Some surgeries depend on availability of aggressive physical therapy for rehab after the procedure as well. This needs to be in place too. Our local leadership is trying to be sure testing and contact tracing is sufficient before anything is opened up.
The last posts are why my husband wonāt be getting his elective rotator cuff surgery as soon as allowed. (1) He needs a current blood test before theyāll schedule (only being done in hospitals where heād prefer not to go). (2) Heāll need PT and they are currently closed for at least two more weeks.
I have seen studies that bear on these issues. Iāll see if I can dredge anything up.
I wanted to report that DHās paper was peer-reviewed, and will be published in the July issue of a respected journal. More importantly, it is up online already for all to read. Thatās just over two weeks from the time he submitted it, which is unprecedented. Normally, new research would not see the light of day for months. Good news for the dissemination of clinical knowledge. He has submitted two more papers.
@Creekland wrote
The info DH is getting is that patients are improving and regaining their lung capacity. His general sense is that doctors are not getting the reports of lasting pulmonary or cognitive impairment which they feared, thank goodness. However, itās likely too soon to say, there may be outliers, and this information is basically word-of-mouth.
@3SailAway , I look forward to reading your Hās paper. I work as a NP at a medical school and work close by the pulmonary and ID docs. Would love to share this paper with them.
@TVBingeWatcher2 , thank you. Iām a bit concerned about posting a link to the paper because it is identifying. Iāll PM you with it!
@3SailAway do you feel from your DH that the mortality rate is going down? (i.e less dying from the admits to the hospital)
Me too, please, @3SailAway.
H is due for his yearly physical this month. He called to postpone and the office said they will be doing telehealth only for well visits the rest of the year! They are hoping to do it in two parts - telehealth physical and then lab work in the Fall if itās safe.
Can I please get a PM as well with this paper. Thanks. Sounds encouraging.
Anyone who would like a link, just PM me!
Admissions have gone way down, from about 20-30 a day to 3. But I know that isnāt what you asked. DH would say that in his experience, our ability to treat Covid-19 is growing daily. He feels like they are saving more people, and preventing people from progressing to the ICU and/or ventilators.
However, he would also be the first to say that healthcare providers must always guard against their own optimism and bias. At the beginning of the pandemic, they had no choice but to figure out what made sense and try it to help their patients. He honestly believes that what his team is doing is working, but he knows thatās not evidence-based medicine. Nothing should become the standard of care until it is studied in properly designed clinical trials, because people can fool themselves, especially when they desperately want a good outcome.
Trials do have caveats that say they will be halted if it becomes clear that the treatment is overwhelmingly beneficial, or harmful. Trials can also be designed so that no patient gets placebo, if it is felt that the treatment is very likely to work.
There are a growing number of trials of tocilizumab, one of the drugs DHās team is using, and preliminary results look good (links below). But I know DH will sleep better when the final results are peer reviewed and published.
https://www.clinicaltrialsarena.com/news/french-early-trial-tocilizumab-covid-19/
https://www.bioworld.com/articles/433822-genentech-moves-actemra-into-phase-iii-covid-19-trial
There is so much activity that is encouraging. Another article I came across today about anti-inflammatories in COVID, including colchicine, tocilizumab, and others. https://www.tctmd.com/news/hopes-high-anti-inflammatories-combat-covid-19-immune-system-storms
Improvements here, once they are well documented, may be the real benefit of āflattening the curveā, and potentially leading the way to reopening before a vaccine, and getting people to be less afraid of going back to some of their normal activities when things are reopened, because the risk a bad result after getting COVID-19 will be lower and better defined later than it is now (or especially compared to last month).
(Of course, after risks are better defined, it is likely that some populations will be in high risk categories and have to be more careful. But perhaps a larger percentage of the population will no longer feel like it is playing a lottery of unknown odds.)
So here is one of the problems. I own my own OR in our office. We held off sx till today. Rupture tendons and ligaments in this case needed to be repaired. So yes elective sx in my locale in hospitals and surgery centers opens up May 1st. My anesthesia person works multiple surgical centers and hospitals. He said there is a mad rush to get cases booked (yes, you are not only a number but a caseā¦LOL). But he said everyone is afraid of running out of PPE. That is the problem . After 2.5 months of trying my rep from Henry Schien sent me 4 surgical gowns. So you might go through all of this to find out, sorry. we canāt safety perform your surgery if things donāt improve like now.
This seems not right. I just had a patient go to her doctor for lab work and they did a complete physical in the office on a days noticeā¦I have people going for lab-work to Quest and Labcorp now. You can actually go to their website and sign up with or without your doctorā¦Maybe if he needs it for a job to go elsewhere?
@Knowsstuff - Itās crazy because our D just had a full physical for her pre-employment screen, along with blood work. Iām not sure why our GPās office isnāt doing well visits. Thankfully H and I are fine and weāre just due for our physicals.
My son had lab work done today. He wore a mask and they took his temperature when he went in the office.
More on the seller of the $400 Covid āvaccine.ā
? ?
I have my doubts about that.
The improvements here are fantastic, donāt get me wrong. If I show up at a hospital with covid-19, seriously ill, these treatments (we hope) will make it less likely that Iāll die. And that is wonderful!
But. The treatments (so far) donāt do anything to make it less likely that I show up at the hospital, seriously ill with covid-19, in the first place. āWell you still have the same chance of getting seriously ill but you have a smaller (but still scarily big) chance of dying if youāre admitted to the hospital,ā is not what Iād call a slam dunk.