NBA season suspended

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I.Greyhound Fan

Re: NBA season suspended
« Reply #20 on: 12 Mar 2020, 11:43 pm »
Thanks for your input Greyhound Fan.  Glad to know a fellow ED doc.  Definitely PPE is time consuming, but we must protect the front line people.  Hopefully your facilities have adequate supplies.  Please do be careful, and take care of yourself.  I’m 52 and have HTN.  I guess our job contributed to that.

While I kinda agree that patients without symptoms should not be tested, they can still have it (kids in particular).  I think it is important to test if the flu swab and viral cultures are negative however.  The problem is that they can pass it to others with significant  medical problems, elderly, frail, immunocompromised, etc.  Current testing involves swabbing the oropharynx and nasopharynx.  The test can then result within 24 hours, as we can send the swab to labs other than the CDC.  No matter the case, we must act now and try to limit the spread.

My colleagues have shared the following link to provide some insight: 
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

Please stay safe.


pan·dem·ic
/panˈdemik/
 Learn to pronounce
adjective
adjective: pandemic
(of a disease) prevalent over a whole country or the world

Thanks, yep forgot about the Oropharynx swab.   I usually have the nurses do it as they come in the room with us initially.  Every patient gets a flu swab even though there is a national shortage of them.  We stopped testing suspected influenza patients because of this until we get an adequate supply of swabs.

Stu Pitt

Re: NBA season suspended
« Reply #21 on: 13 Mar 2020, 02:04 am »
There is no point in testing for it if you have no symptoms.  It is a nasopharyngeal swab and you need to have an active infection.
We just had a patient who has been ill for 6 weeks with viral bronchitis  (viral bronchitis typically lasts 4-8 weeks) and has been seen twice for this.  The patient presented again yesterday demanding to be tested for Corona and said if not tested they would go to the news media. The patient doesn't fking get it that the virus does not last that long and that we cant test everybody.  It also ties us up for almost an hour because we have to put on PPE protection twice and fill out several forms that have to go the the dept. of health. 
Then the room cannot be used for at least 2 hours per our protocol.  In addition, we do not have enough protective gear (PPE) to test every one because as soon as you step out of the room, you have to throw it all away.  If you go back in the room, you have to put on all new gear.
I’m not arguing why I shouldn’t be tested from a logistical standpoint. I didn’t know the extent of what’s needed on your end, but I figured it was as such. It would be nice if I could get tested so I don’t unknowingly give my immunosuppressed mother the virus. There’s a big difference between “it would be nice” and the “I absolutely have to” mentality. I empathize with people’s concern/panic; I don’t share it.

If there’s no reason to be tested if you’re asymptomatic, then why have I seen claims rom what seem like reliable sources that people can be carrying it for 14 days before showing symptoms? I’m trying to learn from you, as you’re someone who’s actually seeing it. Is it because the test is far less reliable for asymptomatic people? I believe the test isn’t as reliable as it should be even when people have symptoms.

OzarkTom

Re: NBA season suspended
« Reply #22 on: 13 Mar 2020, 02:06 am »
The fear will cause far more damage than the virus ....

Economy is going to suffer big time, that will probably be the biggest damage.

JerryM

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Re: NBA season suspended
« Reply #23 on: 13 Mar 2020, 02:19 am »
If one is truly interested, I strongly encourage them to watch this - for at least the first five minutes.

Joe Rogan is interviewing Michael Osterholm.

Michael Osterholm is an American public-health scientist and a biosecurity and infectious-disease expert. He is an internationally recognized expert in infectious disease epidemiology. He is Regents Professor, McKnight Presidential Endowed Chair in Public Health, the Director of the Center for Infectious Disease Research and Policy (CIDRAP), Distinguished Teaching Professor in the Division of Environmental Health Sciences, School of Public Health, a professor in the Technological Leadership Institute, College of Science and Engineering, and an adjunct professor in the Medical School, all at the University of Minnesota.

https://www.youtube.com/watch?v=E3URhJx0NSw

I.Greyhound Fan

Re: NBA season suspended
« Reply #24 on: 13 Mar 2020, 03:47 am »
I’m not arguing why I shouldn’t be tested from a logistical standpoint. I didn’t know the extent of what’s needed on your end, but I figured it was as such. It would be nice if I could get tested so I don’t unknowingly give my immunosuppressed mother the virus. There’s a big difference between “it would be nice” and the “I absolutely have to” mentality. I empathize with people’s concern/panic; I don’t share it.

If there’s no reason to be tested if you’re asymptomatic, then why have I seen claims rom what seem like reliable sources that people can be carrying it for 14 days before showing symptoms? I’m trying to learn from you, as you’re someone who’s actually seeing it. Is it because the test is far less reliable for asymptomatic people? I believe the test isn’t as reliable as it should be even when people have symptoms.


You can't test 300 million people.  You may be carrying the virus and the test may be negative because there is not enough virus in the nasopharynx or mouth.  The test also has false negatives and false positives.  Also if you are negative, what about 2 weeks later if you become exposed, are we to test the whole population every 1-2 weeks over and over.  Unfortunately, this is a bad situation for everyone, some more than others.  My wife and I are in the high risk age group and we have some chronic illnesses that make us even more at risk for dying.  I see possible Corona virus patients several times a day and other patients that may have it that we don't suspect of having it.   I don't get tested at all.  You would think with me being in the line of fire that my Healthcare system would require wee be tested every week.

However, I understand your concern.

Here is a great article about the problems of testing-

https://www.msn.com/en-us/news/us/sick-people-across-the-us-say-they-are-being-denied-the-coronavirus-test/ar-BB117d9s?li=BBnb7Kz
« Last Edit: 13 Mar 2020, 04:58 am by I.Greyhound Fan »

Stu Pitt

Re: NBA season suspended
« Reply #25 on: 13 Mar 2020, 09:10 am »

You can't test 300 million people.  You may be carrying the virus and the test may be negative because there is not enough virus in the nasopharynx or mouth.  The test also has false negatives and false positives.  Also if you are negative, what about 2 weeks later if you become exposed, are we to test the whole population every 1-2 weeks over and over.  Unfortunately, this is a bad situation for everyone, some more than others.  My wife and I are in the high risk age group and we have some chronic illnesses that make us even more at risk for dying.  I see possible Corona virus patients several times a day and other patients that may have it that we don't suspect of having it.   I don't get tested at all.  You would think with me being in the line of fire that my Healthcare system would require wee be tested every week.

However, I understand your concern.

Here is a great article about the problems of testing-

https://www.msn.com/en-us/news/us/sick-people-across-the-us-say-they-are-being-denied-the-coronavirus-test/ar-BB117d9s?li=BBnb7Kz
Thank you for the information. My concern isn’t what it’ll do to me if I become sick. It’ll most likely run it’s course and I’ll be fine. My concern is spreading it to others. Spreading it to my mother, my 7 and 9 year old daughters, and/or compromising the medicine I make. These are my concerns; I’m not dwelling on them and going to waste anyone’s time and resources to gain a little piece of mind because there’s no indication I’m carrying anything. It would be nice to be tested, but there are way more people who actually need to be tested. That’s been my thought since it was discovered in my area.

Letitroll98

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Re: NBA season suspended
« Reply #26 on: 13 Mar 2020, 12:14 pm »
Much thanks to kmmd and I Greyhound Fan for stepping up and giving us the real info.  There's so much disinformation going around is nice to have a voice of authority to rely on.  I'm in the high risk groups (yes groups with an s) so I have some concern for myself, but even more for my mother who is quite elderly and frail, and my grandson at 2 1/2 years old may be on the edge of high risk.  As I understand it travel bans are silly at this point, and no one is being screened at international airports in the US anyway.   With testing a limited option, why aren't we wearing masks in public?  I realize even the N95 and N99 aren't fully effective, but some protection is better than none, right?  Or is that wrong?

Photon46

Re: NBA season suspended
« Reply #27 on: 13 Mar 2020, 02:52 pm »
Much thanks to kmmd and I Greyhound Fan for stepping up and giving us the real info.  There's so much disinformation going around is nice to have a voice of authority to rely on.  I'm in the high risk groups (yes groups with an s) so I have some concern for myself, but even more for my mother who is quite elderly and frail, and my grandson at 2 1/2 years old may be on the edge of high risk.  As I understand it travel bans are silly at this point, and no one is being screened at international airports in the US anyway.   With testing a limited option, why aren't we wearing masks in public?  I realize even the N95 and N99 aren't fully effective, but some protection is better than none, right?  Or is that wrong?

My understanding of your question regarding masks is that masks are primarily most functional for those that are already sick, it really helps prevent the spread of viral particles when a sick person coughs and sneezes. They are generally much less effective for those that aren't ill primarily because the correct use of a mask is difficult to maintain. If a mask actually stops viral particles from entering mucus membranes, the exterior of the mask is now contaminated. Used correctly, you need to throw a mask away EVERY time you remove it and you need to wear gloves or wash your hands before doing so. Second problem with wearing masks is that they have to fit tight to work and that means you are fiddling with them constantly during the course of the day and so you are doing the worst thing you could do: putting your hands all over your face. So, theoretically yes a mask could help prevent contagion. The reality is that day to day use of them actually makes things worse not better. Besides, at this point there is a shortage of masks and we need to let the medical community have what's available because they need them and they use them correctly. Main things are to quit touching your face and wash your hands! If we all did that and practiced social distancing for a couple weeks, we'd make a huge dent in the spread of Covid-19!

One additional piece of information I ran across in the South China Morning Post a couple days ago concerns epidemiological research in South Korea. Their government has been extremely pro active about testing for the virus and they have been open about sharing that research, as opposed to other large outbreak epicenters in China and Iran. They have tested 20,000 people a day for some time and have a much larger data base from which to draw conclusions from than previously. They have found that viral infection is even more widespread than previously suspected and that even more people than previously realized have low grade symptoms. As a result, they have revised the overall mortality statistic in their country to 0.6%. (This is still 4 or 5 times the mortality rate for influenza and 20,000 people died from that last year in the USA.) Time will tell if this statistic holds or if there is much variation from country to country.

Photon46

Re: NBA season suspended
« Reply #28 on: 13 Mar 2020, 03:05 pm »
Accidental posting

kmmd

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Re: NBA season suspended
« Reply #29 on: 13 Mar 2020, 03:22 pm »
My understanding of your question regarding masks is that masks are primarily most functional for those that are already sick, it really helps prevent the spread of viral particles when a sick person coughs and sneezes. They are generally much less effective for those that aren't ill primarily because the correct use of a masks is difficult to maintain. If a mask actually stops viral particles from entering mucus membranes, the exterior of the mask is now contaminated. Used correctly, you need to throw a mask away EVERY time you remove it and you need to wear gloves or wash your hands before doing so. Second problem with wearing masks is that they have to fit tight to work and that means you are fiddling with them constantly during the course of the day and so you are doing the worst thing you could do: putting your hands all over your face. So, theoretically yes a mask could help prevent contagion. The reality is that day to day us of them actually makes things worse not better. Besides, at this point there is a shortage of masks and we need to let the medical community have what's available because they need them and they use them correctly. Main things are to quit touching your face and wash your hands! If we all did that and practiced social distancing for a couple weeks, we'd make a huge dent in the spread of Covid-19!

One additional piece of information I ran across in the South China Morning Post a couple days ago concerns epidemiological research in South Korea. Their government has been extremely pro active about testing for the virus and they have been open about sharing that research, as opposed to other large outbreak epicenters in China and Iran. They have tested 20,000 people a day for some time and have a much larger data base from which to draw conclusions from than previously. They have found that viral infection is even more widespread than previously suspected and that even more people than previously realized have low grade symptoms. As a result, they have revised the overall mortality statistic in their country to 0.6%. (This is still 4 or 5 times the mortality rate for influenza and 20,000 people died from that last year in the USA.) Time will tell if this statistic holds or if there is much variation from country to country.

Photon, you are absolutely correct in everything that you stated.  We place masks on sick patients upon checking in, and N95's need to be fit tested annually.  PPE is disposable, but we have been looking at our supply, and it will run low.  There's even discussion on possibly reusing some of the PPE, but we will have to see.

Leitroll, you're very welcome. :) I'm trying to share my knowledge, not vent and provide some info so that people don't end up on the vent.  We are all here to learn and share, but I am frustrated and angered with the misinformation being spread.  No, there are not millions of tests being available, and no, not everyone who wants one will get one.  Yesterday, California received 8K tests for the entire state.  Unfortunately the kits did not come complete and cannot be used immediately.  Several of our hospitals have implemented drive through testing, but only the appropriate patients can have that after extensive screening.  Hopefully, we can run the tests locally in our hospitals next week as planned.

Here is more info and what is happening in Italy.  Are we next to lock down?  The healthcare workers in the video are wearing proper PPE with PAPR's.  This is what is needed to appropriately protect yourself.
https://nypost.com/2020/03/10/italian-doctor-at-heart-of-illness-shares-chilling-coronavirus-thoughts/

https://twitter.com/jasonvanschoor/status/1237142891077697538?s=21
Please click on "Show thread"

I.Greyhound Fan

Re: NBA season suspended
« Reply #30 on: 13 Mar 2020, 03:43 pm »
Thanks guys,

Masks do offer some protection  you also need to wear goggles to protect the eyes as the virus can enter your body that way.  And as Proton said, the masks become contaminated and need to be thrown out.  Even your clothes and skin will become contaminated.  Also think about the transfer of money, using gas pumps etc.  Everything becomes contaminated.

Yes, the overall mortality rate is below 1% but it is still higher in the high risk age groups and people with comorbid chronic illnesses.

Here is an interesting article on incubation period-

https://www.sciencedaily.com/releases/2020/03/200310164744.htm

Photon46

Re: NBA season suspended
« Reply #31 on: 13 Mar 2020, 04:36 pm »
Thanks guys,

Masks do offer some protection  you also need to wear goggles to protect the eyes as the virus can enter your body that way.  And as Proton said, the masks become contaminated and need to be thrown out.  Even your clothes and skin will become contaminated.  Also think about the transfer of money, using gas pumps etc.  Everything becomes contaminated.

Yes, the overall mortality rate is below 1% but it is still higher in the high risk age groups and people with comorbid chronic illnesses.

Here is an interesting article on incubation period-

https://www.sciencedaily.com/releases/2020/03/200310164744.htm

Yes to watching out for gas pumps. A couple weeks ago I started keeping disposable vinyl gloves in the car. I put them on before getting out to pump gas and throw the gloves in the waste bin before I get back in the car. I don't even let my credit card contact fingers that punched the pump buttons. After picking up a nasty case of pink eye twenty years ago I realized how careful you have to be about touching your face after leaving the house. I've tried to avoid touching my face unless I've washed my hands since that time. Seems to help keep me well because I've only had three colds in the last ten years.

stlrman

Re: NBA season suspended
« Reply #32 on: 13 Mar 2020, 07:05 pm »
Most people touch their face about 25 times an hour . Or more.
I watched food workers touching their nose , coughing while making my hoagies today !!!
My face  is itching like crazy the past week .im trying , but failing not to touch my face .

SteveFord

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Re: NBA season suspended
« Reply #33 on: 13 Mar 2020, 09:29 pm »
I find it helpful to touch other people's faces when the urge strikes.  Even poking them with a pencil eraser helps.

They just shut down all of the schools here in Pennsyltucky, all the govt. buildings in one county, hope they shut mine down.
Rumor has it Monday they send us packing for a bit.

Stu Pitt

Re: NBA season suspended
« Reply #34 on: 14 Mar 2020, 12:26 am »
First the NBA season. Then March Madness. And now my daughters’ AAU basketball season has been postponed for at least 3 weeks. Most likely the entire season. Now it’s gone too far :)

Stu Pitt

Re: NBA season suspended
« Reply #35 on: 14 Mar 2020, 01:28 am »
Is there a diarrhea pandemic going on that no one’s discussing alongside Coronavirus? If not, then why the hell are people buying up all the toilet paper? I can’t find any at any store around me. If something doesn’t change, after about 3 rolls I’ve got 2 options - hold it until I get to work, or steal it from somewhere like a mall bathroom.

F’ing animals!

Photon46

Re: NBA season suspended
« Reply #36 on: 14 Mar 2020, 10:41 am »
Is there a diarrhea pandemic going on that no one’s discussing alongside Coronavirus? If not, then why the hell are people buying up all the toilet paper? I can’t find any at any store around me. If something doesn’t change, after about 3 rolls I’ve got 2 options - hold it until I get to work, or steal it from somewhere like a mall bathroom.

F’ing animals!

Some of those contracting the virus experience gastrointestinal distress. No doubt that has provoked the toilet paper hoarding syndrome we see.

I.Greyhound Fan

Re: NBA season suspended
« Reply #37 on: 14 Mar 2020, 11:27 am »
I think it is more that people are planning for staying in their house for weeks or months if this gets worse.  Diarrhea is not a huge part of COVID although it can occur.  I went to Target 2 days ago and the canned goods were just about all gone.  Soups, Tuna Fish, canned fruits and vegetables, Peanut Butter etc were just about all gone from the shelves.   Same with a couple of supermarkets I went to.  My daughter sent me a video  of the local market she goes to in Denver and all the shelves were empty.

Wind Chaser

Re: NBA season suspended
« Reply #38 on: 14 Mar 2020, 02:46 pm »
I went to Target 2 days ago and the canned goods were just about all gone.  Soups, Tuna Fish, canned fruits and vegetables, Peanut Butter etc were just about all gone from the shelves.

Seeing the same thing up here in small town Canada. On Friday the banks are typically quite busy, but not yesterday. The food court was unusually quiet at noon, it's as if people are self quarantining themselves as everything seems to be grinding to a halt here, except for the grocery stores. And there isn't even one known case of the virus within a 4 hour drive from here.

People are scared. Time to listen to some music.




stlrman

Re: NBA season suspended
« Reply #39 on: 14 Mar 2020, 04:16 pm »
The Governor closed all schools state wide for two weeks, so far.
I’m a substitute teacher  , so no pay for me. I also drive for Uber, but the wife will not let me drive either. No income for me for the foreseeable future. I am also a wedding photographer, but I am thinking that most if not all of my May events will be cancelled.
I am pretty much self quarantined with my wife and teen. The teen is thriving , and barely leaving her room. Lol..
My wife does not want me going to the grocery store , or even doing a pick up at the grocery store where you order online and they bring your goods to your trunk . My wife has OCD tendencies, and she woke up in tears a couple of days ago.
I have been driving her to work. She hopes to be working from home starting next week .