OG doc. AMA on COVID-19

SC MMA MD -
NoNeed4aScreenName -

Dude is not verified so take it for what it's worth.

 

Likely pretty accurate for areas not swamped with COVID patients. Hospitals have stopped non-emergent procedures due to lack of PPE and lots of patients are rescheduling non-urgent outpatient visits to avoid going to medical centers and possibly being exposed. It is eerie how quiet the hospitals and clinics in my area are now

My friend in vegas works at a hospital and was telling me how they normally have 70 or so patients in there and now they got 10 if that. They are setting up for the rush of patients but are going to get very low very fast on protective equipment and said he wont work once they run out. I wonder once that starts happening and the odds of a Dr/Nurse/EMT increases drasticallyl of getting sick themselves, how many stop coming into work? Any ideas, just asking as IDK the mentality of people in those fields since I don't work in them.

If it ain't Dutch, it ain't much -
SC MMA MD -
NoNeed4aScreenName -

Dude is not verified so take it for what it's worth.

 

Likely pretty accurate for areas not swamped with COVID patients. Hospitals have stopped non-emergent procedures due to lack of PPE and lots of patients are rescheduling non-urgent outpatient visits to avoid going to medical centers and possibly being exposed. It is eerie how quiet the hospitals and clinics in my area are now

My friend in vegas works at a hospital and was telling me how they normally have 70 or so patients in there and now they got 10 if that. They are setting up for the rush of patients but are going to get very low very fast on protective equipment and said he wont work once they run out. I wonder once that starts happening and the odds of a Dr/Nurse/EMT increases drasticallyl of getting sick themselves, how many stop coming into work? Any ideas, just asking as IDK the mentality of people in those fields since I don't work in them.

Statistics on this are usually around 30% when workers are anonymously polled. I imagine it will be much higher.

Hey doc,

I'm still having chest pains, pain in my left shoulder and arm. Been about a month now and getting worse. Not worried that it's CV but was wondering how I should get looked. Is a telemedcine appointment with a doctor a good start or should I book an appointment at a clinic? Basically, I'm thinking with my symptoms they might just tell me to go to the ER and I don't want to expose myself unnecessarily to a doctor's office.

Thanks in advance

NoNeed4aScreenName -
mataleo1 -
The Stewed Owl - 

mataleo1, I'd be interested in hearing your opinion on the new "Oxford model" if you have time to read it. Seems like either very good news or very very bad news if wrong. 

The latest study is surprisingly encouraging


Yes I had read that. I actually have friends (in Oxford!) who do AI-based epidemiological models. Their conclusions: according to their model, this could turn out to weather the storm quicker than those proposing very stringent isolation. HOWEVER, considering the unknowns there are small chances that this will produce VERY bad results.

Something like (that's how they voiced it):
Oxford: 96% good outcome, 2% bad outcome, 2% catastrophic
Confinement: 95% good outcome, 4% bad outcome, 1% catastrophic

Their conclusions: bad idea. The risks of a catastrophic outcome do not compensate for a significant potential for a quicker recovery

So he mentioned an imperial study. Looks like that imperial study has also been revised?

 

No it wasn't. Thread here:


 




1 Like

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.

Here’s what experts have told us:

1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.

So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.

Hence, assuming *no* other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are *clearly* causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 

How am I wrong?

Piyo -

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.


Here’s what experts have told us:


1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.


So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.


Hence, assuming no other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are clearly causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 


How am I wrong?

You are not looking at exponential growth of the virus. If we lift shelter in place the numbers will absolutely get out of hand and overwhelm the hospitals like they already have. Some patients take LONGER to recover then others, some die. Taking shelter in place out right now would be an absolute disaster. I cannot believe ppl think the magic number for all this to go back to normal is 2 weeks or mid April or even at the end of April. This COULD last well into August or September or even the holidays. 

1 Like

thebehemoth73 -
Piyo -

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.


Here’s what experts have told us:


1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.


So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.


Hence, assuming no other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are clearly causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 


How am I wrong?

You are not looking at exponential growth of the virus. If we lift shelter in place the numbers will absolutely get out of hand and overwhelm the hospitals like they already have. Some patients take LONGER to recover then others, some die. Taking shelter in place out right now would be an absolute disaster. I cannot believe ppl think the magic number for all this to go back to normal is 2 weeks or mid April or even at the end of April. This COULD last well into August or September or even the holidays. 

Lol, shit man...why should any non-essential worker even return to work ever? 

When people are on a ventilator, how do they eat?  Are patients in critical condition being fed with a peg tube?

turducken -

When people are on a ventilator, how do they eat?  Are patients in critical condition being fed with a peg tube?

IV

thebehemoth73 - 
Piyo -

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.


Here’s what experts have told us:


1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.


So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.


Hence, assuming no other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are clearly causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 


How am I wrong?

You are not looking at exponential growth of the virus. If we lift shelter in place the numbers will absolutely get out of hand and overwhelm the hospitals like they already have. Some patients take LONGER to recover then others, some die. Taking shelter in place out right now would be an absolute disaster. I cannot believe ppl think the magic number for all this to go back to normal is 2 weeks or mid April or even at the end of April. This COULD last well into August or September or even the holidays. 


Just in the last two days, three people I know have been laid off.

I understand that we're dealing with a lot of unknowns and current safety measures are based on the best information available but there is real and potentially long term damage being done to the global economy just as the largest cohort is nearing retirement age.

The boomer generation does not have time to recover from a deep and prolonged recession or depression, and their financial health is paramount to maintaining social safety nets and our general standard of living. We need to tread very lightly here and only take action that is absolutely necessary.

1 Like

My brother and his wife (a nurse working on a covid ward) are both working through this and have different schedules that makes it difficult for them to look after their dog during the day. Would it be a bad idea for me to take the dog during the day and pass him between houses? I haven’t offered to do it yet 

used2wrestle - 

Hey doc,


I'm still having chest pains, pain in my left shoulder and arm. Been about a month now and getting worse. Not worried that it's CV but was wondering how I should get looked. Is a telemedcine appointment with a doctor a good start or should I book an appointment at a clinic? Basically, I'm thinking with my symptoms they might just tell me to go to the ER and I don't want to expose myself unnecessarily to a doctor's office.


Thanks in advance


Hey man.

I again think this is potentially serious. It might be many things but that includes angina or pulmonary emboli.

You need a proper physical examination, some lab tests and an EKG (at the very least). You need to go to the ER. The risks of you not going exceed those of going.

1 Like

turducken - 

When people are on a ventilator, how do they eat?  Are patients in critical condition being fed with a peg tube?


They put in a tube that goes from your mouth/nose to your stomach through which they put in some type of feeding (like Ensure).

If that doesn't work (rare) they'll feed you through an IV

Jored1990 - 

My brother and his wife (a nurse working on a covid ward) are both working through this and have different schedules that makes it difficult for them to look after their dog during the day. Would it be a bad idea for me to take the dog during the day and pass him between houses? I haven’t offered to do it yet 


I don't think dogs are vectors but they certainly can carry a shitload of droplets. I'm sure your brother's wife respects protocol but I wouldn't take the risk here.

1 Like

mataleo1 -
Jored1990 - 

My brother and his wife (a nurse working on a covid ward) are both working through this and have different schedules that makes it difficult for them to look after their dog during the day. Would it be a bad idea for me to take the dog during the day and pass him between houses? I haven’t offered to do it yet 


I don't think dogs are vectors but they certainly can carry a shitload of droplets. I'm sure your brother's wife respects protocol but I wouldn't take the risk here.

It’s what I thought. Thanks 

Eskimo - 
If it ain't Dutch, it ain't much -
SC MMA MD -
NoNeed4aScreenName -

Dude is not verified so take it for what it's worth.

 

Likely pretty accurate for areas not swamped with COVID patients. Hospitals have stopped non-emergent procedures due to lack of PPE and lots of patients are rescheduling non-urgent outpatient visits to avoid going to medical centers and possibly being exposed. It is eerie how quiet the hospitals and clinics in my area are now

My friend in vegas works at a hospital and was telling me how they normally have 70 or so patients in there and now they got 10 if that. They are setting up for the rush of patients but are going to get very low very fast on protective equipment and said he wont work once they run out. I wonder once that starts happening and the odds of a Dr/Nurse/EMT increases drasticallyl of getting sick themselves, how many stop coming into work? Any ideas, just asking as IDK the mentality of people in those fields since I don't work in them.

Statistics on this are usually around 30% when workers are anonymously polled. I imagine it will be much higher.


Where I work, essential health care workers have been issued strict guidelines:

-No vacation days until further notice
-As doctors, we need to put 2 backups for every clinical on-call resource (so if we are 2 on-call, there needs to be 4 back ups)
-No one can retire until further notice
-People can call in sick but this needs to be either backed with a medical note or from quarantine (and then testing is needed)

They just forced a pregnant pharmacist to stay at work.

thebehemoth73 -
Piyo -

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.


Here’s what experts have told us:


1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.


So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.


Hence, assuming no other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are clearly causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 


How am I wrong?

You are not looking at exponential growth of the virus. If we lift shelter in place the numbers will absolutely get out of hand and overwhelm the hospitals like they already have. Some patients take LONGER to recover then others, some die. Taking shelter in place out right now would be an absolute disaster. I cannot believe ppl think the magic number for all this to go back to normal is 2 weeks or mid April or even at the end of April. This COULD last well into August or September or even the holidays. 

I don’t know what this means. I’m not “looking at exponential growth”? My whole post involves exponential growth.

thebehemoth73 -
Piyo -

Somebody, please make a case to me that these shelter-in-place orders aren’t ridiculous and excessive.


Here’s what experts have told us:


1) The issue is exponential growth. 
2) Everyone will get it eventually 
3) The R-0 when taking no measures at all is about 2.5.


So, this means an R-0 of 1.0 is not an issue. It won’t overwhelm the system, and the final result will be the same anyway.


Hence, assuming no other measures (like extra hand washing, isolation in face of symptoms, masks, etc) if the average person cuts their personal interactions by 60%, we’re in the clear. Anything beyond that is useless economic damage. SIP orders are clearly causing a much, much greater reduction than that. Therefore, these orders are ridiculous and extremely harmful. 


How am I wrong?

You are not looking at exponential growth of the virus. If we lift shelter in place the numbers will absolutely get out of hand and overwhelm the hospitals like they already have. Some patients take LONGER to recover then others, some die. Taking shelter in place out right now would be an absolute disaster. I cannot believe ppl think the magic number for all this to go back to normal is 2 weeks or mid April or even at the end of April. This COULD last well into August or September or even the holidays. 

Lol I can’t believe people think there will even be a country if we don’t start working in May or June. This has been a real wake up call for me about how economically stupid the average person really is.

mataleo1 -
Eskimo - 
If it ain't Dutch, it ain't much -
SC MMA MD -
NoNeed4aScreenName -

Dude is not verified so take it for what it's worth.

 

Likely pretty accurate for areas not swamped with COVID patients. Hospitals have stopped non-emergent procedures due to lack of PPE and lots of patients are rescheduling non-urgent outpatient visits to avoid going to medical centers and possibly being exposed. It is eerie how quiet the hospitals and clinics in my area are now

My friend in vegas works at a hospital and was telling me how they normally have 70 or so patients in there and now they got 10 if that. They are setting up for the rush of patients but are going to get very low very fast on protective equipment and said he wont work once they run out. I wonder once that starts happening and the odds of a Dr/Nurse/EMT increases drasticallyl of getting sick themselves, how many stop coming into work? Any ideas, just asking as IDK the mentality of people in those fields since I don't work in them.

Statistics on this are usually around 30% when workers are anonymously polled. I imagine it will be much higher.


Where I work, essential health care workers have been issued strict guidelines:

-No vacation days until further notice
-As doctors, we need to put 2 backups for every clinical on-call resource (so if we are 2 on-call, there needs to be 4 back ups)
-No one can retire until further notice
-People can call in sick but this needs to be either backed with a medical note or from quarantine (and then testing is needed)

They just forced a pregnant pharmacist to stay at work.

Wow man holy shit. What is your opinion on the entire situation now? Do you think the quarantine lasts more than two weeks from now? More than a month? 

mataleo1 -
Eskimo - 
If it ain't Dutch, it ain't much -
SC MMA MD -
NoNeed4aScreenName -

Dude is not verified so take it for what it's worth.

 

Likely pretty accurate for areas not swamped with COVID patients. Hospitals have stopped non-emergent procedures due to lack of PPE and lots of patients are rescheduling non-urgent outpatient visits to avoid going to medical centers and possibly being exposed. It is eerie how quiet the hospitals and clinics in my area are now

My friend in vegas works at a hospital and was telling me how they normally have 70 or so patients in there and now they got 10 if that. They are setting up for the rush of patients but are going to get very low very fast on protective equipment and said he wont work once they run out. I wonder once that starts happening and the odds of a Dr/Nurse/EMT increases drasticallyl of getting sick themselves, how many stop coming into work? Any ideas, just asking as IDK the mentality of people in those fields since I don't work in them.

Statistics on this are usually around 30% when workers are anonymously polled. I imagine it will be much higher.


Where I work, essential health care workers have been issued strict guidelines:

-No vacation days until further notice
-As doctors, we need to put 2 backups for every clinical on-call resource (so if we are 2 on-call, there needs to be 4 back ups)
-No one can retire until further notice
-People can call in sick but this needs to be either backed with a medical note or from quarantine (and then testing is needed)

They just forced a pregnant pharmacist to stay at work.

In another 4-6 when the entire economy has crashed and burned and civil unrest starts, people won’t care about their jobs or those patients. It’s obvious that most on here can’t see the forest for the trees. Nobody wants granny to die or the hospital overwhelmed. But they just shutdown the largest Toyota plant in the country through the end of April. The government will own every big business in the country and every small business will close. We’re gonna have 30% or higher unemployment after this. You guys advocating for shutting everything down to save a million old people now have no idea what’s coming. It’s sad and I feel sorry for all of us. You guys really think civil unrest is some impossibility. Society is super fragile and we’re about to experience that firsthand.