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MixedAnimals77 said:
Maybe my message wasn't clear or I'm taking this the wrong way. We're restricting household gatherings to 0 but still saying gathering inside in church possibly up to 200 people is fine- how does it make any sense?
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Churches are large and people would be able to socially distance appropriately, plus will require masks. Household gatherings people are not going to be socially distancing, nor will they be wearing masks. Plus, these are basically back to our phase one restrictions so it's what we've had before. It's frustrating and sucks for businesses to lose that income, but WA cases/day have increased to higher than they were in March. It's not surprising at all Inslee is locking things down again right now when he has always taken covid seriously from day 1 :shrug:
 
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Caiter92 said:
Churches are large and people would be able to socially distance appropriately, plus will require masks. Household gatherings people are not going to be socially distancing, nor will they be wearing masks. Plus, these are basically back to our phase one restrictions so it's what we've had before. It's frustrating and sucks for businesses to loose that income, but WA cases/day have increased to higher than they were in March. It's not surprising at all Inslee is locking things down again right now when he has always taken covid seriously from day 1 :shrug:
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Considering outside gatherings and church weren't allowed last time some of the nuances are just seeming a bit arbitrary is all:shrug:. Also at least from my situation my risk of exposure is way higher in a church with people and some improper mask wearing than gathering with my 2 classmates to study that's been happening since school started because none of us go anywhere but the store and school labs. I know not everyone is as diligent about social distancing but yeah just the feels because of different restrictions in regard to severity
 
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MixedAnimals77 said:
No indoor social gatherings with people outside your household-but they don't know how to enforce it yet.
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I honestly dont know how enforceable this will be unless neighbors call cops on each other. People will still need babysitters if they're essential employees working. And like your own personal study-buddy example, there are probably tons of people who have kept a small social bubble this whole time for the sake of mental health (my fiance is a good example). I dont see how that kind of small group gathering will be prevented from a practical standpoint.
 
I doubt they'll actually be enforcing it except with large gatherings, which is basically what they've been doing up until now anyway. But they can't exactly close indoor dining again and be like yeah totally fine to keep having gatherings at home. Plus with the holidays coming up there is a huge potential for further spread. Aside from the churches, this is basically phase one of WA's covid plan so this isn't surprising. Personally I feel really fortunate to live in a state where our covid numbers have stayed so low and that is 100% because of how strict Inslee has been. Even with the double in cases over the last few weeks WA still has on of the lowest rates.
 
finnickthedog said:
I'm specifically asking about when I'm distanced though. I don't necessarily mind being asked to wear them when close to people because I know that makes a difference and that was already the rule here that if you were closer than 6 ft you needed a shield/goggles (actually originally was closer than 3ft but changed to 6). It's changed though and students are now required to wear them 100% of the time. And it's really frustrating that I now can't even let my face breathe for a few minutes even if I'm like... 10 ft away from the nearest person.
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Might have to do with recent studies that have shown a common cough can send particles more than 6-feet away without a face covering. The combination of face shield and mask appears to reduce particles by 89% - which is just slightly below the protection offered by professional surgical masks (versus 77% reduction offered by a cloth mask only).

To minimize the risk of infection, via aerosol transmission, stricter mitigation measures have been adopted for indoor environments, which are more likely to be enclosed and crowded, and also pose airflow issues.

[Here is a citation: https://www.tandfonline.com/doi/full/10.1080/02786826.2020.1846679]
 
(Disclaimer: You’re entitled to your feelings/rant and please don’t feel like I am trying to attack you/your opinion in any way...) I’m not in Washington and obviously in any broad category there’s going to be people who follow guidelines closely and those who don’t, but I have to say, my church has been really diligent about covid protective measures. Since we’ve been allowed to meet in person the leadership has stressed “do this now so we can keep on meeting”. We did virtual church for months, then once the church opened they don’t let you in without a mask, they’ve blocked every other row of pews off to make six feet between the rows, there’s literal tape on the pews you’re allowed to sit on every six feet down the pew...the only exceptions are families who live together are allowed to sit closer. We stopped congregational singing and only this month reintroduced the band with a small group of 3 singers...the singers all stand over six feet apart facing away from each other, get a temp check, and there’s over 20 ft between the singers and the people sitting in the pews (in reality even more bc no one sits on the first row or two haha). The band wears a mask the whole time. There’s no handshaking or hugging, Sunday school has been cancelled, and even the nursery and children’s programs were suspended. I feel much safer at church than I would be at a thanksgiving gathering with my family where I know there would be no mask wearing. Sure there’s a few people at church who wear the mask under their nose but it’s a big building and I just steer clear of those rare people. I’m forced to be closer to the under-nose-maskers at the grocery store. And even if you did wear a mask at a family or small non-family gathering the purpose of thanksgiving is to eat and you can’t eat with a mask on. I’m not saying I agree or disagree with the WA guy’s decision, but I don’t feel like my risk is high at church than anywhere else out in public at this point. But I acknowledge not every church is probably following local guidelines as hard as mine is.

Edit to add: but then again I’m also in an apparent minority that thinks mask mandates should be at a more local level (and I mean actually done when needed not that local people should just get to shrug it off)...The situation in the city of over 500,000 I live in is not anywhere the same as the situation in the small town of 800 my parents live in. The first case in their county wasn’t until August where as my state was over like 20,000 cases by then.
 
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MixedAnimals77 said:
Maybe my main point wasn't clear or I'm taking this the wrong way. We're restricting household gatherings to 0 but still saying gathering inside in church possibly up to 200 people is fine- how does it make any sense?
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It seems clear to me that your governor is trying hard to balance the necessity of managing this with sensitivity toward government overstep into religion, which is incredibly important to many people.

I don't know that how your governor did it is exactly how I would have done it, but I applaud him (I think? Can't quite remember.) taking steps and trying to balance as best he can.

I cannot IMAGINE how difficult it would be to be a governor right now trying to manage this and make public policy on the fly that - no matter what you do - is going to severely anger a large percentage of the population. Sounds like your governor is doing right by Washington's people and doing his best.
 
JaynaAli said:
Edit to add: but then again I’m also in an apparent minority that thinks mask mandates should be at a more local level (and I mean actually done when needed not that local people should just get to shrug it off)...The situation in the city of over 500,000 I live in is not anywhere the same as the situation in the small town of 800 my parents live in. The first case in their county wasn’t until August where as my state was over like 20,000 cases by then.
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The problem I have with handling things at smaller, local levels is that we live in a large, contiguous nation. There really aren't interstate travel bans and there sure aren't intrastate travel bans. So while it seems nice to treat every town individually the fact is-- people move. That is how we got spread to begin with. You go visit small town or small town person goes into big city and that is all that is needed to perpetuate the disease. Mask mandates need to be large scale unless we are going to implement strict travel bans nationwide and actually enforce them.
 
LetItSnow said:
It seems clear to me that your governor is trying hard to balance the necessity of managing this with sensitivity toward government overstep into religion, which is incredibly important to many people.

I don't know that how your governor did it is exactly how I would have done it, but I applaud him (I think? Can't quite remember.) taking steps and trying to balance as best he can.

I cannot IMAGINE how difficult it would be to be a governor right now trying to manage this and make public policy on the fly that - no matter what you do - is going to severely anger a large percentage of the population. Sounds like your governor is doing right by Washington's people and doing his best.
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I would hate to be in any sort of governmental position at this current time. No thank you.
 
DVMDream said:
The problem I have with handling things at smaller, local levels is that we live in a large, contiguous nation.
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Agreed. As far as I'm concerned, this is a nationwide emergency, not an individual state problem. And people from small towns still travel to large cities and people in large cities still travel to small towns.

Unfortunately, our current federal government has largely abdicated its responsibility because its top dawg doesn't give a crap. So it falls to the states to manage as best they can for now.
 
LetItSnow said:
Agreed. As far as I'm concerned, this is a nationwide emergency, not an individual state problem.

Unfortunately, our current federal government has largely abdicated its responsibility because its top dawg doesn't give a crap. So it falls to the states to manage as best they can for now.
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I really hope the new administration can really implement some change. My fear is that it will be too late.

I also fear when he implements a nationwide mask mandate that it will create protests and riots because the current administration has down-played severity so much that people really can't comprehend and will continue to refuse to comprehend how serious this really is.
 
One of my closest friends is at a clinic that's not taking COVID seriously at all. I'm worried for her health and safety, and I feel like there's nothing I can do from where I am other than be supportive of her, and it sucks 🙁
 
Caiter92 said:
It is not against the constitution to tell people to wear a damn mask for the safety of others.
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It also isn't against the constitution to tell and demand of citizens to shelter in place either, specifically in regards to pandemic response. It is also not unconstitutional (and there has been past precedence) to force vaccination as well (Jacobson vs Massachusetts). Most of these are state laws, since the US constitution still wanted states to have power, most of the federal court cases revert back to state laws and uphold that states are allowed to create and implement laws to protect public health.
 
I'm feeling super stressed out about my fourth year rotations and we haven't even picked them yet, which is contributing to the problem. The match window doesn't open until December, but you can pre-match some sites, which more or less guarantees you'll get that one during the block you specify. There's one site I really want that's not eligible for pre-match but I want to pre-match it. I talked to a fourth-year friend of mine who suggested emailing the experiential office, which I just did, but now I just feel whiny, even though I tried to frame it as "I'm stressed out about this and I need help" (which is true). And really I need to focus on studying for an exam tomorrow and NOT my rotations.
Edit: The site is my state's vet school's hospital, which I can't imagine would be too popular right? Then again, there isn't any similar rotation on the list...
 
AuburnVet said:
The constitution states that anything not specifically deemed to be a responsibility of the federal government has to be left up to the states. So no. You can’t make someone wear a mask. No matter how justified you think your fascism is.
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Mask mandates have been brought before courts and deemed completely legal. The court case I've identified above has been used as a precedent case to justify the legality of facemasks and stay at home orders. So, yes, according to the law, the government can demand that of its citizens.

But then again, only a whiny baby complains about wearing a facemask to protect human health and calls it "fascism"...
 
AuburnVet said:
The constitution states that anything not specifically deemed to be a responsibility of the federal government has to be left up to the states. So no. You can’t make someone wear a mask. No matter how justified you think your fascism is.
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It’s truly horrifying someone in the medical profession has such a blatant disregard for public health.
 
Caiter92 said:
It’s truly horrifying someone in the medical profession has such a blatant disregard for public health.
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I know lol. Do these people also think it's wrong to ask them to wear a mask when they're performing surgeries?

Also lol, leaving things up to the states to decide. Turns out many states want to mandate masks. And in areas without statewide mandates, they often defer to county or municipal level orders. And even in areas without those, private business owners are allowed to not let you in if you don't wear a mask. So yes, you can make someone wear a mask. Very easily, in fact.

but muh constitution. I wish more people would read the damn thing
 
vetmedhead said:
but muh constitution. I wish more people would read the damn thing
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Most people don't realize just how much control over our lives the constitution allows the government to have in times of crisis. If this were the threat of a foreign invader and potential nuclear war, no one would be going anywhere, well, provided the current administration could rub enough brain cells together to actually form a thought that would keep the citizens of the country safe, but we've all seen how well that's played out thus far. (Heck they don't even have to rub their own brain cells together or come up with a thought, there's literally experts that can explain to them what's best...oh wait, we don't listen to them either.)
 
I’m not really sure where to put this and might delete it but I need to just get it off my chest.

My father in-law is coming next week for the holiday. He’s from Texas and will be flying in. There are many ways that it’s the least-worst case scenario - it will only be the three of us the whole week, he literally only goes to work where he works with three family members, etc. We all had covid, but it was like six months ago at this point. I’m not going to ask him not to come, for many reasons. Flippancy about covid is not any one of the reasons but I still feel like I have to acknowledge somewhere that I know this isn’t a good idea and that if we had discussed his visit around the time things started worsening again, I would have said yeah just don’t come. But for a handful of reasons I feel like I can’t ask him to not come. I still feel like the world’s worst person that we have someone coming from out of town for Thanksgiving 🙁
 
DVMdreamcometrue said:
I wonder how these people would feel if someone performing surgeries on them or their loved ones refuses to wear a mask.......:shrug:
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Well, there isn't really any good evidence that masks, head attire, or scrubs affect surgical site infection rates. Gloves and gowns have demonstrated benefit to decreasing surgical site infections, but masks don't really have any evidence behind their mandatory wear. They're more to protect the surgeon/scrub from getting gross stuff on their face than to protect the patient from anything.

Edit: to be clear, there is absolutely good evidence that masks reduce or stop the spread of coronaviruses. Anyone who argues we shouldn't all be wearing them out is denying science, and misinformation like that goes against our anti-science policy. I encourage anyone who sees that kind of thing to report it.
 
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not sure if at this point I’m being mentored or just made to be part of an assembly line. Either way, I feel like my quality of medicine and confidence are suffering for it. I am following my gut and I have a phone interview for a new job next week, so we will see what the future brings.
 
thathorsegirl said:
just found out I am failing my first class ever today and i don’t know what to. a literal F in biochem of all things. i’ve never failed before and now i feel like i’m useless and my entire life plan is in ruins. i just wish i could pick my past self and tell her to get her **** together or she’s going to regret it.
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My first fail ever was organic chemistry 1 my fall semester junior year. Also ended up with a D in developmental bio that same semester. I'm a week from my boards exam, two weeks away from starting the job hunt, and 5.5 months away from my DVM and being the first health professions doctor on either side of the family (and the first to earn an advanced degree at all on my mom's side).

Failure happens cause life happens. If you can salvage the class and swipe up a C, do it. If you can take a W, take a W. Regardless of what happens, take a long, hard look at what happened with this class and this semester so you can come back in January with a plan to make sure it doesn't happen again.

It really sucks to experience your first big failure. But one class in your undergraduate degree won't make or break you life, not by a long shot. You got this.
 
thathorsegirl said:
just found out I am failing my first class ever today and i don’t know what to. a literal F in biochem of all things. i’ve never failed before and now i feel like i’m useless and my entire life plan is in ruins. i just wish i could pick my past self and tell her to get her **** together or she’s going to regret it.
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I had 26 Ws and 3 Fs on my transcript, plus like 5 different schools cause I kept transferring. Now I’m an MS2 finishing up preclinicals in med school. **** happens. You get knocked down, you just get up again.

I realize this is vettie territory, but I still wanted to contribute. Also veteran sounds kind of like veterinarian.
 
RANT - please ignore, i am just venting.
Just accidentally discovered that i have a certain condition that increases risk of cancer if untreated, and a few other permanent life changing things, and as an M2 i am basically TREATING MYSELF, because doctor in student health clinic is clueless.... like, i am following UptoDate and Dynamed guidelines to ask for certain labs, etc. He doesnt even bother letting me know the results of the labs, i have to message him to request them.... Had abnormal ultrasound, radiology did not even put that in the report. Like, they ruled out a tumor, but there were other pathological findings that they did not bother listing, because my genius provider did not ask the questions (even though they were in differential). I saw the ultrasound and any 2nd year medical student would be able to diagnose it based on ultrasound. It is OBVIOUS. like, PAINFULLY obvious. But radiology did not list it.... maybe because they thought i was already diagnosed, maybe because they didnt care, maybe because my provider didnt ask to list all the findings.... no idea. But the bottom line is that now i am cutting through the tape trying to get the originals of ultrasound, so i can take it to a different doctor who can officially diagnose me and treat me (because if it is not in my chart, insurance company wouldnt cover it). Also, i can diagnose myself, but i cannot treat myself..... ahhhhhh ...... i am so heartbroken. This is THE OPPOSITE of what they teach us in medical school.... all i want is to get treatment, and hopefully not have cancer, and i have to fight for this. This is insane. Absolutely heartbreaking...

also, occurs to me, - what if i was NOT a medical student? and have NOT seen the ultrasound? it means that the condition would be undiagnosed, and i would eventually probably get cancer. This is insane.
 
M&L said:
MD, graduated from WVU according to his profile. Family medicine.
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Lord. Obviously without details I have no clue if it’s actually an obvious miss, but I’ll take your word for it. Unfortunately there are bad docs out there. Hope you can get to a good physician (which ime is most of them).
 
Matthew9Thirtyfive said:
@M&L is this a real doctor or a doctor like dr pepper is a doctor?
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honestly the more i am thinking about it, the more furious i am getting. They will kill someone this way, - if radiology doesnt list all findings, and family physician doesnt review them, they WILL kill someone one day. I am furious, and i am determined to go as high as i need to about this. I dont care what it takes. If this is human error - i want those people to get in trouble, so that they are aware of what they are doing. If this is a system error, - i want the hospital policy to be changed. It is a huge hospital that treats a lot of people. What if i was NOT a medical student? This is a missed diagnosis... and i wouldnt know that anything is wrong till i show up with cancer in 5 years. And the cancers that i could get from this have only 50% chance of 5 year survival.
 
M&L said:
honestly the more i am thinking about it, the more furious i am getting. They will kill someone this way, - if radiology doesnt list all findings, and family physician doesnt review them, they WILL kill someone one day. I am furious, and i am determined to go as high as i need to about this. I dont care what it takes. If this is human error - i want those people to get in trouble, so that they are aware of what they are doing. If this is a system error, - i want the hospital policy to be changed. It is a huge hospital that treats a lot of people. What if i was NOT a medical student? This is a missed diagnosis... and i wouldnt know that anything is wrong till i show up with cancer in 5 years. And the cancers that i could get from this have only 50% chance of 5 year survival.
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I’m betting it’s a systems issue. You should push it.
 
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Don't quote, but this reminds me of my sister who had this weird thing my parents asked about every year at her annual health visit and were told it's normal that her ankles were the size of grapefruits. Then because she was in incredible pain all the time they decided to do an x-ray and our family dr told us her foot was broken so they put it in a cast and nothing really happened. Well, like a decade later we learned her foot was never broken, she has a bizarre condition where she's straight up missing the joints in her ankle so the bone grows all weird trying to compensate and the radiologist wrote this down all those years ago but no one just ever told us about it. Podiatrist said if we knew a decade ago it could probably have been treated with special shoes, but at that point she needed several surgeries.

So basically, you have every right to be mad. If you didn't know more about medicine you could have easily gone on blissfully unaware at a potentially great consequence to yourself. There are people/families out there who will go on not knowing, and they shouldn't need to be drs/med students to get proper care.
 
Again, I’m wondering if that was actually a doctor. I have seen that kind of thing sooooo many times with MLPs, but infrequently with physicians. A PEM fellow missed a super obvious diagnosis on my kid because she didn’t listen to us and caused her extra x-rays and delayed care, but other than that the only negative experiences anyone in my family have had has been with MLPs. And I think the current state of emergency medical care almost forced EM docs to be vulnerable to mistakes because they are forced to operate in system 1 thinking, which is prone to all kinds of cognitive errors. That’s a systems issue.
 
Matthew9Thirtyfive said:
Again, I’m wondering if that was actually a doctor. I have seen that kind of thing sooooo many times with MLPs, but infrequently with physicians. A PEM fellow missed a super obvious diagnosis on my kid because she didn’t listen to us and caused her extra x-rays and delayed care, but other than that the only negative experiences anyone in my family have had has been with MLPs. And I think the current state of emergency medical care almost forced EM docs to be vulnerable to mistakes because they are forced to operate in system 1 thinking, which is prone to all kinds of cognitive errors. That’s a systems issue.
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I don’t think you meant it this way, but this post comes off very much as “doctors don’t make mistakes...let’s blame the NP.”
 
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mmmdreamerz said:
I don’t think you meant it this way, but this post comes off very much as “doctors don’t make mistakes...let’s blame the NP.”
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I literally cited an example where a doctor made a huge mistake and caused harm to my daughter. Maybe you missed that part of my post.

Edit: But yes, I will gladly say that MLPs are way more likely to make mistakes and cause harm when unsupervised. This is not controversial and honestly I’m continually shocked at how many people in medicine continue to deny that MLPs do not have the education to be seeing patients unsupervised. There have been zero studies where MLPs have been compared to physicians where the MLPs were practicing independently. Every single study on this issue has shown that they can provide equivalent care some of the time when adequately supervised. The only thorough studies done in the US on this have shown equivalence in 55-60% of encounters when supervised—that means even when they have been supervised, they are providing inferior care up to 45% of the time.

I’m not against them at all. There is really solid data that they can provide excellent care and help extend care to wider audiences. But those studies involved appropriate supervision and appropriate and adequate training, which now is not present or guaranteed in half the states in this country.

So yeah, when I hear about gross negligence I tend to think it’s a midlevel practicing unsupervised because most of the time it is if you do any sort of reading on malpractice trends.
 
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I can go on a fairly substantial rant about the numerous harms and near harms I have seen MLPs cause over just the last couple years. I guess my rant is that I’m sick of the blurring of the lines of education and experience in the name of ego and money. We are driving down the quality of care patients are getting by pretending everyone is the same, and that it’s totally okay that a person with an online NP degree and 500 hours shadowing in a well woman prenatal clinic is adequately prepared to see patients independently in an emergency room or literally any other setting.

And yet that is literally what is happening, and patients are literally dying because of it. And yes that’s an actual case, and that NP is still practicing independently despite literally killing people with negligence.
 
I'm honestly annoyed that I can't get an appointment to see a Dr on baseline anymore. It is always an NP or PA and after my last experience with a PA I'm so over the whole system. I went in with respiratory issues and complaints of exhaustion.. no pulse ox tested, no chest rads order, no CBC, but she sure managed to order unnecessary HIV/HepC tests. It is hog wash. I'm paying to see a doctor, I expect to see an actual Dr.

If we attempted anything similar in vet med our clients would lose their damn minds, and for good reason, you can't replace the training of a medical degree with a partial degree or what is the equivalent of an extended nursing degree.
 
DVMDream said:
I'm honestly annoyed that I can't get an appointment to see a Dr on baseline anymore. It is always an NP or PA and after my last experience with a PA I'm so over the whole system. I went in with respiratory issues and complaints of exhaustion.. no pulse ox tested, no chest rads order, no CBC, but she sure managed to order unnecessary HIV/HepC tests. It is hog wash. I'm paying to see a doctor, I expect to see an actual Dr.
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Not all PAs are like this. I’ve had some great ones. I’ve actually had better experiences with them than an actual DO/MD half the time. I had a DO ignore my chronic back pain for 10+ years.
 
SkiOtter said:
Not all PAs are like this. I’ve had some great ones. I’ve actually had better experiences with them than an actual DO/MD half the time. I had a DO ignore my chronic back pain for 10+ years.
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I had a DO tell me that my torn rotator cuff (that ultimately required surgery) was "just the way god made [me]."

It has made me, unfairly IMO, very leery of DOs.
 
SkiOtter said:
Not all PAs are like this. I’ve had some great ones. I’ve actually had better experiences with them than an actual DO/MD half the time. I had a DO ignore my chronic back pain for 10+ years.
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Yes, there is good and bad in everything. Does not change that a PA degree is not equivalent of that of an MD/DO and thus should not be a replacement for one.
 
Lupin21 said:
Goodness. I got all confused and thought I was in pre allo for a minute. Clinic is closing for 10 days due to covid exposure. sigh.
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Dang. That’s sucks 🙁 Are you not curbside? The health department here hasn’t shut any clinics down unless multiple staff members test positive, but every where is curb side and masks mandated by the state so I imagine that’s why.
 
Caiter92 said:
Dang. That’s sucks 🙁 Are you not curbside? The health department here hasn’t shut any clinics down unless multiple staff members test positive, but every where is curb side and masks mandated by the state so I imagine that’s why.
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staff member tested positive
 
Lupin21 said:
Goodness. I got all confused and thought I was in pre allo for a minute. Clinic is closing for 10 days due to covid exposure. sigh.
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I wanted to like this for the first part but not the second. So I’m commenting instead. I hope they recover quickly and your ten days passes smoothly!
 
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