Medical Discussion of Coronavirus

[Rando]

I told them absolutely not, but wanted to ensure I'm not overreacting?

I think there definitely is a safety risk, namely an active COVID patient in an inadequately ventilated space potentially exposing the staff for a prolonged period Heck we don't even let active COVID patients in the building. But my advice would be to focus on that as some of the points in your post aren't relevant.

[White.Beard.Doc]

Admin was in my office yesterday eyeing a small (maybe 6x8' exam) room attached to my office. The room fits one chair and is occasionally used to provide IV infusions. We try not to use it because it shares a wall and false ceiling with my office and exam rooms and voices travel right through. In any event, they decided they want to run an outpatient COVID infusion center out of that room. It is 6'' from my office door, 2' from my nurses' desks, and immediately adjacent to all of my exam rooms. Furthermore, there is no special ventilation, the ceilings are false tile ceilings, and the clinic is not a large area. ie nobody can distance from anyone because we are tucked back in a corner. Despite having an entirely empty 4th floor, numerous more isolated empty offices/exam rooms, and a building down the street which has dozens of empty rooms they choose a tiny room, in a corner, in the Urology clinic.

I told them absolutely not, but wanted to ensure I'm not overreacting? There's no way this isn't some type of OSHA, department of health, CDC, violation? I had to move a case into a special OR yesterday because they were persistently COVID positive (asymptomatic and recovered) from COVID in September due to CDC guidelines, but somehow they can march actively infected COVID patients into my office for infusions and that's not against some guideline? Also one of my nurses is pregnant so they are removing her from my team (no replacement) due to risk of exposure. How they somehow thought this was a reasonable idea and is in anyway safe at all is beyond me. Completely undue risk to my nursing staff, healthy patients, and myself. Would anyone else stand for this? Perhaps I'm overreacting and this is the new normal we need to accept with COVID?

Sometimes administrators make totally hare-brained decisions. This is one of those situations.

I would recommend you stay very focused, very straightforward with your response. "Putting Covid positive patients in that location represents a massive infection control risk. You are creating an unnecessary risk of nosocomial transmission for staff and other patients when there are much safer options in other locations."

[Kamban]

Admin was in my office yesterday eyeing a small (maybe 6x8' exam) room attached to my office. The room fits one chair and is occasionally used to provide IV infusions. We try not to use it because it shares a wall and false ceiling with my office and exam rooms and voices travel right through. In any event, they decided they want to run an outpatient COVID infusion center out of that room. It is 6'' from my office door, 2' from my nurses' desks, and immediately adjacent to all of my exam rooms. Furthermore, there is no special ventilation, the ceilings are false tile ceilings, and the clinic is not a large area. ie nobody can distance from anyone because we are tucked back in a corner. Despite having an entirely empty 4th floor, numerous more isolated empty offices/exam rooms, and a building down the street which has dozens of empty rooms they choose a tiny room, in a corner, in the Urology clinic.

I told them absolutely not, but wanted to ensure I'm not overreacting? There's no way this isn't some type of OSHA, department of health, CDC, violation? I had to move a case into a special OR yesterday because they were persistently COVID positive (asymptomatic and recovered) from COVID in September due to CDC guidelines, but somehow they can march actively infected COVID patients into my office for infusions and that's not against some guideline? Also one of my nurses is pregnant so they are removing her from my team (no replacement) due to risk of exposure. How they somehow thought this was a reasonable idea and is in anyway safe at all is beyond me. Completely undue risk to my nursing staff, healthy patients, and myself. Would anyone else stand for this? Perhaps I'm overreacting and this is the new normal we need to accept with COVID?

I absolutely would not accept it and would not show up for work if they went ahead with this plan. And will also report it to the department of health if they threaten to fire you.

[Tim]

"Also one of my nurses is pregnant so they are removing her from my team (no replacement) due to risk of exposure."

The increase risk is rather obvious. Why is pregnancy given preference? Creating a hazardous work environment is not an acceptable practice.
This is only to point out their own admission that they have already acknowledged that it is unsafe.

[Kamban]

I would recommend you stay very focus, very straightforward with your response. "Putting Covid positive patients in that location represents a massive infection control risk. You are creating an unnecessary risk of nosocomial transmission for staff and other patients when there are much safer options in other locations."

Something tells me that they will not be able to process this info with what little is present between their thick skulls and will still go ahead with their original plan. Sometimes you have to play fire with fire.

[CordMcNally]

I think there definitely is a safety risk, namely an active COVID patient in an inadequately ventilated space potentially exposing the staff for a prolonged period Heck we don't even let active COVID patients in the building. But my advice would be to focus on that as some of the points in your post aren't relevant.

You just described an ER.

[Jaqen Haghar MD]

We started our #2 round of Pfizer vaccines the last 2 days. Got mine yesterday. Wow. #2 was no joke. By 12 hours, started getting super freezing cold, then fever, mild headache, body aches, lymphadenopathy, and basically felt like influenza without respiratory symptoms. A fair amount of people are reporting the same. It definitely generates an immune response.

People who had covid who get the vaccine seem to get this or worse on the 1st shot. They are a bit scared to get #2.

Man my **s is kicked.

[FunkDoc83]

We started our #2 round of Pfizer vaccines the last 2 days. Got mine yesterday. Wow. #2 was no joke. By 12 hours, started getting super freezing cold, then fever, mild headache, body aches, lymphadenopathy, and basically felt like influenza without respiratory symptoms. A fair amount of people are reporting the same. It definitely generates an immune response.

People who had covid who get the vaccine seem to get this or worse on the 1st shot. They are a bit scared to get #2.

Man my **s is kicked.

Feel better soon. Did you take tylenol or NSAIDS? I get my second shot tomorrow. Based on a positive antibody test I had done a few months back, I at some point had COVID. I did not have any side effects from the first shot though. I think I will probably pre-treat myself after the second shot.

[StarTrekDoc]

Yeah - had GRounds yesterday by ID team and pretty much the same general tone: #2 gonna have more symptoms for the young. They said 'okay' for tylenol, especially after the 2nd dose is considered okay. - Our ID team runs pretty conservative by-the-book too so think it's ok to antipyretic

[Jaqen Haghar MD]

Feel better soon. Did you take tylenol or NSAIDS? I get my second shot tomorrow. Based on a positive antibody test I had done a few months back, I at some point had COVID. I did not have any side effects from the first shot though. I think I will probably pre-treat myself after the second shot.

No... I’m the suffer through type. I work today and yesterday. Yesterday was fine. Today will suck. Hours 12-18 I started feeling pretty beat up. I could barely get up this afternoon.

[Lordosis]

Second shot coming up on Saturday! After reading your experiences it sounds like I have some fun stuff to look forward too!

[Hatton]

I had a neighbor walk my dog after shot 2 because I did not think I could do it. Also the skin reaction was dramatic.

[EyeOweYou]

We started our #2 round of Pfizer vaccines the last 2 days. Got mine yesterday. Wow. #2 was no joke. By 12 hours, started getting super freezing cold, then fever, mild headache, body aches, lymphadenopathy, and basically felt like influenza without respiratory symptoms. A fair amount of people are reporting the same. It definitely generates an immune response.

People who had covid who get the vaccine seem to get this or worse on the 1st shot. They are a bit scared to get #2.

Man my **s is kicked.

Had almost the exact same experience with dose #2. Awakened by intense chills/rigors about 12 hours after receiving it, then nearly 24 hours of chills, myalgia, fever, etc. Worked through it but it was no fun.

[nephron]

A secretary told me she had all the symptoms of covid again after she got the vaccine. I just saw a patient who had severe covid with altered mental status for about a month sometime in April who just had the vaccine and now had a fever and altered mental status again. That's something else that bothers me about this whole roll out. I know that we don't have any evidence to recommend against getting a vaccine if you've already had covid but, I also don't think that you have any evidence supporting vaccinating all of these people with covid. I can't imagine a randomized controlled trial demonstrating a benefit for covid vaccine in patients with prior covid because the incidence of reinfection seems to be so small. It would take large numbers before you showed any difference between the vaccinated and unvaccinated group (probably much more then 30,000 of which only 160-180 patients in the placebo got infected which is pretty remarkable if you think about it too). They are vaccinating patients and nursing homes now and I have seen a lot of patients telling me how pleased they are they got the vaccine when I know that they are infected in April. This is probably going to be another blunder of the cdc, making more recommendations where there is no evidence. I think that it would be much better just to offer the vaccine to people who have had the virus and tell them that there is no evidence rather then doing what the cdc and Fauci are doing in telling people to get vaccinated 90 days or so after the virus. They may eventually show a benefit, but I certainly wouldn't recommend doing something that as far as I can tell is very unproven. I think that it will be a while before we know anything. I don't know what I would do if I had the virus previously and I am certainly not advocating anyone not get vaccinated, I am just complaining about the CDC.

[Lordosis]

I don't know... Every time I get the vaccine I get covid...