Medical Discussion of Coronavirus

[StarTrekDoc]

Testing for our system. 50/40/10. Unvac/vac/boosted. This is in pop about 10/60/30
Ed. Surge hitting hard l. Record levels. Don't ask status

hospitalizations covid related creeping upwards. Up about 60% from preomicron levels. After an unvaccinated surge back to a 75/25 ratio and trending other way.

Icu. Slow increase but anticipate higher in one-two weeks as trailing admits. Still only one vaccinated.

Anticipate surge for testing to peak late Jan now

[Tim]

"now the ER is thr gateway to testing and Rona style Tamiflu."
Just as the bulk need for vaccines were bottlenecks were not solved by using the ER's, neither will testing nor Tamiflu prescriptions in large volumes.
I just don't think they will solve the logistics in 2-4 weeks. Just dumping on the ER's again.
I wonder if everyone has the PPE needed. Might last for 2-4 weeks.

There are other options to this: "we lack the intestinal fortitude to tell people to stay home and suck it up (or stay homr and die)"
ER can say, "Not my job, open the testing sites and do the tests. Send the emergencies to the ER."

[CordMcNally]

There are other options to this: "we lack the intestinal fortitude to tell people to stay home and suck it up (or stay homr and die)"
ER can say, "Not my job, open the testing sites and do the tests. Send the emergencies to the ER."

You're minimizing how the hospitals want to treat their patie...I mean, clients.

[Perry Ict]

I don't even ask vaccination status anymore as lately it doesn't seem to matter and is largely clinically irrelevant. Hopefully leaders here and abroad will get off the 'pandemic of the unvaccinated' train. Macron's recent comments about making life miserable for the unvaccinated is unsettling.

Agreed. It always seemed to me that this rhetoric is/was largely a matter of politics and scapegoating for failure of leadership. It's also a product of our corporate media landscape which feeds off of encouraging us to hate our neighbor.

[Tim]

You're minimizing how the hospitals want to treat their patie...I mean, clients.

Or their ER docs. Remember all the testing tents and drive by testing sites? Even the pharmacies had drive by's and lines. Couldn't get into an ER unless you passed the gauntlet and CDC "approved" the test. NFL stadiums were used for testing sites. Fat change, the NFL needs the stadiums filled with paying fans.
We certainly know how to do it, but won't and can't do it by choices having and currently being made. Maybe after the playoffs and Superbowl. Money makes the world go round. Enough of this "sacrifice bit", big pharm will probably had TV ads on the Super Bowl.
This is no longer about lowering the curve, or patient care. Cynical yes I am. I bet the NFL has no shortage of test kits.

[HikingDO]

You're minimizing how the hospitals want to treat their patie...I mean, clients.

Our medical group literally calls patients “customers”, so you know how that’s going here. There’s no money in not testing them in the ERs, UCs, and PCP clinics. Reminds me why I often really hate medicine.

[CordMcNally]

Or their ER docs. Remember all the testing tents and drive by testing sites? Even the pharmacies had drive by's and lines. Couldn't get into an ER unless you passed the gauntlet and CDC "approved" the test. NFL stadiums were used for testing sites. Fat change, the NFL needs the stadiums filled with paying fans.
We certainly know how to do it, but won't and can't do it by choices having and currently being made. Maybe after the playoffs and Superbowl. Money makes the world go round. Enough of this "sacrifice bit", big pharm will probably had TV ads on the Super Bowl.
This is no longer about lowering the curve, or patient care. Cynical yes I am. I bet the NFL has no shortage of test kits.

I don't believe there were ever testing tents to just be able to check into the ER. You'd likely run afoul of EMTALA quickly trying to do that. There are no shortages of places to test around here but many want you to make an appointment. Why make an appointment when you can go to the ER and both are essentially no cost to that particular person?

[Tim]

Our medical group literally calls patients “customers”, so you know how that’s going here. There’s no money in not testing them in the ERs, UCs, and PCP clinics. Reminds me why I often really hate medicine.

If it was up to the hospital systems, it would be handled the same way as the Phase 1 vaccine roll out. If vaccinating staff was a cost and patients was a revenue maker, every nursing home in the USA would have been vaccinated by unvaccinated staff. Phase 1a vs phase 1b. That is exactly how phase 2 was handled. Taking care of business. Most of you folks would have been trying to get an appointment, ER staff included. Money to be made by non-profits, a law of nature.

[Dusn]

He recommended a 4th dose of mRNA vaccines for healthcare workers. So does Israel.

Israel is using mainly Pfizer. It seems like Pfizer wears off sooner than moderna. Why are people getting 4th doses of Pfizer rather than switching to moderna so that they can get boosted less often? And, if getting moderna, is anyone recommending a 4th dose of moderna at this time based on evidence?

[snowcanyon]

Pfizer, Pfizer, full dose Moderna, Moderna booster last week. Will reassess in March-April.

[CordMcNally]

Pfizer, Pfizer, full dose Moderna, Moderna booster last week. Will reassess in March-April.

I know that Israel is recommending a 4th dose and some countries have talked about another 3 shot series but do we have good data that this is necessary to continue to do?

[Bellescamp]

I don't even ask vaccination status anymore as lately it doesn't seem to matter and is largely clinically irrelevant. Hopefully leaders here and abroad will get off the 'pandemic of the unvaccinated' train. Macron's recent comments about making life miserable for the unvaccinated is unsettling.

But it does matter when they get out of the ER and upstairs to see me. Much higher risk of icu transfer and death. It’s helpful to know, as is who is MDPOA that I need to call when crashing

so I still ask, I just don’t care about the twisted reasoning and don’t ask about that

[Hatton]

Pfizer, Pfizer, full dose Moderna, Moderna booster last week. Will reassess in March-April.

So far pfizer, pfizer, full dose Moderna. Considering booster dose of Moderna prior to flying to WCIcon in February. Worried about the Atlanta airport. Any downside?

[CordMcNally]

But it does matter when they get out of the ER and upstairs to see me. Much higher risk of icu transfer and death. It’s helpful to know, as is who is MDPOA that I need to call when crashing

so I still ask, I just don’t care about the twisted reasoning and don’t ask about that

So are you watching the unvaccinated closer or something? I don't see how it significantly changes management.

[Bellescamp]

So are you watching the unvaccinated closer or something? I don't see how it significantly changes management.

If 2 patients come in with the same disease/illness and I can ask them one question to find out which is 10-20x higher risk of icu admission and/or death?

maybe it doesn’t change management but I find it very helpful information