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3 minutes ago, Shive said:

It wouldn't be any different in our healthcare system if overloaded. Hospital administrators would be making those same exact calls here. The whole point of the measures in place are to flatten the curve and avoid overloading our healthcare system.

 

Also keep in mind that per capita, Italy has more ICU beds than the US by far. Here's an infographic showing just this:

 

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You can s*** on Italy's healthcare system all you want, but their system was way more well equipped than ours is. They just got hit harder and faster, because they didn't take it seriously up front.

 

Many experts are also saying that in the US this is the calm before the storm and expect the next few weeks to be the worst so far.

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As much as I like the NFL and how it takes us away mentally from everyday problems this virus has to be contained at any cost. When you realize just how many people are effected with their jobs a

Meanwhile on Wall Street....    

Chances are you don’t know what you’re talking about. It is most not certainly going to be “done” in a month. 

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3 minutes ago, DougDew said:

Respectfully, this process is the reason that scientists are hardly ever elevated to positions of leadership.  They go by evidence, data, and proof in order to get the right answer, and any decision made that doesn't follow that process is a "highly questionable" decision. 

 

Science has its place, but that place isn't everywhere.

 

The French scientist who did the hydro....zpak study...which was basically a 100% cure rate for 40 patients...said that the "data" was so overwhelming in the less than scientific process that it was basically as useful as Dr. Fauchi's clinical process.  

 

It about being right or wrong.  Not about process.

 

And the new studies, similarly with very small sample of people, show that this treatment(hydroxychloroquine + azithromycin) is no better than a regular care of patients with the virus. This is the reason why double blind randomized studies with huge samples are important - because the methodology and samples of both those studies are not reliable. Yes - the first one showed promise, and in the case of people dying every day with this illness by the thousands it's probably worth trying it before the big sample double blind studies come in, but selling it as some sort of panacea is NOT responsible. 

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7 minutes ago, stitches said:

And the new studies, similarly with very small sample of people, show that this treatment(hydroxychloroquine + azithromycin) is no better than a regular care of patients with the virus. This is the reason why double blind randomized studies with huge samples are important - because the methodology and samples of both those studies are not reliable. Yes - the first one showed promise, and in the case of people dying every day with this illness by the thousands it's probably worth trying it before the big sample double blind studies come in, but selling it as some sort of panacea is NOT responsible. 

I think the decision to use it or not is based upon possible harm or side effects to the patient, where almost everyone agrees that it can cause no real harm (and Dr Fauchi said that any harm caused can be reversed).  He is speaking in terms of whether or not the cocktail is effective. He doesn't know, because the proper process has not been followed yet.

 

The medical science community would never want to make any decision about a patient that causes harm to that patient.  That is more the goal of clinical studies, IMO, and to support the future development of drugs that can be effective.

 

The process has to be a little different when in a medical emergency, and if they don't know that it WON'T help patients, there is no reason to not administer it in the face of conflicting information.

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40 minutes ago, Chloe6124 said:

What happens when a system gets overwhelmed and there isn’t enough people to treat the ones sick or not enough supplies. The government makes the choice who gets treated when there is nationalized healthcare. The old are left to die. Don’t be dumb.

 

False, the government does not this decision at all. Clinicians make the call, same as in the US and in every other medical setting. 

 

How are the old "left to die"? If you're referring to, the introduction of revised clinical treatment guidelines during a pandemic, that's the reality of dealing with this. If the US hit an Italy like scenario, you would see the same. They would shift treatment priorities to save the greatest number of people net. Sadly, that means it likely that the patients with lower chances of survival may well only receive palliation. 

 

I'm far from dumb when it comes to healthcare and it's provision. It's my profession. 

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8 minutes ago, ColtsBlueFL said:

 

True.  The only silver lining is... has industry caught up in having the necessary facilities, equipment, and devices for healthcare teams to treat the resurgence?  Presently, the fear is spike in serious infections too fast and dire circumstances arise.

Not likely. Let me put it like this. 

 

15-20% of cases require hospitalization. As @Shive posted the stats above the US has 2.8 beds per 1000 people. This is 0.28%... This is a huge discrepancy between the ability of the healthcare system to accommodate the people who need it and the number of people who will likely need it. 

 

5% of people will require ventilators. The current capacity of the US healthcare system is 0.035%. 

 

And last point - all this equipment and patients require live medical workers to care for them. How do you do that in the matter of 2 weeks or month? 

 

So to summarize:

-you don't have anywhere close to the beds required to hospitalize everyone that needs hospitalizing

-you don't have anywhere close to the ventilators required to keep alive everyone that will need to be kept alive

-you don't have anywhere close to the medical work force to operate this equipment and take care of the sick.

 

Notice - I didn't even mention ALL THE OTHER sick people with various other illnesses that will need taking care of. 

 

 

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1 minute ago, SteelCityColt said:

 

False, the government does not this decision at all. Clinicians make the call, same as in the US and in every other medical setting. 

 

How are the old "left to die"? If you're referring to, the introduction of revised clinical treatment guidelines during a pandemic, that's the reality of dealing with this. If the US hit an Italy like scenario, you would see the same. They would shift treatment priorities to save the greatest number of people net. Sadly, that means it likely that the patients with lower chances of survival may well only receive palliation. 

 

I'm far from dumb when it comes to healthcare and it's provision. It's my profession. 

Socialdistancing GIF by mixdesign, incYou are doing a great job

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33 minutes ago, stitches said:

Pretty much all models and experts say the same thing - easing up restrictions before this is dealt with completely is a recipe for disaster. Meaning - all the measures you took in the first place will be for naught, you will still get similar spread after you ease restrictions as if you never had those strict restrictions in the first place. 

I don’t think anyone is talking about just going back to everything the same. You do it in a slow process and target the worst areas. Why shut down rural America or parts that aren’t affected.  Target the areas of need.

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2 minutes ago, stitches said:

Not likely. Let me put it like this. 

 

15-20% of cases require hospitalization. As @Shive posted the stats above the US has 2.8 beds per 1000 people. This is 0.28%... This is a huge discrepancy between the ability of the healthcare system to accommodate the people who need it and the number of people who will likely need it. 

 

5% of people will require ventilators. The current capacity of the US healthcare system is 0.035%. 

 

And last point - all this equipment and patients require live medical workers to care for them. How do you do that in the matter of 2 weeks or month? 

 

So to summarize:

-you don't have anywhere close to the beds required to hospitalize everyone that needs hospitalizing

-you don't have anywhere close to the ventilators required to keep alive everyone that will need to be kept alive

-you don't have anywhere close to the medical work force to operate this equipment and take care of the sick.

 

Notice - I didn't even mention ALL THE OTHER sick people with various other illnesses that will need taking care of. 

 

 

Thank goodness for companies like Toyota and the medical shows who have donated medical level equipment 

   Sadly I fall in the other group and already nervous about things

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1 hour ago, SteelCityColt said:

 

What happens when you don't have insurance in the US...

 

I disagree strongly with your interpretation of how the NHS works, it's just not true.

Maybe a few reports on how this has happened to dozens of people does not apply to whole of how NHS is supposed to work. But the evidence is out there that it happens. The specialists in the hospitals are openly complaining that the NHS is too restrictive on what and when they allow doctors to perform procedures. 

 

These restrictions lead to people not getting procedures they should and could otherwise get in non-state run healthcare systems. 

 

and I very well could be associating malpractice by doctors with NHS policies. But some of the reports were clearly stating that the NHS restrictions denied people from getting procedures done until it became too severe to cope on a daily basis. When preventative care and procedures would likely have been best in the long run for the individual and cost to NHS.

 

Idk if your so high up that your "echelons above reality" as some like to say, but this is what is happening, this is what people think of the NHS. The policies and procedures in black and white might not be saying exactly this, but how they are implemented is creating these situations.

 

I just needed a simple blood draw and a fibro liver scan. It was over 3 months to get them scheduled, and it was a full day off of work to complete. In the states that's a walk in and a couple hours.  Top it off the cost was paid for by my insurance and no cost to NHS, course that doesn't matter if the system is just back logged.

 

That speaks more towards your point about cuts to funding and lack of ability to hire more workers. Which is a highly unfortunate situation and wish you guys were more funded. But it's a zero sum game, the money has to come from somewhere. Either cut from someplace else, increase taxes, implement premiums, or expand co-pays.

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40 minutes ago, ColtsBlueFL said:

 

True.  The only silver lining is... has industry caught up in having the necessary facilities, equipment, and devices for healthcare teams to treat the resurgence?  Presently, the fear is spike in serious infections too fast and dire circumstances arise.

That's the whole point of our actions to date, to slow the spread.  Only treatments and vaccines will solve the problem.  So far, we are simply slowing down the pace at which the entire country will get infected so the supply of equipment and remedies can catch up.

 

The number of infections could continue to climb all over the country for for months, or a year.  At some point we have to acknowledge that we can get infected as we live are lives normally again, albeit with applying knowledge about preventative hygiene, social distancing and recreational gatherings so each person can defend themselves.  Hopefully, we have enough equipment and useful remedies to save more lives as we move along. 

 

The measurement is going to be the projected mortality rate.  50,000 people die from influenza, and that never caused government action.  If the number of deaths can be reduced to a certain level, life will go on.

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5 minutes ago, Narcosys said:

Maybe a few reports on how this has happened to dozens of people does not apply to whole of how NHS is supposed to work. But the evidence is out there that it happens. The specialists in the hospitals are openly complaining that the NHS is too restrictive on what and when they allow doctors to perform procedures. 

There is a lot of factors that go into deciding what is/isn't available on the NHS. You'd have to cite specifics here to understand the nuance of why/why not.

 

5 minutes ago, Narcosys said:

These restrictions lead to people not getting procedures they should and could otherwise get in non-state run healthcare systems. 

You mean in healthcare systems where you have to "pay". How does that spin out when you're uninsured. You always have the same choice here, i.e. to pay for a procedure. At least you have the fall back of free provision for a large amount of treatment. 

 

5 minutes ago, Narcosys said:

and I very well could be associating malpractice by doctors with NHS policies. But some of the reports were clearly stating that the NHS restrictions denied people from getting procedures done until it became too severe to cope on a daily basis. When preventative care and procedures would likely have been best in the long run for the individual and cost to NHS.

Agree, up front term prevention is the key, but that starts well before people even sniff a healthcare provider.

 

5 minutes ago, Narcosys said:

 

Idk if your so high up that your "echelons above reality" as some like to say, but this is what is happening, this is what people think of the NHS. The policies and procedures in black and white might not be saying exactly this, but how they are implemented is creating these situations.

 

I mean this now just into opinion unless you can cite any evidence. I could point you to the patient experience dataset for a quantifiable public view of the NHS. 

 

5 minutes ago, Narcosys said:

 

I just needed a simple blood draw and a fibro liver scan. It was over 3 months to get them scheduled, and it was a full day off of work to complete. In the states that's a walk in and a couple hours.  Top it off the cost was paid for by my insurance and no cost to NHS, course that doesn't matter if the system is just back logged.

You're going to have to explain this one... if it was a private insurance provider paying for it, are you sure it was treatment via the NHS. Treat at NHS facilities by "NHS" staff does not always mean you were treated by the NHS. 

 

A blood draw should have been offered in primary care unless you're talking something specialised. 

 

5 minutes ago, Narcosys said:

 

That speaks more towards your point about cuts to funding and lack of ability to hire more workers. Which is a highly unfortunate situation and wish you guys were more funded. But it's a zero sum game, the money has to come from somewhere. Either cut from someplace else, increase taxes, implement premiums, or expand co-pays.

 

The spending per capita on health is markedly higher the US compared to most similar countries (if memory serves), however the outcomes aren't proportionally "better". Just shows there's a whole lot more in play than just raw funding. For one thing, there literally isn't the staff to hire, because a gap has emerged between retirement rates and new qualifications of clinical staff here. 

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2 hours ago, SteelCityColt said:

 

I would agree it would be hard to change the system in the US, it's not so much the organisational changes, but equally the societal ones. 

 

There are however flaws in both approaches. If there was a perfect model, it would be adopted worldwide. 

 

I think the cultural aspects of places are the largest hurdles to mass changes. You have to be able to accept the Cons to go with the Pros of each. 

State run: you have to accept higher taxes and more say on what you can or cannot do at times.

Privatized: Higher costs which can result in not being able to have insurance at all. Ironically I fell the US could do more to force prices down...lookin at you big pharma...increased demand on Medicare and Medicaid affect the cost of health insurance. 

 

However, population growth and aging population demand (baby boomers) are something that you just cant help. Plus like you said about populations being lazy and not staying healthy has increased the cost associated with healthcare due to increased chronic illnesses.

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3 minutes ago, Narcosys said:

 

However, population growth and aging population demand (baby boomers) are something that you just cant help. Plus like you said about populations being lazy and not staying healthy has increased the cost associated with healthcare due to increased chronic illnesses.

 

Forget healthcare, these things worry me all round. I know it's a bit mad to say but we really don't take the long view as a species and this rock is finite in resource and space, so I think it's egregious in the long term that we're not pursuing sustaining habitation off Earth. 

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22 minutes ago, DougDew said:

That's the whole point of our actions to date, to slow the spread.  Only treatments and vaccines will solve the problem.  So far, we are simply slowing down the pace at which the entire country will get infected so the supply of equipment and remedies can catch up.

 

The number of infections could continue to climb all over the country for for months, or a year.  At some point we have to acknowledge that we can get infected as we live are lives normally again, albeit with applying knowledge about preventative hygiene, social distancing and recreational gatherings so each person can defend themselves.  Hopefully, we have enough equipment and useful remedies to save more lives as we move along. 

 

The measurement is going to be the projected mortality rate.  50,000 people die from influenza, and that never caused government action.  If the number of deaths can be reduced to a certain level, life will go on.

This is exactly right. We live in a free country.  There are risks in life everyday and we don’t stop what we are doing.  We need to get back to most things as soon as possible with  info on how to protect ourselves and protect the most vulnerable.  Companies are already  doing things. My mom had to go to Walmart today and they have the floor tape to keep people in line farther apart. Kroger is doing  things also. It does seem places that mass transit are being hit the worst.

 

Like they were just saying on the news NY is becoming the epicenter. We need to concentrate on the big metro areas it is effecting the most.  

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18 minutes ago, SteelCityColt said:

 

Forget healthcare, these things worry me all round. I know it's a bit mad to say but we really don't take the long view as a species and this rock is finite in resource and space, so I think it's egregious in the long term that we're not pursuing sustaining habitation off Earth. 

 

Well that escalated quickly

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21 minutes ago, Chloe6124 said:

This is exactly right. We live in a free country.  There are risks in life everyday and we don’t stop what we are doing.  We need to get back to most things as soon as possible with  info on how to protect ourselves and protect the most vulnerable.  Companies are already  doing things. My mom had to go to Walmart today and they have the floor tape to keep people in line farther apart. Kroger is doing  things also. It does seem places that mass transit are being hit the worst.

 

Like they were just saying on the news NY is becoming the epicenter. We need to concentrate on the big metro areas it is effecting the most.  

Just saw where NYTimes wants the entire country on lockdown....even Bozeman Montana.  LOL.  Its hard to keep people from driving out of state.   I don't think the US military has enough bullets to lock down everybody. 

 

Young people are asking why can't we just quarantine and isolate old people and the most vulnerable.  That would be the proper approach, but we are a free country, and more to the point, the government couldn't do that because our particular free country passed the civil rights act of 1964 and isolating old people would be age discrimination, LOL.

 

There are no solutions to something like this in a free country and a free economy, other than people need to protect themselves.  Kinda the point of the second amendment too but that's another topic.

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1 hour ago, SteelCityColt said:

 

False, the government does not this decision at all. Clinicians make the call, same as in the US and in every other medical setting. 

 

How are the old "left to die"? If you're referring to, the introduction of revised clinical treatment guidelines during a pandemic, that's the reality of dealing with this. If the US hit an Italy like scenario, you would see the same. They would shift treatment priorities to save the greatest number of people net. Sadly, that means it likely that the patients with lower chances of survival may well only receive palliation. 

 

I'm far from dumb when it comes to healthcare and it's provision. It's my profession. 

Governor of New York says he's not prioritizing younger people so, I guess it's first come first serve when the system gets overwhelmed

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4 minutes ago, Nadine said:

Governor of New York says he's not prioritizing younger people so, I guess it's first come first serve when the system gets overwhelmed

By law, he's walking a discrimination line if he signals that he is making policies based upon age in any way.  Even if its the best approach, that doesn't matter.  He simply can't go there.

 

Other countries may be able to take that more efficient approach.  We can't

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5 minutes ago, Nadine said:

Governor of New York says he's not prioritizing younger people so, I guess it's first come first serve when the system gets overwhelmed

 

I'm not sure that is his call to make. The attending physicians should have on the ground powers to decide on a case by case basis.  

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1 hour ago, DougDew said:

Respectfully, this process is the reason that scientists are hardly ever elevated to positions of leadership.  They go by evidence, data, and proof in order to get the right answer, and any decision made that doesn't follow that process is a "highly questionable" decision. 

 

Science has its place, but that place isn't everywhere.

 

The French scientist who did the hydro....zpak study...which was basically a 100% cure rate for 40 patients...said that the "data" was so overwhelming in the less than scientific process that it was basically as useful as Dr. Fauchi's clinical process.  

 

 

There has been more of a meet in the middle already.  That French study was very small where they report, “showed a significant reduction of the viral carriage” after six days of treatment and “much lower average carrying duration” compared to patients receiving other treatment."  Just like newer studies saying they found essentially no difference.

 

The information they referring to specifically in both cases is purely anecdotal. However, It’s already being given to many hospitalized patients in New York, and larger trials are starting -- part of a broad effort to find anything that might work against the illness. And the supply is very low still, so trials on the hospitalized is warranted, and they're already beginning.

 

These studies are needed to prove the drugs are safe and effective against coronavirus, and to show that people would not have recovered just as well on their own. One such study started Tuesday in New York.  Becasue of the potentially bad side effects, they have to be sure they are actually helping people, and not unintentionally hurting them as well. I'm on record as allowing compassionate use (though getting useful data from that is low, for various reasons) but really focusing the currently limited supplies to the hotbed of infectionsvand in structured clinical trials.

 

1 hour ago, stitches said:

Not likely. Let me put it like this. 

 

15-20% of cases require hospitalization. As @Shive posted the stats above the US has 2.8 beds per 1000 people. This is 0.28%... This is a huge discrepancy between the ability of the healthcare system to accommodate the people who need it and the number of people who will likely need it. 

 

5% of people will require ventilators. The current capacity of the US healthcare system is 0.035%. 

 

And last point - all this equipment and patients require live medical workers to care for them. How do you do that in the matter of 2 weeks or month? 

 

This mean all restriction will be lifted?  I missed that, and if so is completely irresponsible policy.

 

Quote

 

So to summarize:

-you don't have anywhere close to the beds required to hospitalize everyone that needs hospitalizing

 

Thus flattening the curve.  Reduce infections, spread it out over time. It's a matter of numbers- % of beds needed to be added by rate/time {click to enlarge}

 

S5N8ltd.jpg

VIIOUfH.jpg

 

I'm hoping for the left side. And hopefully states/healthcare institutions are already preparing to add bed capacity in some way.  Failing to address this now would be irresponsible too.

 

Quote

-you don't have anywhere close to the ventilators required to keep alive everyone that will need to be kept alive

 

The process to address that has already begun-

 

https://www.nsmedicaldevices.com/analysis/seven-ventilator-manufacturers/

 

There's more joining the brigade as well.

 

Quote

-you don't have anywhere close to the medical work force to operate this equipment and take care of the sick.

 

To me, the dire need of PPE is just as much a concern.  Being addressed-

 

"Gerber PPE Task Force and Resource Team to support their global customers and partners as they work to increase their production or transition to manufacturing personal protective equipment (PPE). More than 300 manufacturers, including major global companies, rely on Gerber's advanced software, hardware solutions and expertise to produce masks and other PPE."

 

https://www.massdevice.com/honeywell-3m-ramp-up-n95-face-masks-production/

 

Seems like workforce is being addressed (especially easing restrictions temporarily on 3rd and 4th year medical students) as well -

 

https://www.npr.org/sections/health-shots/2020/03/25/820706226/states-get-creative-to-find-and-deploy-more-health-workers-in-covid-19-fight

 

 

Quote

Notice - I didn't even mention ALL THE OTHER sick people with various other illnesses that will need taking care of. 

 

 

Elective stuff is back burner.  Acute illness, severe burns, emergencies, and trauma still have to be cared for.

 

1 hour ago, DougDew said:

That's the whole point of our actions to date, to slow the spread.  Only treatments and vaccines will solve the problem. 

 

Yes. Treatments and vaccines take time though.  Medical workers might get early vaccination maybe as early as fall-

 

https://techcrunch.com/2020/03/23/moderna-could-make-experimental-covid-19-vaccine-available-to-healthcare-workers-by-fall/

 

Quote

 

So far, we are simply slowing down the pace at which the entire country will get infected so the supply of equipment and remedies can catch up.

 

Done right, it can work, from where I see it.

 

Quote

The number of infections could continue to climb all over the country for for months, or a year.  At some point we have to acknowledge that we can get infected as we live are lives normally again, albeit with applying knowledge about preventative hygiene, social distancing and recreational gatherings so each person can defend themselves.  Hopefully, we have enough equipment and useful remedies to save more lives as we move along. 

!

 

Quote

The measurement is going to be the projected mortality rate.  50,000 people die from influenza, and that never caused government action.  If the number of deaths can be reduced to a certain level, life will go on.

 

For influenza, it's not because these lacked for treatment/remedies.  It's just they bdidn't work well enough.  The goal here is to prevent fatalities of COVID-19 that otherwise could have been avoided only because they could not get the necessary treatment.

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2 minutes ago, DougDew said:

By law, he's walking a discrimination line if he signals that he is making policies based upon age in any way.  Even if its the best approach, that doesn't matter.  He simply can't go there.

 

Other countries may be able to take that more efficient approach.  We can't

 

There is a difference between a policy that limits or controls access by demographic, and the clinical decision process as who to gets treated first and how. 

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9 minutes ago, SteelCityColt said:

 

There is a difference between a policy that limits or controls access by demographic, and the clinical decision process as who to gets treated first and how. 

I would bet that if the clinical process listed age as a significant criteria for who gets preferred treatment, it would be legally challenged.  But I could be wrong.

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4 minutes ago, ColtsBlueFL said:

This mean all restriction will be lifted?  I missed that, and if so is completely irresponsible policy.

I don't know if they will be. Trump was talking about doing it for Easter because people wanted to go to church. "Easter Sunday... and you will have packed churches all over our country. I think it will be a beautiful time".

 

4 minutes ago, ColtsBlueFL said:

 

Thus flattening the curve.  Reduce infections, spread it out over time. It's a matter of numbers-

 

S5N8ltd.jpg

VIIOUfH.jpg

 

I'm hoping for the left side. And hopefully states/healthcare institutions are already preparing to add bed capacity in some way.  Failing to address this now would be irresponsible too.

Yep, all the restrictions are done in an attempt to flatten the curve and spread the infections over longer period of time. But if you pull back on the restrictions and send people to church, you can only guess what will happen. 

 

4 minutes ago, ColtsBlueFL said:

 

The process to address that has already begun-

 

https://www.nsmedicaldevices.com/analysis/seven-ventilator-manufacturers/

 

There's more joining the brigade as well.

 

 

To me, the dire need of PPE is just as much a concern.  Being addressed-

 

"Gerber PPE Task Force and Resource Team to support their global customers and partners as they work to increase their production or transition to manufacturing personal protective equipment (PPE). More than 300 manufacturers, including major global companies, rely on Gerber's advanced software, hardware solutions and expertise to produce masks and other PPE."

 

https://www.massdevice.com/honeywell-3m-ramp-up-n95-face-masks-production/

 

Seems like workforce is being addressed (especially easing restrictions temporarily on 3rd and 4th year medical students) as well -

 

https://www.npr.org/sections/health-shots/2020/03/25/820706226/states-get-creative-to-find-and-deploy-more-health-workers-in-covid-19-fight

 

 

 

Elective stuff is back burner.  Acute illness, severe burns, emergencies, and trauma still have to be cared for.

 

Yeah, those are all important things and they need to be done one way or another if saving lives is anywhere near the top of the list of priorities. I still don't think it will be enough if you don't flatten the curve. And BTW this won't be done in 2 weeks time. You need months both to flatten the curve and to accomplish most of the measures that will help with increasing capacity. above. 

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Just now, DougDew said:

I would bet that if the clinical process listed age as a significant criteria for who gets preferred treatment, it would be legally challenged.  But I could be wrong.


Well no.. because this is in existing clinical guidelines. Here it is anyway. For instance a doctor here won’t give an endoscopy on a 90 year old unless you’re talking very unusual circumstance due to the risk. But here we are talking doctors treating masses of individuals so they will be risk stratifying the entire cohort. 

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36 minutes ago, DougDew said:

Just saw where NYTimes wants the entire country on lockdown....even Bozeman Montana.  LOL.  Its hard to keep people from driving out of state.   I don't think the US military has enough bullets to lock down everybody. 

 

Young people are asking why can't we just quarantine and isolate old people and the most vulnerable.  That would be the proper approach, but we are a free country, and more to the point, the government couldn't do that because our particular free country passed the civil rights act of 1964 and isolating old people would be age discrimination, LOL.

 

There are no solutions to something like this in a free country and a free economy, other than people need to protect themselves.  Kinda the point of the second amendment too but that's another topic.

My mom said when she went to Walmart there wasn’t a lot of people but there was quite a few elderly. One guy had his scooter and didn’t look like he had a care in the world. Now I live in northern Indiana in Allen County. We have only had 7 confirmed cases. It seems the Indy area has most of the cases. 

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33 minutes ago, ColtsBlueFL said:

 

There has been more of a meet in the middle already.  That French study was very small where they report, “showed a significant reduction of the viral carriage” after six days of treatment and “much lower average carrying duration” compared to patients receiving other treatment."  Just like newer studies saying they found essentially no difference.

 

The information they referring to specifically in both cases is purely anecdotal. However, It’s already being given to many hospitalized patients in New York, and larger trials are starting -- part of a broad effort to find anything that might work against the illness. And the supply is very low still, so trials on the hospitalized is warranted, and they're already beginning.

 

These studies are needed to prove the drugs are safe and effective against coronavirus, and to show that people would not have recovered just as well on their own. One such study started Tuesday in New York.  Becasue of the potentially bad side effects, they have to be sure they are actually helping people, and not unintentionally hurting them as well. I'm on record as allowing compassionate use (though getting useful data from that is low, for various reasons) but really focusing the currently limited supplies to the hotbed of infectionsvand in structured clinical trials.

 

 

This mean all restriction will be lifted?  I missed that, and if so is completely irresponsible policy.

 

 

 

I'm only aware of the credible study (not clinical) coming from France.  I don't know if the other studies you speak of that countered the positivity from that study were from a credible doctor like the well-respected French doctor.  I said before, political fissures have begun to develop and there is a good chance that these other studies are simply mentioned now to support the political criticism of Trump being inappropriately positive. 

 

At this point, the only two studies that matter are the French study that started this and the Fauchi clinic trials that will either support or not.  No matter what trials say however, the drug will be administered even if it mildly thwarts the replication of the virus within the body, keeping more ventilators free and available.

 

Medical professionals were not elected, so they won't decide to enforce or lift restriction policies.  They only advise, and every medical professional would want everybody inside for 3 years until the virus was completely eliminated.

 

The decision will probably be based upon projected mortality rates in any given area, which will have a lot to do with population density, number of beds and ventilators locally available.   Sounds like NYC and maybe New Orleans is in trouble. 

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12 minutes ago, SteelCityColt said:


Well no.. because this is in existing clinical guidelines. Here it is anyway. For instance a doctor here won’t give an endoscopy on a 90 year old unless you’re talking very unusual circumstance due to the risk. But here we are talking doctors treating masses of individuals so they will be risk stratifying the entire cohort. 

But its the risk, not the age.  If two equally infected people are at equal risk of dying, I doubt that a doctor can choose to pick the 39 year old over the 60 year old simply because of age.

 

If they say that a 60 year old is inherently at greater "risk" than a 39 year old, that's a different story, but that appears to give doctors the ability to discriminate based on age simply because they are deemed to be an expert on health.

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42 minutes ago, ColtsBlueFL said:

 

Done right, it can work, from where I see it.

 

 

What if we are fighting a prolonged battle we cannot win with flattening the curve of new infections?? I still think there needs to be more resources in certain clusters and selective shutdowns. 

 

Kentucky has done a remarkable job compared to its neighbors TN and IN, and the high rates of smoking and other illnesses made their population a high risk target for Covid-19, they closed down a week or two earlier than TN and IN, but when is it really going to be good enough to resume some normalcy??? You can never make a cinch of an argument or judgement, even when numbers are in your favor. You are still playing the odds for a while, IMO.

 

To put it crudely, shut down more states than necessary, have 5,000 deaths and hurt the economy and the backbone of the country even more hurting millions of families or shut down fewer states, letting governors choose what to do with their state, whether to reopen work places or not, have a semblance of a normal economy and have 15,000 deaths while just hurting thousands of families?? Are those our choices??

 

I may have enough rainy day funds worth 3 months of paychecks but millions of Americans do not. I am just thinking out loud because these are hard choices to make.

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4 minutes ago, stitches said:

 

I don't know if they will be. Trump was talking about doing it for Easter because people wanted to go to church. "Easter Sunday... and you will have packed churches all over our country. I think it will be a beautiful time".

Which is completely insane to me. Ease restrictions so people can jam into churches, share a single thing of wine, exploding the infection rate yet again, and completely starting this over again. 

 

1 minute ago, DougDew said:

But its the risk, not the age.  If two equally infected people are at equal risk of dying, I doubt that a doctor can choose to pick the 39 year old over the 60 year old simply because of age.

 

If they say that a 60 year old is inherently at greater "risk" than a 39 year old, that's a different story, but that appears to give doctors the ability to discriminate based on age simply because they are deemed to be an expert on health.

I cannot fathom a doctor choosing between two patients based on risk and solely using age as a determining factor. It's a more holistic view of the patient's potential to recover.

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7 minutes ago, DougDew said:

But its the risk, not the age.  If two equally infected people are at equal risk of dying, I doubt that a doctor can choose to pick the 39 year old over the 60 year old simply because of age.

 

If they say that a 60 year old is inherently at greater "risk" than a 39 year old, that's a different story, but that appears to give doctors the ability to discriminate based on age simply because they are deemed to be an expert on health.


Yes but the age sets a line in the sand where they assess differently. 
 

In your example the difference between 39 and 60 isn’t that great and without other complications, changes of survival probably not hugely different. 
 

But yes doctors have the right to make that kind of judgement call. The influence of age will be factored in alone with co morbidity etc. It’s a clinical decision. If there is not enough capacity to treat all, they will adopt a strategy that will produce the best net survival. 
 

This is why I’m so vocal about taking measures now to flatten the curve. It decreases the number of decisions like this. 

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1 minute ago, SteelCityColt said:


Yes but the age sets a line in the sand where they assess differently. 
 

In your example the difference between 39 and 60 isn’t that great and without other complications, changes of survival probably not hugely different. 
 

But yes doctors have the right to make that kind of judgement call. The influence of age will be factored in alone with co morbidity etc. It’s a clinical decision. If there is not enough capacity to treat all, they will adopt a strategy that will produce the best net survival. 

Its a fine line.  A doctor deciding on a case by case basis is different than a Governor making a policy.

 

 

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33 minutes ago, SteelCityColt said:


Yes but the age sets a line in the sand where they assess differently. 
 

In your example the difference between 39 and 60 isn’t that great and without other complications, changes of survival probably not hugely different. 
 

But yes doctors have the right to make that kind of judgement call. The influence of age will be factored in alone with co morbidity etc. It’s a clinical decision. If there is not enough capacity to treat all, they will adopt a strategy that will produce the best net survival. 
 

This is why I’m so vocal about taking measures now to flatten the curve. It decreases the number of decisions like this. 

I'll pass on socialized medicine if that's how it works

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40 minutes ago, DougDew said:

Its a fine line.  A doctor deciding on a case by case basis is different than a Governor making a policy.

 

 


Completely agree, why I said I don’t feel it’s his call to make.

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1 hour ago, SteelCityColt said:

 

I'm not sure that is his call to make. The attending physicians should have on the ground powers to decide on a case by case basis.  

Heard him say that during his press conference this am. Not the first come first serve thing but, that they were not going to assume older patients didn't get treatment

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7 minutes ago, jvan1973 said:

I'll pass on socialized medicine if that's how it works


No that’s just clinical practice, nothing to do with the nature of the overarching healthcare system itself. 
 

In the simplest level it’s all interpretations of “do no harm”, 

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Just now, Nadine said:

Heard him say that during his press conference this am. Not the first come first serve thing but, that they were not going to assume older patients didn't get treatment


Which is a fair thing to say, and to be honest probably is to offset panic. Leave the medical decisions to the professionals.

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