Since this thread is supposed to be about INSIDE information from medical professionals, I will share that a nurse posted on my nursing forum that she could not get to the hospital to work-because of protests in the vicinity. Ambulances were locked out due to the traffic situation as well.
It’s just ridiculous that a willing and able nurse could not get to work to take care of the vulnerable, all the while people are engaging in behavior that will further stress the system.
In my city, elective surgeries may be re-started next week. I was called and asked to work, but I told them I think it’s just too early. I have high blood pressure, take a medicine that is allegedly either a death sentence or a Godsend (it might mitigate lung injury in infected individuals). Until I get a clearer idea of my risk (there are some ongoing medical trials with my medicine), I do not want additional exposure so that someone can get breast implants.
Yes, how you want to classify “shut down” can mean various things. All those things matter in the end - each component. Large gatherings, state institutions, etc.
I work for a state university and we were directed to “work from home” starting March 19. Our public schools last day was March 13. So many different components that can make a difference!
I’ll be honest though, none of that matters so much now. Now it’s just getting control of the numbers and lowering the stats each day.
Our state has under 600 cases diagnosed statewide total now with 9 deaths and about 2/3s declared recovered. We had had fewer than 2 dozen cases/day for many days now. Most of our schools are helping make 3D printed Visor shields for healthcare workers.
37% of employees have filed for unemployment claims! We will have challenges making up lost tourism income—gone forever. I believe fabric masks are mainly for public (everyone is to wear a mask in public). I’m not certain about the status of PPE for our healthcare workers, as I’ve heard/read varying reports.
In response to an earlier question about reimbursement for telephone v telemedicine visits, during the crisis we are being paid the same for video visits as in person visits. In contrast telephone visits pay close to $40.
It has been a struggle to get patients to complete the set up for the video visits and we now have medical students helping patients with this. Also as it seems that this will continue through May, we are being firmer with requiring video visits although some can still only do phone.
I have a PCP appointment the first week of May. The only reason for me to go in person is so she can take my blood pressure. I’m sort of hoping for a telehealth visit.
I’d politely suggest either a telehealth visit or a postponed office visit. If your blood pressure needs to be checked regularly, I suggest you buy your own machine and take it regularly. They are pretty reasonably-priced and can store several readings and even download then to a computer.
Machine as are at pharmacies, Costco, even some markets. They range down to $30-40 up to $100 or less.
I think the problem is that “elective” is a broad category, and there are probably quite a few surgeries that would fit in the range of being highly advisable but not urgent or absolutely necessary, but where the patient may be suffering or even deteriorating without it. I think it could also include situations where the patient clearly needs treatment, but surgery is one of several different valid options.
So in a situation where there is plenty of PPP available & hospitals & clinics are not being impacted by Covid 19 cases – it might make sense to go ahead with many surgeries. Not all “elective” is cosmetic – here’s a quote from the Johns Hopkins site:
Of course it is a valid choice for YOU to decide to defer work, even if the clinic where you work wants to start seeing patients. And I think that if surgery is elective, it certainly means that it can be scheduled in a way to maximize protection of the patients and health workers. But I do get why there may be good reason to allow some surgeries to go forward. It’s not for the patient who wants breast implants – it is for the patient whose day-to-day life and ability to function and care for themselves is being hampered by delaying non-urgent surgery, such as cataract removal.
@HImom I have a blood pressure cuff. I take my blood pressure twice a day.
I’m scheduled for a partial knee replacement which is elective for me now. I actually scheduled it for the first week in October in hopes that it will actually happen then, and won’t need to be postponed.
I’m hoping doctors offices open for visits with some care taken. I would like to see my dermatologist…but the office is closed. I guess it’s an elective visit…but I have some suspicious little marks I would like checked and dealt with. Guess I need to wait.
@thumper1 — can you take a photo of the suspicious skin areas and send to dermatologist so md can tell you what s/he thinks as interim measure. It’s not as good as in person but especially with good lighting and a metric ruler by suspicious areas for scale should help.
Likewise, can’t you have a photo of you taking your blood pressure or take it during telehealth visit and have reading show on screen?
Agree that “elective” definitely doesn’t mean unimportant to patient health and quality of life.
For anyone doing state (or country comparisons), it can be helpful to consider the rates per capita instead of gross numbers. It’s also helpful to look at how much testing has been done (or not) per capita. So many places (as I’ve learned) are sending people home without testing - hence - lower numbers (likely).
This site allows one to click on the categories to line them up by whichever one you want to compare.
Yes, it seems like the strain with the deletion would be out-competed by the ones without. But, in SARS-1, the virus with that deletion eventually dominated the epidemic. It is unknown why that happened or whether that is part of why SARS-1 faded away.
I thought the good news was:
Along with SARS-1, they’ve found the same deletion in the other human and bat coronaviruses.
“Given the prevalence of a variety of deletions in the ORF8 of SARSr-CoVs, it is likely that we will see further deletion variants emerge with the sustained transmission of SARS-CoV-2 in humans.”
Which sounds to me like it’s a common mistake in replication and could happen in other viral chains.
Many people think that a mutated virus would be stronger. In fact, most mutations (mistakes in replication) inhibit viral function, which makes sense because they are random errors.
I wanted to post this because it seemed there was a worry out there about a “super strain” emerging. We all have enough to worry about, so I thought maybe this one could at least go to the bottom of the list.
As far as inside medicine, DH has had blood taken as part of a study of hospital workers. They will be checking for antibodies to the virus, and he will have results in about a week. I would be so relieved if he has already had Covid. However, he has not been sick at all, not even a little bit, and he is OCD about PPE. He is currently taking care of a severely ill patient exactly his age, with no preexisting health problems other than well-controlled hypertension. I know this would feel different if he had any immunity. Fingers-crossed.
What one should look at is infection rate. They are shooting for 10%. If 10% of the tests comes back positive, that’s the right amount of testing. Most counties/states come out at about 10% except NY of course. They have all this mapped out from AIDS that also transmits asymptomatically. Did I say I admire bio statisticians?
How is 10% of symptomatic people coming back positive a good sign? It means 90% of those who think they have it don’t - they have something else (eg allergies, colds, flu) or perhaps just stress. It means the virus still has a super majority of the people to infect as they get exposed.
In our county 7% of people being tested are positive and we have few cases listed (< 100) with only one death. Seems to me the virus isn’t really prevalent around us (yet). It is nearby - esp in some workplaces - in the next door county. If our county were to open because we don’t really have it*, plenty of idiots from the next county over would come to our shops/restaurants, etc, and bring it with them - esp those who aren’t “sick enough” to stay home in their own opinion or those who have no symptoms and don’t realize they’re sick.
I think 100 cases is plenty with an exponential virus to warrant closure, but that's the reasoning some use wanting to open up. "We don't really have it around us."
I have been a nurse for 24 years. I’m well aware that not all elective surgeries are “unimportant” for patient health and well being. That’s completely irrelevant to my post. I work in a cosmetic surgery OR where our cases are 100% cosmetic and completely unnecessary for patient health and well being. So when I said I did not want to risk my health in order to help someone get breast implants, that is exactly what I meant. The surgeries I was asked to work were to insert breast implants. And the next one would be to insert breast implants, or do liposuction on someone’s hips, or a tummy tuck or a face lift. I’m not interested in risking my life to give someone bigger boobs.
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I don’t think we are testing most people here. We only have ~30 official cases to date, but according to a close friend at the hospital, we have 20 currently hospitalized. So, we either have a LOT more cases out there, or a very dismal hospitalization rate.