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COVID-19 Impacts- No Conspiracy Theories

Discuss anything that doesn't fit elsewhere on the site. As a reminder, religion, politics and weaponry are prohibited.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by tjcdas »

The head of WHO is spreading poor data:

The pandemic is accelerating,” WHO Director-General Tedros Adhanom Ghebreyesus said at a press briefing from the organization’s Geneva headquarters. “It took 67 days from the first reported case to reach 100,000 cases, 11 days for second 100,000 cases, and just four days for the third 100,000 cases.”

This has been caused by the increase in testing, test availability, not testing non-symptamatic people, seeing the testing focusing on a much sicker group of people than early on in the virus situation.

Come on MOT you are a numbers guy being more efficient proficient identifying the sick patients does not mean the virus is spreading faster or accelerating.
Last edited by tjcdas on Tue Mar 24, 2020 5:31 pm, edited 1 time in total.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by yinzburgher »

ManOnTime wrote: Tue Mar 24, 2020 3:35 pm
Boourns wrote: Tue Mar 24, 2020 2:07 pm
tjcdas wrote: Tue Mar 24, 2020 10:20 am Right now Italy is the worst case scenario, if the USA reaches this point we are looking at 32,700 deaths.

Right now our death rate per million is 50 times lower than Italy.
Man, I have not seen anything that indicates we aren't exactly on Italy's path. Especially now that many seem to be taking the line that getting people back to work takes precedence over their health.
I find it hard to adequately express the blind rage I've been in about this.
I'm entirely cool with these sort of discussions among government officials taking place and in fact I think we should be at least keeping the economy in mind every step of the way. I think it is worth talking about and debating at every level of government. What I won't be cool with is if the doctors, epidemiologists, virologist, and public health officials are left out of the discussion or just ignored. I do think that could likely end up happening unfortunately. I'm starting to think that our only real hope of mitigating the death toll and health system crisis would be finding some drug that's reasonably effective. We're starting to see how it's going in the places that took half-ass measures.....not good. I have absolutely no guess as to where the numbers will go but I imagine it's gonna be pretty bad. I think the only real silver lining with this whole debacle will be that it could serve as an example for future generations when something just as contagious but even deadlier comes about.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by tjcdas »

ManOnTime wrote: Tue Mar 24, 2020 3:35 pm
Boourns wrote: Tue Mar 24, 2020 2:07 pm
tjcdas wrote: Tue Mar 24, 2020 10:20 am Right now Italy is the worst case scenario, if the USA reaches this point we are looking at 32,700 deaths.

Right now our death rate per million is 50 times lower than Italy.
Man, I have not seen anything that indicates we aren't exactly on Italy's path. Especially now that many seem to be taking the line that getting people back to work takes precedence over their health.

I find it hard to adequately express the blind rage I've been in about this.
[/qu



Italy has 25% of the population over the age of 65, the age of Italians dying of COVID-19 averaging out at 78.5.

Italy has the second oldest population in the world.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by MoT »

ManOnTime wrote: Tue Mar 24, 2020 3:35 pm
Boourns wrote: Tue Mar 24, 2020 2:07 pm
tjcdas wrote: Tue Mar 24, 2020 10:20 am Right now Italy is the worst case scenario, if the USA reaches this point we are looking at 32,700 deaths.

Right now our death rate per million is 50 times lower than Italy.
Man, I have not seen anything that indicates we aren't exactly on Italy's path. Especially now that many seem to be taking the line that getting people back to work takes precedence over their health.

I find it hard to adequately express the blind rage I've been in about this.

Let me clarify my position on this.

Scaling back measures to combat this pandemic to "save the economy" is only going to result in an incredibly horrific number of deaths (much, much higher than would occur with drastic mitigation efforts), the total collapse of hospitals and healthcare systems and a ripple effect that will take down the economy.

"It's just old people that will die" is not only demonstrably incorrect, but it is a monstrous, and frankly, evil stance.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by tjcdas »

ManOnTime wrote: Tue Mar 24, 2020 6:17 pm
ManOnTime wrote: Tue Mar 24, 2020 3:35 pm
Boourns wrote: Tue Mar 24, 2020 2:07 pm

Man, I have not seen anything that indicates we aren't exactly on Italy's path. Especially now that many seem to be taking the line that getting people back to work takes precedence over their health.

I find it hard to adequately express the blind rage I've been in about this.

Let me clarify my position on this.

Scaling back measures to combat this pandemic to "save the economy" is only going to result in an incredibly horrific number of deaths (much, much higher than would occur with drastic mitigation efforts), the total collapse of hospitals and healthcare systems and a ripple effect that will take down the economy.

"It's just old people that will die" is not only demonstrably incorrect, but it is a monstrous, and frankly, evil stance.
I can't see any statements made by me that are monstrous or implied any thing about just old people will die.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by The Sultan of SoWhat »

yinzburgher wrote: Tue Mar 24, 2020 4:59 pm
ManOnTime wrote: Tue Mar 24, 2020 3:35 pm
Boourns wrote: Tue Mar 24, 2020 2:07 pm

Man, I have not seen anything that indicates we aren't exactly on Italy's path. Especially now that many seem to be taking the line that getting people back to work takes precedence over their health.
I find it hard to adequately express the blind rage I've been in about this.
I'm entirely cool with these sort of discussions among government officials taking place and in fact I think we should be at least keeping the economy in mind every step of the way. I think it is worth talking about and debating at every level of government. What I won't be cool with is if the doctors, epidemiologists, virologist, and public health officials are left out of the discussion or just ignored. I do think that could likely end up happening unfortunately. I'm starting to think that our only real hope of mitigating the death toll and health system crisis would be finding some drug that's reasonably effective. We're starting to see how it's going in the places that took half-ass measures.....not good. I have absolutely no guess as to where the numbers will go but I imagine it's gonna be pretty bad. I think the only real silver lining with this whole debacle will be that it could serve as an example for future generations when something just as contagious but even deadlier comes about.
-------

One would hope so. As the philosopher George Santayana famously said, "Those who cannot learn from history are doomed to repeat it."

However, there are always the Henry Fords: "History is bunk."
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by MoT »

tjcdas wrote: Tue Mar 24, 2020 7:20 pm
ManOnTime wrote: Tue Mar 24, 2020 6:17 pm
ManOnTime wrote: Tue Mar 24, 2020 3:35 pm


I find it hard to adequately express the blind rage I've been in about this.

Let me clarify my position on this.

Scaling back measures to combat this pandemic to "save the economy" is only going to result in an incredibly horrific number of deaths (much, much higher than would occur with drastic mitigation efforts), the total collapse of hospitals and healthcare systems and a ripple effect that will take down the economy.

"It's just old people that will die" is not only demonstrably incorrect, but it is a monstrous, and frankly, evil stance.
I can't see any statements made by me that are monstrous or implied any thing about just old people will die.
My comment wasn't directed at you, but if you'd like to infer it was, that's your prerogative.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by PetWatch »

California stats:

As of March 23, 2pm

531: Community-acquired cases

1,571: Cases acquired through person-to-person transmission, travel (including cruise ship passengers), repatriation, or under investigation.

This includes 31 health care workers

Ages of all confirmed positive cases:

Age 0-17: 28 cases - 1%

Age 18-49: 970 cases - 46%

Age 50-64: 493 cases - 23%

Age 65 and older: 449 cases - 21%

Unknown: 162 cases - 8%

Gender of all confirmed positive cases:

Female: 843 cases - 40%

Male: 1,081 cases - 51%

Unknown: 178 cases - 8%


Total cases above: 2102
As of March 24, 5:50pm total cases 2628, 25% increase in 27 hrs, in part due to the greater number of tests being done.

51 confirmed deaths 0.019% almost 2%, including a 17 year old. The actual % should be much lower since there is sure to be a much greater number of cases not accounted for due to late start and inadequate supply to date. Then again deaths are a lagging indicator.


There was a report yesterday that 10% of people being tested in LA county were proving positive, and only about half of all tests had been analyzed. There is a delay between testing and results of several days, expected to improve in the future.

With this in mind, tested 26400, positive 2628 = 9.95%.
Last edited by PetWatch on Tue Mar 24, 2020 10:25 pm, edited 8 times in total.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by Dub Rubb »

yinzburgher wrote:Serious question: Where are people buying hand sanitizer? Every time I've been in the grocery store, pharmacy, department store, it's been too late in the day to get hand sanitizer. I don't need a lot. I mostly just wash my hands with soap and water and try to think about what I'm touching. But I like to keep a small bottle in the car or in my pocket when I walk around. When I see it online it is usually sold out or doesn't ship for weeks. Is there some secret website or do I just need to line up at a store at 6am and wait for it to open?
Don't know how close you are to the boonies, but I have found that small mom and pop shops in the middle of nowhere still have stock. I know, not a big help, but that little general store an hour away in the middle of nowhere just might have what you need.

Also, check to see if any local breweries/distilleries are using their facilities to make hand sanitizer. I know they are around here.

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Re: COVID-19 Impacts- No Conspiracy Theories

Post by The Sultan of SoWhat »

Cash Toll Payments Suspended on New Jersey Turnpike & Garden State Parkway.

There are no toll collectors on duty.


PARKWAY/TURNPIKE NEWS: As of 10:00 pm tonight, the New Jersey Turnpike Authority will no longer accept cash collections at all toll locations on the New Jersey Turnpike and Garden State Parkway.

Per the NJTP, if you do not have an E-ZPass tag, the equipment in the lane will capture a photograph of the license plate on the vehicle you are driving, and an invoice for the cost of the toll will be mailed to the registered owner. You will be billed at the cash toll rate; no additional administrative fees will be charged.


NJ is following the Pennsylvania Turnpike in this.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by yinzburgher »

Some patients from this past hospital that stood out to me.....but intentionally short on identifying details and specifics for reasons of privacy.

One pt I had on one of my first days was a rule out COVID-19. A family member traveled to an area with a large cluster of CV-19 and got ill with flu-like symptoms. Came home and isolated for 2 weeks for obvious reasons. Passed the illness along to the other people in the household. Everyone in the house got better except one developed a fever, cough and some degree of respiratory distress and then a cardiac arrest at home. Revived by EMS and brought to the hospital intubated and ventilated. At the very least there was some degree of anoxic brain injury. After some discussion the family decided to make the pt DNR (Do Not Resuscitate). Around that time the pt came back with a negative COVID test so I moved them out of the COVID area to a regular ICU room. The pt really declined over the next few hours and passed away. Luckily (in some sense) the pt was positive for a different respiratory condition (that is rarely lethal) that requires droplet precautions so I was justified in still wearing a mask in the new room. But I kept thinking of the above circumstances and wondering how many false negatives there could be with this brand new test of a brand new virus that we don't know much about. It all just sounded like COVID.

A confirmed COVID positive pt I took care of a few days into the job. This pt was beyond any meaningful recovery at this point. On roughly 8-10 different drips. On ridiculous ventilator settings. Chemically paralyzed. We tried a form of slow continuous dialysis but they were just too hemodynamically unstable. Multiple arrhythmias and sudden drops in blood pressure and oxygen saturation (at one point going down to the 30s before taking several hours just to come back up to 80%). It takes so long to put on your spacesuit that I often just stayed in the room for extended periods of time bc you can't do much to intervene when you're on the other side of the glass. Luckily other helpful nurses come and check on you from time to time to see what you need. And fortunately I worked at this facility 2 years ago so they knew me and were willing to be runners for me when necessary.......which is a nice change from having to win people over at every new place you go. The family couldn't really grasp how sick the pt was for a long time. They weren't allowed to visit due to quarantine orders. I took an iPad into the room with me so a family member could use a video app to see the pt. I like to think that seeing how the pt looked at that point might have helped convince the family to change the code status so we didn't have to do CPR on a pt that had no chance of survival. Plus they got to say a few words to the pt so maybe it helped a little bit with closure. The pt was not very old, not chronically ill, but did have a significant medical condition. I would have had this patient for a third straight day but they passed away minutes before the start of my shift.

On my last day at the hospital I had a rule-out COVID pt. An underlying medical condition had left them anemic and immunocompromised. Recently traveled on a plane. Came in with fevers and shortness of breath. The docs were thinking COVID and it certainly could have been but it probably could just as likely been another respiratory illness. A further complication developed at the hospital could have once again been consistent with COVID or could have been a side-effect of a treatment. So some quicker test results might have been helpful in this case. Anyway, this pt's oxygen requirements were increasing very quickly. They progressed from a nasal cannula to a higher flow mask to BiPAP (non-invasive ventilation) in fairly short order. Next step would be a mechanical ventilator. This pt was conversant (when not too short of breath), mentally very sharp, and seemed well aware of the seriousness of the situation. Occasionally when awake, they would turn on one of the 24 hour cable news channels with nothing but COVID coverage. Needless to say, that's gotta be an unfortunate and bizarre situation to find yourself in. It bothers me a bit that I don't know whether this patient was CV positive or negative. At some point I'll likely text one of the nurses to find out the result and hopefully hear some good news about how they're doing.

I realize none of these anecdotes are very positive (although I'm hoping the third one could be) but I should say that other COVID-19 patients in the ICU did get better and transfer to a less acute department. I heard one of the ICU doctors discussing how impressed she was with one of the pt's progress. I should also add that the above situations are maybe not all that different than every day ICU scenarios. But in each case, this brand new infectious disease that we don't entirely understand added to the uncertainty and complexity. Also, in these cases we had the staff, the supplies and the resources to adequately care for these patients. So it's really just one portrait of things before the onslaught.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by Dub Rubb »

yinzburgher wrote:Some patients from this past hospital that stood out to me.....but intentionally short on identifying details and specifics for reasons of privacy.

One pt I had on one of my first days was a rule out COVID-19. A family member traveled to an area with a large cluster of CV-19 and got ill with flu-like symptoms. Came home and isolated for 2 weeks for obvious reasons. Passed the illness along to the other people in the household. Everyone in the house got better except one developed a fever, cough and some degree of respiratory distress and then a cardiac arrest at home. Revived by EMS and brought to the hospital intubated and ventilated. At the very least there was some degree of anoxic brain injury. After some discussion the family decided to make the pt DNR (Do Not Resuscitate). Around that time the pt came back with a negative COVID test so I moved them out of the COVID area to a regular ICU room. The pt really declined over the next few hours and passed away. Luckily (in some sense) the pt was positive for a different respiratory condition (that is rarely lethal) that requires droplet precautions so I was justified in still wearing a mask in the new room. But I kept thinking of the above circumstances and wondering how many false negatives there could be with this brand new test of a brand new virus that we don't know much about. It all just sounded like COVID.

A confirmed COVID positive pt I took care of a few days into the job. This pt was beyond any meaningful recovery at this point. On roughly 8-10 different drips. On ridiculous ventilator settings. Chemically paralyzed. We tried a form of slow continuous dialysis but they were just too hemodynamically unstable. Multiple arrhythmias and sudden drops in blood pressure and oxygen saturation (at one point going down to the 30s before taking several hours just to come back up to 80%). It takes so long to put on your spacesuit that I often just stayed in the room for extended periods of time bc you can't do much to intervene when you're on the other side of the glass. Luckily other helpful nurses come and check on you from time to time to see what you need. And fortunately I worked at this facility 2 years ago so they knew me and were willing to be runners for me when necessary.......which is a nice change from having to win people over at every new place you go. The family couldn't really grasp how sick the pt was for a long time. They weren't allowed to visit due to quarantine orders. I took an iPad into the room with me so a family member could use a video app to see the pt. I like to think that seeing how the pt looked at that point might have helped convince the family to change the code status so we didn't have to do CPR on a pt that had no chance of survival. Plus they got to say a few words to the pt so maybe it helped a little bit with closure. The pt was not very old, not chronically ill, but did have a significant medical condition. I would have had this patient for a third straight day but they passed away minutes before the start of my shift.

On my last day at the hospital I had a rule-out COVID pt. An underlying medical condition had left them anemic and immunocompromised. Recently traveled on a plane. Came in with fevers and shortness of breath. The docs were thinking COVID and it certainly could have been but it probably could just as likely been another respiratory illness. A further complication developed at the hospital could have once again been consistent with COVID or could have been a side-effect of a treatment. So some quicker test results might have been helpful in this case. Anyway, this pt's oxygen requirements were increasing very quickly. They progressed from a nasal cannula to a higher flow mask to BiPAP (non-invasive ventilation) in fairly short order. Next step would be a mechanical ventilator. This pt was conversant (when not too short of breath), mentally very sharp, and seemed well aware of the seriousness of the situation. Occasionally when awake, they would turn on one of the 24 hour cable news channels with nothing but COVID coverage. Needless to say, that's gotta be an unfortunate and bizarre situation to find yourself in. It bothers me a bit that I don't know whether this patient was CV positive or negative. At some point I'll likely text one of the nurses to find out the result and hopefully hear some good news about how they're doing.

I realize none of these anecdotes are very positive (although I'm hoping the third one could be) but I should say that other COVID-19 patients in the ICU did get better and transfer to a less acute department. I heard one of the ICU doctors discussing how impressed she was with one of the pt's progress. I should also add that the above situations are maybe not all that different than every day ICU scenarios. But in each case, this brand new infectious disease that we don't entirely understand added to the uncertainty and complexity. Also, in these cases we had the staff, the supplies and the resources to adequately care for these patients. So it's really just one portrait of things before the onslaught.
I really appreciate this insight. Sadly you are seeing the darker reality of this situation first hand, but I feel that information is the most important thing we have right now. And while a lot of us are sitting at home, and watching the news, I prefer to hear some first-hand info.

Much respect to you and everyone else out there working face to face with this ****. You guys are the people we really need right now, and I am proud to "know" each and every one of you working the frontlines. Much love bros, and I wish the best for you and all of your families. Stay safe out there, and keep fighting the good fight.

Hopefully next time you are out this way it is for reasons of sharing beverages and shooting the **** about watches. I'm looking forward to it. Stay strong Yinz.

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Re: COVID-19 Impacts- No Conspiracy Theories

Post by Sporkboy »

A couple things.
1. Yinzburgher is a hero and doing some amazing work.
2. Boiling down a countries case numbers and comparing them is difficult and misleading for many reasons. We aren’t comparing apples to apples here. Each government has different resources, demographics, infrastructure, size, population density, testing capacity, testing protocols, preparedness, decisiveness, credibility with the people, trustworthy ness of numbers reported, etc.

Looking at Germany’s numbers I think that they are onto something with store clerk protective tents regardless of how silly it may sound.

Every situation is different, so I would take comparisons with a grain of salt. The bottom line is that we aren’t doing a very good job here and thank goodness this easily transmitted disease isn’t more lethal than it is.

3. When talking about policies that a government is taking, it can be hard to separate those from the political arena as those personalities are intertwined. Please remember to keep this apolitical as this forum is not a place for political talk.

I am not sure how a firm line can be drawn with policies and this topic, but this is a really great informational thread, and I would hate to see it locked. Even though I don’t disagree with talk of certain policy changes not being based in fact, that direction could quickly lead us to political topics.

4. Take a breath and remember that we are all friends here. We can educate one another in a civil manner, but try to keep the tone constructive. Citing sources at times is very helpful in a time of misinformation is a good practice and is encouraged.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by tjcdas »

yinzburgher wrote: Wed Mar 25, 2020 1:10 am Some patients from this past hospital that stood out to me.....but intentionally short on identifying details and specifics for reasons of privacy.

One pt I had on one of my first days was a rule out COVID-19. A family member traveled to an area with a large cluster of CV-19 and got ill with flu-like symptoms. Came home and isolated for 2 weeks for obvious reasons. Passed the illness along to the other people in the household. Everyone in the house got better except one developed a fever, cough and some degree of respiratory distress and then a cardiac arrest at home. Revived by EMS and brought to the hospital intubated and ventilated. At the very least there was some degree of anoxic brain injury. After some discussion the family decided to make the pt DNR (Do Not Resuscitate). Around that time the pt came back with a negative COVID test so I moved them out of the COVID area to a regular ICU room. The pt really declined over the next few hours and passed away. Luckily (in some sense) the pt was positive for a different respiratory condition (that is rarely lethal) that requires droplet precautions so I was justified in still wearing a mask in the new room. But I kept thinking of the above circumstances and wondering how many false negatives there could be with this brand new test of a brand new virus that we don't know much about. It all just sounded like COVID.

A confirmed COVID positive pt I took care of a few days into the job. This pt was beyond any meaningful recovery at this point. On roughly 8-10 different drips. On ridiculous ventilator settings. Chemically paralyzed. We tried a form of slow continuous dialysis but they were just too hemodynamically unstable. Multiple arrhythmias and sudden drops in blood pressure and oxygen saturation (at one point going down to the 30s before taking several hours just to come back up to 80%). It takes so long to put on your spacesuit that I often just stayed in the room for extended periods of time bc you can't do much to intervene when you're on the other side of the glass. Luckily other helpful nurses come and check on you from time to time to see what you need. And fortunately I worked at this facility 2 years ago so they knew me and were willing to be runners for me when necessary.......which is a nice change from having to win people over at every new place you go. The family couldn't really grasp how sick the pt was for a long time. They weren't allowed to visit due to quarantine orders. I took an iPad into the room with me so a family member could use a video app to see the pt. I like to think that seeing how the pt looked at that point might have helped convince the family to change the code status so we didn't have to do CPR on a pt that had no chance of survival. Plus they got to say a few words to the pt so maybe it helped a little bit with closure. The pt was not very old, not chronically ill, but did have a significant medical condition. I would have had this patient for a third straight day but they passed away minutes before the start of my shift.

On my last day at the hospital I had a rule-out COVID pt. An underlying medical condition had left them anemic and immunocompromised. Recently traveled on a plane. Came in with fevers and shortness of breath. The docs were thinking COVID and it certainly could have been but it probably could just as likely been another respiratory illness. A further complication developed at the hospital could have once again been consistent with COVID or could have been a side-effect of a treatment. So some quicker test results might have been helpful in this case. Anyway, this pt's oxygen requirements were increasing very quickly. They progressed from a nasal cannula to a higher flow mask to BiPAP (non-invasive ventilation) in fairly short order. Next step would be a mechanical ventilator. This pt was conversant (when not too short of breath), mentally very sharp, and seemed well aware of the seriousness of the situation. Occasionally when awake, they would turn on one of the 24 hour cable news channels with nothing but COVID coverage. Needless to say, that's gotta be an unfortunate and bizarre situation to find yourself in. It bothers me a bit that I don't know whether this patient was CV positive or negative. At some point I'll likely text one of the nurses to find out the result and hopefully hear some good news about how they're doing.

I realize none of these anecdotes are very positive (although I'm hoping the third one could be) but I should say that other COVID-19 patients in the ICU did get better and transfer to a less acute department. I heard one of the ICU doctors discussing how impressed she was with one of the pt's progress. I should also add that the above situations are maybe not all that different than every day ICU scenarios. But in each case, this brand new infectious disease that we don't entirely understand added to the uncertainty and complexity. Also, in these cases we had the staff, the supplies and the resources to adequately care for these patients. So it's really just one portrait of things before the onslaught.
Do you see large variation in the antibiograms in hospitals you visit and the risk or ways you deal with nosocomial infections.

My area is neurolgy but for a time also worked with a medication that treated, febrile neutropenia, nosocomialm infections, Pseudomonas aeruginosa ect.

It was amazing that at that time one of our goals was working with the hospitals to change their protocols of how they handled nursing home acquired pneumonia, community vs healthcare-associated pneumonia. It was amazing that multi-drug resistant organisms at work in the nusing homes were not factored in years ago and they treated NHP a community based pneumonia.

Great respect for the oncology teams, the ID teams and ER and ICU teams I met.
Last edited by tjcdas on Wed Mar 25, 2020 10:45 pm, edited 1 time in total.
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Re: COVID-19 Impacts- No Conspiracy Theories

Post by Sporkboy »

5. Sorry to hear you lost your job AndroidisAwesome. That sucks and the job market is going to be a challenging on right now. I hope that it is a time for you to reflect and maybe find a new professional path if the one you were on left something to be desired. Maybe it is time to start flipping bras if you know what I mean.
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