let's look at 1918.

States are starting to reopen as cases of coronavirus plateau. Evidence from the 1918 flu pandemic suggests that is a mistake.

www.businessinsider.com

I think that's why Fauci et al are concerned with reopening too soon. maybe this time we will get lucky...

 

[pmrmd]

Luck? Things are opening with restrictions, not like what is cited in that piece.

 

[SommeRiver]

Full schedule today...

 

[SSdoc33]

Full schedule today...

you brag as if you are doing a good thing.

$$$$$ > life

shame

 

[Disciple]

I'm not sure we learned lessons from 1918.

case in point - reopening early.

this article notes that those cities that reopened early had much greater issues with the second wave than those that kept restrictions in place until much longer.

INSIDER TODAY: What happens if we reopen too early? Let's look at 1918.

States are starting to reopen as cases of coronavirus plateau. Evidence from the 1918 flu pandemic suggests that is a mistake.

www.businessinsider.com

I think that's why Fauci et al are concerned with reopening too soon. maybe this time we will get lucky...

As noted in the last paragraph of that article, it’s not “all or nothing”. We’ll know what the right approach was over the next few months.

 

[callmeanesthesia]

you brag as if you are doing a good thing.

$$$$$ > life

shame

This is not black and white - we aren’t a casino or movie theater where the only justification for reopening is economic. Whether elective medical procedures should proceed depends on the area. My county has had just a couple cases diagnosed in the past 2 weeks. Should I continue to deny patients procedures and evals? If not reopening now then when? If this isn’t low enough disease activity then I would be waiting until there is widespread vaccine rollout and herd immunity. And as for clinic patients, it’s all elective until it isn’t - had a new patient a couple weeks ago with severe neck pain and headaches that started in September. Would have rejected it on that basis if totally closed down, and told her to go to the ER if it was that severe. Turns out she had been to the ER already, and her PCP, and had an MRI of her neck a month ago, and no one (including the radiologist) noticed the golf ball sized cyst in her cerebellum. She went from my office to the hospital, and had surgery the day after I saw her. Sure, that’s a once in a lifetime catch (hopefully) but I think about that a lot in balancing whether to see patients. Telemed as much as possible, and the schedulers are instructed to ask people if they feel it can wait, but I’m still seeing patients. Better to come see me than go to urgent care from a COVID risk perspective.

 

[SSdoc33]

This is not black and white - we aren’t a casino or movie theater where the only justification for reopening is economic. Whether elective medical procedures should proceed depends on the area. My county has had just a couple cases diagnosed in the past 2 weeks. Should I continue to deny patients procedures and evals? If not reopening now then when? If this isn’t low enough disease activity then I would be waiting until there is widespread vaccine rollout and herd immunity. And as for clinic patients, it’s all elective until it isn’t - had a new patient a couple weeks ago with severe neck pain and headaches that started in September. Would have rejected it on that basis if totally closed down, and told her to go to the ER if it was that severe. Turns out she had been to the ER already, and her PCP, and had an MRI of her neck a month ago, and no one (including the radiologist) noticed the golf ball sized cyst in her cerebellum. She went from my office to the hospital, and had surgery the day after I saw her. Sure, that’s a once in a lifetime catch (hopefully) but I think about that a lot in balancing whether to see patients. Telemed as much as possible, and the schedulers are instructed to ask people if they feel it can wait, but I’m still seeing patients. Better to come see me than go to urgent care from a COVID risk perspective.

yes, i saw the mri. nice catch. a zebra.

please show me the data that there are only 2 cases in your country diagnosed int he past 2 weeks.

certainly there are gray areas, and there definitely will come a time when cases are no longer "elective". im starting to do some shots as well. but a full clinic? how many of those are mbbs? mbb f/u? sij? hips and shoulders?

you should not be opening your doors as if we are back to normal. if you have screened the patients, and they all need an in-person visit, then thats a different story.

 

[SommeRiver]

you brag as if you are doing a good thing.

$$$$$ > life

shame

Your post means nothing to me.

 

[pmrmd]

certainly there are gray areas, and there definitely will come a time when cases are no longer "elective". im starting to do some shots as well. but a full clinic? how many of those are mbbs? mbb f/u? sij? hips and shoulders?

you should not be opening your doors as if we are back to normal. if you have screened the patients, and they all need an in-person visit, then thats a different story.

Watch your step getting down from the soap box.

So what if he did those injections? If he took steps to mitigate risk then there is nothing to criticize at all. Stay home if you want if you think its the best way to go for your patients. I think he's doing the right thing.

 

[hyperalgesia]

We have to remember the whole point is to ensure the health systems are not overwhelmed. That's it. Yes, more people will get the virus and die because they are not holed up in the house. That's not a failure.

 

[Sig123]

Put an N95 mask on, have your patients put masks on, and go to work.

Or don't.

Your call.

 

[DODOCSS]

Put an N95 mask on, have your patients put masks on, and go to work.

Or don't.

Your call.

or responsibly quarantine like comrade cuomo

 

[SSdoc33]

Put an N95 mask on, have your patients put masks on, and go to work.

Or don't.

Your call.

irresponsible

 

[SSdoc33]

Watch your step getting down from the soap box.

So what if he did those injections? If he took steps to mitigate risk then there is nothing to criticize at all. Stay home if you want if you think its the best way to go for your patients. I think he's doing the right thing.

doesnt work if we dont all follow the rules. this isnt the wild wild west. what pmrmd decides to do affects ssdoc33. believe me, i wish that wasnt the case. if you dont like listening to my soapbox speech, then dont give me a reason to give one. frankly, if we had more people in gvt thinking like me and fewer thinking like you, we would be in a lot better shape. the main reason america has BY FAR the worst outbreak in the world (>4x any other country) is because we have cowboys who think they know better. they dont. you dont, and certainly the white house doesnt

 

[SSdoc33]

Your post means nothing to me.

funny, it wasnt directed at you. feel a bit insecure or guilty do you?


Edit: actually it was. My bad

 

[Laryngospasm]

You quoted his post and told him shame like he was a child but you weren’t referring to him?

 

[SSdoc33]

.

 

[SSdoc33]

Wow. Second time today i confused my insults. Perhaps im out for so much blood im forgetting who im pissed off at. I apologize, callmeanesthesia.

I was trying to shame the charlatan in BFE georgia who brags about reopening like governor kemp or DJT. First do no harm, dude.

 

[pmrmd]

funny, it wasnt directed at you. feel a bit insecure or guilty do you?

You quoted his post calling his behavior shameful, bro. His response was to yours. Don't let your illogical reasoning spread to all aspects of your life.

 

[SSdoc33]

You quoted his post calling his behavior shameful, bro. His response was to yours. Don't let your illogical reasoning spread to all aspects of your life.

Yeah yeah. I messed up. But too late on my reasoning spreading

 

[lobelsteve]

Trump, Kemp, doctodd. Carl Rove, Hannity. Tucker.

ssdoc:

A little wine, or thc.

 

[clubdeac]

Yes the death rate will be far less than 1%. It'll probably be somewhere b/w 0.2-0.5%. We'll see in a few months. But that's where I'm putting my money.

Welp here ya go. The CDC caught up with my original estimate

(Remember, in March, the World Health Organization estimated a 3.4% fatality rate and Dr. Anthony Fauci estimated that the fatality rate of the coronavirus was about 2%.)

Fatality rate now per new CDC estimates:

0-49 years old: .05%
50-64 years old: .2%
65+ years old: 1.3%
Overall ages: .4%

According to the CDC’s current best estimate, the case fatality rate of the coronavirus is .4%. And that’s just among symptomatic cases, which, the CDC estimates, is 65% of all cases. This means the CDC estimates that the fatality rate for all infections across all age groups, symptomatic as well as asymptomatic, is approximately
.26%

 

[Tramadeezy]

Source?

 

[hyperalgesia]

Welp here ya go. The CDC caught up with my original estimate

(Remember, in March, the World Health Organization estimated a 3.4% fatality rate and Dr. Anthony Fauci estimated that the fatality rate of the coronavirus was about 2%.)

Fatality rate now per new CDC estimates:

0-49 years old: .05%
50-64 years old: .2%
65+ years old: 1.3%
Overall ages: .4%

According to the CDC’s current best estimate, the case fatality rate of the coronavirus is .4%. And that’s just among symptomatic cases, which, the CDC estimates, is 65% of all cases. This means the CDC estimates that the fatality rate for all infections across all age groups, symptomatic as well as asymptomatic, is approximately
.26%

Those numbers seem too low based on mass casualty events like the one in Washington.

This event happened at a time when the facility would have an incentive to downplay the deaths that may have been attributed to their negligence.

"Preliminary case fatality rates among residents and visitors as of March 9 were 27.2% and 7.1%, respectively"

There's definitely some grey area about a covid death though. As others have pointed out, people on their death bed are gonna die with our without covid.

 

[SSdoc33]

Welp here ya go. The CDC caught up with my original estimate

(Remember, in March, the World Health Organization estimated a 3.4% fatality rate and Dr. Anthony Fauci estimated that the fatality rate of the coronavirus was about 2%.)

Fatality rate now per new CDC estimates:

0-49 years old: .05%
50-64 years old: .2%
65+ years old: 1.3%
Overall ages: .4%

According to the CDC’s current best estimate, the case fatality rate of the coronavirus is .4%. And that’s just among symptomatic cases, which, the CDC estimates, is 65% of all cases. This means the CDC estimates that the fatality rate for all infections across all age groups, symptomatic as well as asymptomatic, is approximately
.26%

And what about your estimate re: hydroxychloroquine?

Or your estimate about 'more deaths from broken hearts' or whatever BS that was

If you are going to play the "i told you so game" you cant be wrong more than you are right

 

[pmrmd]

doesnt work if we dont all follow the rules. this isnt the wild wild west. what pmrmd decides to do affects ssdoc33. believe me, i wish that wasnt the case. if you dont like listening to my soapbox speech, then dont give me a reason to give one. frankly, if we had more people in gvt thinking like me and fewer thinking like you, we would be in a lot better shape. the main reason america has BY FAR the worst outbreak in the world (>4x any other country) is because we have cowboys who think they know better. they dont. you dont, and certainly the white house doesnt

Completely wrong. It depends on what rules you want to follow. This cowboy wouldn't order COVID patients to be placed into nursing homes. Do you think it was wise to follow that rule? Rules like that increased the numbers unnecessarily and led to more deaths which reinforced your erroneous paranoia. I didn't close but I took precautions and no one in my orbit has caronavirus. Same with Sommeriver and deac and whomever else. You responded to River above with "$ > life", as if he was actively harming someone. That's about as irresponsible a post as I can imagine. I take offense that you think I was doing the same. Taking care of patients in an appropriate fashion was far safer than going to Target, the grocery, or other "essential" places at the height of it. If you want to accuse us of something then you better have some kind of evidence other than arrogant presumptions.

The only thing that is clear is that the widespread shutdowns were the wrong approach and targeted limitations would have been better.

 

[paindoc007]

.The only thing that is clear is that the widespread shutdowns were the wrong approach and targeted limitations would have been better.

Please provide evidence for this statement. We don’t want to make arrogant presumptions now do we

 

[clubdeac]

Source?

CDC website

 

[Tramadeezy]

CDC website

Thats where i went. Google searching cdc cfr estimation doesnt pull up those numbers. Not trying to troll you here, do you have a link?

 

[hyperalgesia]

The upcoming "flu season" will be very educational. We could see a massive resurgence due to the huge reservoir of infected people and coronavirus-naiive "stay at home" folks. This could quickly overwhelm our containment strategy in the same way it did this time.

I'm not really sure how we'll handle it differently. Orders to stay at home across the board will be issued, etc.

People look at the charts as if they are instructions for the virus when they only represent seasonality and our mitigation efforts. Both are changing.

 

[pmrmd]

Please provide evidence for this statement. We don’t want to make arrogant presumptions now do we

The CDC data just posted. Why do we have about 20% unemployment for a virus that mainly harmed a select population?

 

[10KHertz]

Reasonable points...

How Fear, Groupthink Drove Unnecessary Global Lockdowns | RealClearPolitics

Reliance on Faulty Models In the face of a novel virus threat, China clamped down on its citizens. Academics used faulty information to build faulty models....

www.realclearpolitics.com

 

[SommeRiver]

Reasonable points...

How Fear, Groupthink Drove Unnecessary Global Lockdowns | RealClearPolitics

Reliance on Faulty Models In the face of a novel virus threat, China clamped down on its citizens. Academics used faulty information to build faulty models....

www.realclearpolitics.com

Over 38 million unemployed despite the fact the Italian data showed death was occurring in not just geriatrics, but those over 80...

Initial quarantine definitely warranted, but if I'm living in South Dakota with a family owned business and this ends us...F you.

 

[paindoc007]

Over 38 million unemployed despite the fact the Italian data showed death was occurring in not just geriatrics, but those over 80...

Initial quarantine definitely warranted, but if I'm living in South Dakota with a family owned business and this ends us...F you.

Yeah. But the pressing question is: who really cares about anyone who lives in South Dakota...?

 

[SommeRiver]

Yeah. But the pressing question is: who really cares about anyone who lives in South Dakota...?

Idiotic comment, but let's swap SD for dozens of other states.

Whoever you are isn't half as smart or important as you may believe.

 

[paindoc007]

Idiotic comment, but let's swap SD for dozens of other states.

Whoever you are isn't half as smart or important as you may believe.

Intelligent comment. Almost made sense

 

[SommeRiver]

Intelligent comment. Almost made sense

My statement was soooo hard to follow and confusing...

There are 30 and possibly up to 40 states that have been largely spared from significant COVID-19.

In the states hit the hardest, look at the locations of cases and they're all large metro areas.

The virus does not care about state boundaries, so take each major city that has been hit with COVID-19 and draw a circle around it that spans X miles in diameter and shut it down.

Let the 95% of the rest of our nation continue to thrive and work and earn money without having to push trillions of dollars of Monopoly money into the economy.

I think this is actually quite simple.

 

[SSdoc33]

My statement was soooo hard to follow and confusing...

There are 30 and possibly up to 40 states that have been largely spared from significant COVID-19.

In the states hit the hardest, look at the locations of cases and they're all large metro areas.

The virus does not care about state boundaries, so take each major city that has been hit with COVID-19 and draw a circle around it that spans X miles in diameter and shut it down.

Let the 95% of the rest of our nation continue to thrive and work and earn money without having to push trillions of dollars of Monopoly money into the economy.

I think this is actually quite simple.

Simplistic yet incorrect at the same time.

What about meat packing plants, as just 1 example?

Ill say it again: the pandemic would have been much worse had we not had these 3 months of crap. Nobody knows where we would have been. Nobody knows where we will be.

Your desire for pretending like there is no problem is well documented for all to see. It will also be very easy to see how foolish and naive you were.

 

[SSdoc33]

The CDC data just posted. Why do we have about 20% unemployment for a virus that mainly harmed a select population?

Because that population DIES, thats why.