Medical Discussion of Coronavirus

[Tim]

Plan A:
The goal needs to be to open things up and find a steady state of social distancing that can be maintained to prevent serial lockdowns.
Plan B:
A good chance this is seasonal. Distinguishing between high tide and a storm surge will be a challenge. The former may require some additional steps. Like work from home, cancel events. The later may be local more extreme measures to put out local flare ups. Testing and tracing to keep it contained rather than allowing it to get out of control.
Both will be hard, new skills learned.

[StarTrekDoc]

Can't begin to even think seasonal when this hasn't gone a single cycle. Not very encouraging when it was summer in Aussie/singapore/HK and still spread with relative ease.

Here in San Diego we barely experienced a surge over the 6 weeks we've gone from 15 in house to 24 in house with a stable positive PCR rate of 2-5%. The surprising part of the initial serology/PCR testing of our ED staff -- it's in the 2% range which is what we're 'guessing' overall status is here in San Diego. --- The scary part of all this is it's STILL going up despite 6 weeks of shelter at home orders.

Let's see if we get an Easter + protest sx and/or admission spike this week. ; But wave 2 is going to be a bit harder for us here in SD as we've been pretty spoiled with the low levels right now. Gonna feel like HongKong with wave 2 I'm suspecting or Like Singapore with the migrant/imported cases for south of the border cases

[triad]

The whole point of flatten the curve was to allow for medical capacity to be ramped up and not overwhelmed. Check. Only considerations now are not allowing another surge to overwhelm that capacity and trying to lessen the economic burden while being maximally responsible. These decisions should be as local as possible.

have you tried to buy PPE recently? good luck getting n95s or level 3 masks...

[ENT Doc]

have you tried to buy PPE recently? good luck getting n95s or level 3 masks...

General public doesn’t need N95s

[Shant]

The people providing that medical capacity you mentioned do.

[Tim]

have you tried to buy PPE recently? good luck getting n95s or level 3 masks...

The PPE supply impacts the public as well as the healthcare providers.
Wear mask use hand sanitizers and disinfect your home. Nothing is available to the public and there are some serious problems asking the public to “make their own “. A mask is not the same bandana worn for a month nor a T-shirt thrown in the car. The public needs a supply chain too.

I drove at 5am, spent 2 hours in a traffic clusterfk,
to get “free masks”. The cheap paper throw always. I was handed 1. Protested and got another.
Ain’t gonna work for anyone if supplies aren’t available an in stock.
But....... this morning some business is attempting to open. This won’t go well without the right equipment. Looking at an emergency order with a potential for 180 days in jail and a $1000 fine for going in public without a mask. Anywhere in public , even completely alone! Might help if Lysol and masks were available. At least tissues and toilet paper occasionally are available. Disinfectant and masks are in short supply. It’s been over a month of “Stay at Home”. Supply chains need to catch up.

[ENT Doc]

The people providing that medical capacity you mentioned do.

Indeed they do. But not in all clinics everywhere. And not in the general public. That medical capacity is specific to hospitals. What is your contention?

[Tim]

Indeed they do. But not in all clinics everywhere. And not in the general public. That medical capacity is specific to hospitals. What is your contention?

You make perfect sense. 4.6 million people are now being told otherwise. You as a physician walking from you car would be subject “legally”
to $1000 fine and/or 180 days in jail. Applies to all over 10 years old and homeless are exempt. This won’t be enforced. Physicians aren’t exempt. Any public place.

https://www.houstonchronicle.com/news/houston-texas/houston/article/face-mask-required-harris-county-hidalgo-order-30-15227291.php

I like your thoughts, but elected officials copied the CDC guidelines and added penalties. Washing your hands before leaving and touching your face are violations as well. Politicians aren’t using common sense either. Right now, what you suggest is criminal. Only in a technical sense.
Alligator clips, coffee filter, rubber bands. Materials needed for a mask?

[Shant]

Indeed they do. But not in all clinics everywhere. And not in the general public. That medical capacity is specific to hospitals. What is your contention?

That the supply lines haven't yet accomplished what is needed to ramp up the medical capacity.

[Kamban]

I can tell you the vitamin D story with COVID. First, they will describe how they have found a mechanism where vitamin D is involved in the COVID pathway. Then, they will publish a lot of observational studies showing how low levels of vitamin D are associated with an increased risk of contracting COVID and dying from COVID. Finally, they will publish large randomized studies showing how supplementing vitamin D does nothing to change the outcome of COVID. You can substitute COVID with heart disease/cancer/kidney disease/bone disease etc and write a book about vitamin D.

It is the same story with every other vitamin and supplement, the most famous being Vitamin C with Linus Pauling heavily promoting megadoses of it.

[ENT Doc]

That the supply lines haven't yet accomplished what is needed to ramp up the medical capacity.

Perhaps in some localities. What data are you using to make the assertion that we can’t or haven’t ramped up capacity? Also, say capacity is fixed and can’t be ramped up. The flatten the curve argument assumes exactly that and just has to do with keeping demand under capacity. I’m still not clear on what you are advocating for as policy.

[Hatton]

I found this to be very interesting. Thoughts?

[triad]

General public doesn’t need N95s

I'm not general public! my job is pretty high risk since I work in mouths all day creating aerosol

[ENT Doc]

I'm not general public! my job is pretty high risk since I work in mouths all day creating aerosol

Ok but the capacity issue has nothing to do with that (assuming you’re a dentist or oral surgeon or ENT). The capacity issue has to do with the hospital systems and their ability to help people affected by the pandemic. Now, if you think you need N95 because of the risk of what you do that’s a different matter - that has to do with how we re-open safely.

[fatlittlepig]

I found this to be very interesting. Thoughts?

Sounds like a group of overly self important financial and business types masquerading as scientists.