The ultimate COVID thread

[deleted87051]

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Can they be run through the Steris or autoclave? Or ethylene oxide ?

Not sure. Probably not autoclave.

 

[BobLoblaw78]

Not trolling. All the guidelines say we need to see 14 days of downward trending new cases and daily deaths before reopening. It’s happened in other countries (Italy, China) but we haven’t seen that yet.

We need to look at regional numbers when looking at these. Put a % weight on the city, lesser on county, least within 60 miles to determine rates (or whatever you like). Not just numbers for the whole USA.

NY could be trending down for 20 days while the whole of USA actually shows an increase.
Rural areas probably don’t need to see 14 days trending down.

I think we are quick to latch on certain ideas and say it is the right one when every solution is just the “best guess”

 

[dannyboy1]

Not sure. Probably not autoclave.

Just wash them off in the sink with soap and water. It is insanity that we ever threw them out.

 

[gcc322]

Whenever your shop resumes elective cases, are you testing everyone preop if there is still evidence of community spread as per the asa recommendations?

 

[We'llBeDoneIn15Minutes]

Wall Street Journal,
"Paycheck Protection Program Loan Terms Amount to Legalized Fraud.
Healthy companies can easily exploit aid meant for those that had to shut down."
This is shocking.... said no one ever.

 

[abolt18]

Not sure. Probably not autoclave.

I believe they tried to autoclave some at my institution. We got emails about reprocessed ones being deformed, cracked, and chipped due to heat. We are saving them and they are working on a new cleaning method.

 

[Ezekiel2517]

"That’s why many countries in the Hammer phase are planning to open up their economy little by little. Some have started opening schools, others their businesses. But most have not done it yet.
How can countries deep in the Hammer phase figure out what the Dance phase will look like in the future? How can they put together a plan that will reduce the sick and the dead, while the population can remain confident that a second outbreak won’t come back and destroy their lives again?
By using a time machine.
It’s called the internet
And the future is called Taiwan, Hong Kong, China, and South Korea."

 

[deleted643396]

My point was we are not “rationing based on ability to pay”. we are a business that provides a service and we want paying costumers. Would that every patient had the ability to pay. No more immoral than the plumber who won’t fix your sink or the grocer that won’t give you food if you don’t pay. Capitalism. It is what it is.

Again. You missed my point. I was making a commentary on ascribing a morality to any kind of payment based system, whether that be some kind of social capital or money. It’s a slippery slope. I don’t need the libertarian lecture.

And for the record, we do ration by the ability to pay. Isn’t that how supply and demand works?

 

[Robotic Wis-Hipple]

"That’s why many countries in the Hammer phase are planning to open up their economy little by little. Some have started opening schools, others their businesses. But most have not done it yet.
How can countries deep in the Hammer phase figure out what the Dance phase will look like in the future? How can they put together a plan that will reduce the sick and the dead, while the population can remain confident that a second outbreak won’t come back and destroy their lives again?
By using a time machine.
It’s called the internet
And the future is called Taiwan, Hong Kong, China, and South Korea."

Reading that only proved to me that we will be the antithesis of what to do in the historical account of this pandemic. There is 0.0% chance we do any of the things half as well as China or S.Korea. We aren’t going to test enough, we won’t track phones, create a government app, contact trace at any respectable level (certainly not with CCTV and credit card monitoring), pay people to check on quarantined individuals Twice daily, or fine people.

We are going to re-open, we won’t be prepared or have a real plan, and it’s going to be a long 12 months.

 

[deleted171991]

Reading that only proved to me that we will be the antithesis of what to do in the historical account of this pandemic. There is 0.0% chance we do any of the things half as well as China or S.Korea. We aren’t going to test enough, we won’t track phones, create a government app, contact trace at any respectable level (certainly not with CCTV and credit card monitoring), pay people to check on quarantined individuals Twice daily, or fine people.

We are going to re-open, we won’t be prepared or have a real plan, and it’s going to be a long 12 months.

It's going to be MUCH more than 12 months, and much worse than now.

As far as I know, we have barely infected about 4-5% of the general population, and that's in the most affected states. So expect this times 10-20. Even then, if the virus mutates, the game restarts from the beginning.

Carpe diem! This is World War C.

And to think that we could have had a competent federal government and pandemic preparation (and many other things), if not for that idiot Comey...

 

[DocMcCoy]

Whenever your shop resumes elective cases, are you testing everyone preop if there is still evidence of community spread as per the asa recommendations?

Just a snap shot of what’s going on in my shop. Resumed elective cases and will continue to do so as long as we have 25% beds available for potential surge and adequate PPE (not really sure how this is defined). The rate limiting step may be viral filters for anesthesia machines.

Basic screening but no mandatory COVID testing. If surgeon has strong suspicion or high risk patient they can get testing prior to surgery ;only have access to PCR at this time).

41 total COVID cases in my county. We have zero new cases in past six days. We currently have no Covid patients in the hospital. we have had one Covid death.

Not arguing right or wrong, this is just what is going on here.

 

[deleted87051]

Whenever your shop resumes elective cases, are you testing everyone preop if there is still evidence of community spread as per the asa recommendations?

We have community spread. We’ve been testing every patient who was getting a procedure. Now we are testing every patient who is getting a procedure and all hospital admissions.

 

[deleted697127]

We have community spread. We’ve been testing every patient who was getting a procedure. Now we are testing every patient who is getting a procedure and all hospital admissions.

Just curious. Do you have access to your positive rate?

 

[coffeebythelake]

We were just informed that there is a national shortage of disposable glidescope blades and will be reusing them.

 

[deleted87051]

Just curious. Do you have access to your positive rate?

Up to this point we’ve only been testing people having procedures and PUIs. We only started testing all admissions today so numbers are not large. But we’ve had 109 positive out of 1337 tests administered to date. In our county we’ve had almost 2500 documented cases and almost 100 deaths.

 

[narcotics999]

Up to this point we’ve only been testing people having procedures and PUIs. We only started testing all admissions today so numbers are not large. But we’ve had 109 positive out of 1337 tests administered to date. In our county we’ve had almost 2500 documented cases and almost 100 deaths.

8% feels fairly high. The whole CA positive rate is 7.6% among all tested. This 7.6% basically came from PUI, but in your hospital it was not. Not to mention that your area is not badly hit; LA is.

 

[deleted87051]

8% feels fairly high. The whole CA positive rate is 7.6% among all tested. This 7.6% basically came from PUI, but in your hospital it was not. Not to mention that your area is not badly hit; LA is.

It depends on the hospital. There are hospitals in the community that have less than 10 COVID inpatients and others that have over 50.

 

[dannyboy1]

Again. You missed my point. I was making a commentary on ascribing a morality to any kind of payment based system, whether that be some kind of social capital or money. It’s a slippery slope. I don’t need the libertarian lecture.

And for the record, we do ration by the ability to pay. Isn’t that how supply and demand works?

Rationing implies the resources are scarce and we are making some judgement call to limit distribution. That’s not the case here. You just need to pay for the service because it is someone else’s time and effort.

 

[Monty Python]

Just wash them off in the sink with soap and water. It is insanity that we ever threw them out.

Back in the pentothal/ethrane/curare dark ages when I trained that’s what we did with laryngoscope blades, using betadine soaked surgeon scrub brushes. This was before Joint Commission stated that was grossly inadequate and mandated current sterilization processes or single-use disposables. Talk about landfill.

 

[deleted87051]

Back in the pentothal/ethrane/curare dark ages when I trained that’s what we did with laryngoscope blades, using betadine soaked surgeon scrub brushes. This was before Joint Commission stated that was grossly inadequate and mandated current sterilization processes or single-use disposables. Talk about landfill.

Same. And washed the reusable black masks.

 

[Monty Python]

Gilead Stock Sinks After Accidental Release of Remdesivir Data Suggests Drug ‘Not a Silver Bullet’

Headlines called the results disappointing, but Gilead said the results were mischaracterized.

www.marketwatch.com

Oops.

 

[BLADEMDA]

Gilead Stock Sinks After Accidental Release of Remdesivir Data Suggests Drug ‘Not a Silver Bullet’

Headlines called the results disappointing, but Gilead said the results were mischaracterized.

www.marketwatch.com

Oops.

Relax, Remdesivir will show efficacy (moderate) when given early in the disease process. I 100% agree it is no silver bullet. We have a brass bullet coming this August/September from Regeneron. That drug will save lives in the ICU. When you combine Remdesivir, Monoclonal Antibodies and IL-6 inhibitors then you get a silver buckshot worthy of treating ICU patients.

I am optimistic that COMBO will be enough to reduce ICU mortality by 50% or more. Hence, Being intubated and put on a Ventilator won't mean a death sentence for most patients (Fall 2020).

 

[BLADEMDA]

 

[Mman]

Relax, Remdesivir will show efficacy (moderate) when given early in the disease process. I 100% agree it is no silver bullet. We have a brass bullet coming this August/September from Regeneron. That drug will save lives in the ICU. When you combine Remdesivir, Monoclonal Antibodies and IL-6 inhibitors then you get a silver buckshot worthy of treating ICU patients.

I am optimistic that COMBO will be enough to reduce ICU mortality by 50% or more. Hence, Being intubated and put on a Ventilator won't mean a death sentence for most patients (Fall 2020).

Would that mean instead of 90% mortality you only see 45% mortality?

 

[deleted162650]

Remdesivir will show efficacy (moderate) when given early in the disease process.

I predict it will be at least as effective as Plaquenil.

 

[vector2]

You really gotta give it to the turtle.....being that evil and unpopular and yet still ekeing out wins in KY over and over

 

[narcotics999]

You really gotta give it to the turtle.....being that evil and unpopular and yet still ekeing out wins in KY over and over

Kentucky has only 4.5million people. It takes 148b federal fund? 32.8 k per cap?

 

[anbuitachi]

The road to hell is paved with good intentions. Read up on stalinism, maoism etc. Or just "1984" (the novel is not far from what actually ended up happening behind the Iron Curtain.)

The State should NEVER have that kind of power. NEVER. That's the end of democracy and freedom. We've already been on that very slippery slope since the "Patriot" Act (probably the most ironic name for a law in US history).

people are concerned about major changes. a lot of changes have significant risks, but if done right can also have significant benefits. I think if in 50 years, China makes this work, and is also the #1 superpower in the world, other countries will attempt to adopt similar models. Obviously if they fail, it can be catastrophic for the country.

i bet many people in the past and present think that allowing regular people to own guns and rifles is a terrible and dangerous idea. but.. we do have it

 

[anbuitachi]

We were just informed that there is a national shortage of disposable glidescope blades and will be reusing them.

we ran out ages ago... we are not reusing blades though

 

[deleted87051]

we ran out ages ago... we are not reusing blades though

So are you doing DL?

 

[deleted126335]

we ran out ages ago... we are not reusing blades though

We are reprocessing.

 

[anbuitachi]

So are you doing DL?

using mcgrath now.

 

[chocomorsel]

I believe they tried to autoclave some at my institution. We got emails about reprocessed ones being deformed, cracked, and chipped due to heat. We are saving them and they are working on a new cleaning method.

How do people clean the reusable metal blades? Why the heck is this so difficult? I remember at my old job I used to see them sitting in the sink in some blue water w some kind of cleaning chemicals.

 

[deleted59964]

I would have posted this is in the clinical thread but refrained at the last second as I suggested we keep our politics out of that thread.



😆😆😆😆🤣🤣🤣

can we start a phase 1 trial of injecting disinfectant starting with the POTUS ...

 

[deleted87051]

The Abbott rapid test is beyond worthless. Sensitivity below 50% according to our intensivists. Our hospital system stopped using them.

We just got numbers from our central lab and the Abbott test has performed very well for us. It has 98% sensitivity compared to the Hologic Panther test. The 2 that were missed by the Abbott rapid test were on recovering patients who were very weakly positive on the Hologic test. Maybe it’s a specimen collection issue?

 

[deleted171991]

We just got numbers from our central lab and the Abbott test has performed very well for us. It has 98% sensitivity compared to the Hologic Panther test. The 2 that were missed by the Abbott rapid test were on recovering patients who were very weakly positive on the Hologic test. Maybe it’s a specimen collection issue?

So you compared the Abbott test to another bad test, and it works about the same? 😆

AFAIK, there is no test with better than 70% sensitivity on the market, which makes all of them pretty worthless at ruling out Covid (especially in mild cases). Of course, nobody advertises this, except their instructions do say that the test cannot be used to rule out an infection, if the symptoms are suggestive.

There was a specimen issue with Abbott ID Now, where people used to put the specimen in transport fluid. It's supposed to be transported in a dry specimen holder. Also, it requires at least 125 viral particles per ml, which is a lot.

 

[deleted87051]

So you compared the Abbott test to another bad test, and it works about the same? 😆

AFAIK, there is no test with better than 70% sensitivity on the market, which makes all of them pretty worthless at ruling out Covid (especially in mild cases). Of course, nobody advertises this, except their instructions do say that the test cannot be used to rule out an infection, if the symptoms are suggestive.

There was a specimen issue with Abbott ID Now, where people used to put the specimen in transport fluid. It's supposed to be transported in a dry specimen holder. Also, it requires at least 125 viral particles per ml, which is a lot.

Yes 70% sensitivity is the best there is, not because the test does not detect viral RNA if it is present in the specimen, but because viral RNA may not be present in an adequate amount in the upper respiratory tract swab.

 

[vector2]

I would have posted this is in the clinical thread but refrained at the last second as I suggested we keep our politics out of that thread.



😆😆😆😆🤣🤣🤣

can we start a phase 1 trial of injecting disinfectant starting with the POTUS ...

Lmao, 60 some million people are still gonna vote for this guy


Lysol manufacturer warns against internal use after Trump comments
A spokesperson for the cleaning product company said it had a responsibility to give accurate info to the public.


WASHINGTON — The manufacturer for Lysol, a disinfectant spray and cleaning product, issued a statement warning against any internal use after President Donald Trump suggested that people could get an "injection" of "the disinfectant that knocks (coronavirus) out in a minute."

Lysol maker warns against internal use of disinfectants after Trump comments

A spokesperson for the cleaning product company said it had a responsibility to give accurate information to the public.

www.nbcnews.com

 

[Monty Python]

How do people clean the reusable metal blades? Why the heck is this so difficult? I remember at my old job I used to see them sitting in the sink in some blue water w some kind of cleaning chemicals.

Ours go out the room with the dirty instruments. Central Supply cleans then steams them in individual steri-peel packs apparently per Joint Commission edict.

 

[d9sccr]

Lmao, 60 some million people are still gonna vote for this guy


Lysol manufacturer warns against internal use after Trump comments
A spokesperson for the cleaning product company said it had a responsibility to give accurate info to the public.


WASHINGTON — The manufacturer for Lysol, a disinfectant spray and cleaning product, issued a statement warning against any internal use after President Donald Trump suggested that people could get an "injection" of "the disinfectant that knocks (coronavirus) out in a minute."

Lysol maker warns against internal use of disinfectants after Trump comments

A spokesperson for the cleaning product company said it had a responsibility to give accurate information to the public.

www.nbcnews.com

Smart move. It was only a matter of time until someone swallowed some fish tank cleaner.

Edit: *bleach

 

[deleted126335]

I would have posted this is in the clinical thread but refrained at the last second as I suggested we keep our politics out of that thread.



😆😆😆😆🤣🤣🤣

can we start a phase 1 trial of injecting disinfectant starting with the POTUS ...

 

[ChiDO]

Here's Trumps response:

Trump then clarified his remarks: “It wouldn’t be through injections, you’re talking about almost a cleaning and sterilization of an area. Maybe it works, maybe it doesn’t work, but it certainly has a big affect if it’s on a stationary object.”

And here is Lysol response:

“Due to recent speculation and social media activity, RB (the makers of Lysol and Dettol) has been asked whether internal administration of disinfectants may be appropriate for investigation or use as a treatment for coronavirus (SARS-CoV-2),” reads RB’s PSA issued in response to false claims about Trump’s comments on potential treatment methods (full text of PSA below). “As a global leader in health and hygiene products, we must be clear that under no circumstance should our disinfectant products be administered into the human body (through injection, ingestion or any other route).”

 

[vector2]

“ First, the president questioned whether people could be treated with "a very powerful light." Then he brought up disinfectant use cases but didn't specify a particular brand.

"I see the disinfectant that knocks it out in a minute, one minute," Trump said. "And is there a way we can do something like that by injection inside or almost a cleaning? As you see, it gets in the lungs, it does a tremendous number on the lungs, so it would be interesting to check that."

 

[VA Hopeful Dr]

“ First, the president questioned whether people could be treated with "a very powerful light." Then he brought up disinfectant use cases but didn't specify a particular brand.

"I see the disinfectant that knocks it out in a minute, one minute," Trump said. "And is there a way we can do something like that by injection inside or almost a cleaning? As you see, it gets in the lungs, it does a tremendous number on the lungs, so it would be interesting to check that."

I mean he's not wrong. Inhaling Lysol will absolutely do "a tremendous number on the lungs".

 

[MirrorTodd]

I mean he's not wrong. Inhaling Lysol will absolutely do "a tremendous number of the lungs".

Kinda reminds me of this...

 

[VA Hopeful Dr]

Kinda reminds me of this...

This should be posted in every thread that mentions the next big thing in COVID therapy at least daily.

 

[Tramadeezy]

How do people with a brain actually feel ok about voting for this idiot; he is a legit danger to society. I don't understand how educated people want to follow this guy back into battle for another 4 years. Gotta get them libs I guess. I am no fan of Biden. I would vote for a republican over him, but I have to vote Biden to send Trump back to reality tv where he belongs.

 

[deleted126335]

How do people with a brain actually feel ok about voting for this idiot; he is a legit danger to society. I don't understand how educated people want to follow this guy back into battle for another 4 years. Gotta get them libs I guess. I am no fan of Biden. I would vote for a republican over him, but I have to vote Biden to send Trump back to reality tv where he belongs.

Sunk cost fallacy.


Sent from my iPhone using SDN mobile

 

[vector2]

Sunk cost fallacy.


Sent from my iPhone using SDN mobile

Sunk? There are a ton of true believers + just highly cynical conservative people who are getting their money's worth vis a vis gun policy, anti-abortion policy, anti-immigration policy, judges, blanket deregulation and cancelation of environmental protections, dismantling of obamacare, tax cuts for the wealthy and corporate class etc.

The nasty side effect is the sheer incompetence that is currently being seen when actual governing or a concerted crisis response is required.

 

[Lawpy]

How do people with a brain actually feel ok about voting for this idiot; he is a legit danger to society. I don't understand how educated people want to follow this guy back into battle for another 4 years. Gotta get them libs I guess. I am no fan of Biden. I would vote for a republican over him, but I have to vote Biden to send Trump back to reality tv where he belongs.

Yeah i'm not voting for Biden for a lot of reasons. Trump may stink and post dumb stuff but that doesn't mean i have to be forced to back his opponent.

I respect the frustrations on Trump's behavior. I'm seeing a lot worse problems than whatever Trump is doing.