Medical Discussion of Coronavirus

[Tim]

“The Death of Expertise” is an excellent book that everyone should read (including experts). I re-read recently in the context of Covid.

Bush II was right, the president is the “decider”. Fauci/NIH/CDC are providing guidance, the president decides what to do with it.

And then the "messaging begins" and various sources praise or complain. Plenty of blame to go around with the absence of facts.

[Sampter]

“The buck stops here”

Don’t become President of the United States if you can’t make difficult decisions and deal with the outcomes and criticisms.

[Tim]

“The buck stops here”

Don’t become President of the United States if you can’t make difficult decisions and deal with the outcomes and criticisms.

Yes, but some don't want to accept the decisions and some don't want to accept responsibility. Some just make things up.

Two positive on the first cruise.

https://www.yahoo.com/gma/2-passengers-test-positive-covid-003023545.html

[Tim]

I see 178 lawsuits heading their way.....

https://www.cbsnews.com/news/covid-vaccine-houston-texas-hospital-lawsuit-dismissed/

117 plaintiffs in the first one dismissed. This is going to be a difficult one for plaintiffs to win.

[pulmdoc]

https://www.cbsnews.com/news/covid-vaccine-houston-texas-hospital-lawsuit-dismissed/

117 plaintiffs in the first one dismissed. This is going to be a difficult one for plaintiffs to win.

I would say impossible to win; Supreme Court precedent is on the side of the hospital and it's going to defy common sense to argue that hospitals don't have an interest in public health.

Individual employees can attempt the "reasonable accomodations" clause under ADA but if you are an OB nurse it's not like you can WFH.

[Shant]

They can't even do that because this group is the people left who did not tell the hospital that they had a religious or medical objection to the vaccine. The hospital has been very accommodating already for legitimate (or at least legally protected) reasons.

[Tim]

I would say impossible to win; Supreme Court precedent is on the side of the hospital and it's going to defy common sense to argue that hospitals don't have an interest in public health.

Individual employees can attempt the "reasonable accomodations" clause under ADA but if you are an OB nurse it's not like you can WFH.

The one ethical point that stands out is this is still EUA, full approval has not been granted.
I’s dotted and T’s crossed. From a scientific procedural point of view, the accepted scientific method has not been completed.

https://irb.ucsf.edu/emergency-use-and-compassionate-use-experimental-drugs-and-devices

There is something to be said when science says, this time it is different. Forget the rigors of process “required”, go ahead and fire them. It should work. Maybe, I think. Informed consent is not really necessary. Just because it should work out okay. It is different, it has never been done before. Is it an emergency that the people are required to be vaccinated? Then why stop at employment? Why stop at consent at all? Where is the line drawn is the question in this war against the pandemic?
Not saying the choice is right or wrong, it is debatable whether an EUA treatment should be mandatory. I don’t necessarily feel one way or the other.
Another alternative would be to terminate a worker that is unvaccinated and turns up positive. Feels different, calling for termination for an illness. Actually makes more sense. Broke a rule and got sick. Fact based, not opinion of bureaucrats as some would say. I seriously doubt that result in harm to patients or employees.

[Shant]

The second ethical point that stands out is the duty to protect vulnerable patients from large predictable risks. The vaccine is not mandatory, it is a condition of employment. If you are not comfortable with the conditions of your employment, you need to change your employment. This testing you propose is unworkable, I doubt that I need to elaborate on why.

[Tim]

The second ethical point that stands out is the duty to protect vulnerable patients from large predictable risks. The vaccine is not mandatory, it is a condition of employment. If you are not comfortable with the conditions of your employment, you need to change your employment. This testing you propose is unworkable, I doubt that I need to elaborate on why.

The Corporate Risk Officer was the first termination. Predictable, he is employed, with zero patient contact. The next step is any vendor that goes on the premises needs to be vaccinated. And then the employees of the vendors company need to be vaccinated. Conclusion, vulnerable patients need to be protected by requiring vaccinations. All in the umbrella of duty without an approved vaccine nor data and short cutting the process. A new condition of employment or doing business.

Rhetorical only. I personally see the vaccine as a fantastic benefit with low risk to both the individual and every segment of society. My opinion is biased because the leader decided to vaccinate on his “own guidelines” rather than CDC or the state. He makes decisions on what is best for his healthcare system, not altruism.
100 foreign nationals were allowed to be flown in and vaccinated while denying vaccines to eligible patients the were in the approved categories. I wonder if the front of the line made donations? He marches to his own drummer which is fine. I wish he had waited for FDA approval. I also wish he had vaccinated my 93 yr old MIL rather than vaccinating what I assume are wealthy international patients with government funded vaccines. He uses ethics when convenient. This is his personal opinion, not science or based on altruism or ethics. He probably is right. I expect it to be approved. I personally don’t understand the resistance to the vaccine.

[StateOfMyHead]

I like it.

https://www.baltimoresun.com/coronavirus/bs-md-maryland-vaccinations-required-at-hospitals-coronavirus-20210609-4vvdtoqov5dfdcpj5ujelei7eu-story.html

[Lordosis]

We were just told that OSHA is putting in all these requirements starting Thursday. We need to have plastic dividers between where staff sit if closer then 6 feet, Wear a N95 if with patient under investigation for covid, Mask and full face guard with all patients, etc.

Where were they last year??? It is like they missed the party and are trying to make up for lost time.

[billy]

We were just told that OSHA is putting in all these requirements starting Thursday. We need to have plastic dividers between where staff sit if closer then 6 feet, Wear a N95 if with patient under investigation for covid, Mask and full face guard with all patients, etc.

Where were they last year??? It is like they missed the party and are trying to make up for lost time.

sigh. More mixed messages. Would've been helpful last year for sure. Now that the majority are presumably vaccinated in your hospital, no. Except for the wear an n95 w a suspected covid case (as we would for TB etc). I swear if JCAHO tells me this year that I need to switch facemasks between every patient including when leaving the OR to go to the PACU (with the same patient) I will likely get fired for the yelling/cursing that will occur. Granted I do wear an N95 all day but that's more because of my home situation- most in my department have switched back to just surgical masks when intubating in the OR.

[artemis]

We were just told that OSHA is putting in all these requirements starting Thursday. We need to have plastic dividers between where staff sit if closer then 6 feet, Wear a N95 if with patient under investigation for covid, Mask and full face guard with all patients, etc.

Where were they last year??? It is like they missed the party and are trying to make up for lost time.

At least the plastic dividers might be useful in the long-term, should another new and nasty respiratory virus emerge (especially one that is spread by droplets rather than aerosol). I'm hoping the plastic dividers my local stores have put up remain for just that reason. Why should cashiers have to put up with customers coughing on them?

The rest, though, is definitely "horse is already out of the barn" stuff.

[HikingDO]

We were just told that OSHA is putting in all these requirements starting Thursday. We need to have plastic dividers between where staff sit if closer then 6 feet, Wear a N95 if with patient under investigation for covid, Mask and full face guard with all patients, etc.

Where were they last year??? It is like they missed the party and are trying to make up for lost time.

It’s CYA time

[FIREshrink]

At least the plastic dividers might be useful in the long-term, should another new and nasty respiratory virus emerge (especially one that is spread by droplets rather than aerosol). I'm hoping the plastic dividers my local stores have put up remain for just that reason. Why should cashiers have to put up with customers coughing on them?

The rest, though, is definitely "horse is already out of the barn" stuff.

Dumb, plastic dividers between cubicles have been associated with higher rates of covid transmission due to reduced air circulation. OSHA is like 12 months behind the science.