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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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Just now, Nice Guy Eddie said:

I agree people are not beating down doors to see their doctor or go to the hospitals. There is an education need that you’re less likely to contract covid at your healthcare provider than the grocery store.

but the fear of the doctors office or hospital visit isn’t removing the healthcare need of the patient.

You’d be amazed at how many people land themselves in the hospital secondary to anxiety. That’s not to say they don’t have issues.  But the impetus to get off their ass and actually go is anxiety.  
Right now they’re much more anxious to have to go vs not go.  It’s a matter of how quickly that changes. I don’t think we can flip a switch.  

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20 minutes ago, ChiTownDoc said:

You’d be amazed at how many people land themselves in the hospital secondary to anxiety. That’s not to say they don’t have issues.  But the impetus to get off their ass and actually go is anxiety.  
Right now they’re much more anxious to have to go vs not go.  It’s a matter of how quickly that changes. I don’t think we can flip a switch.  

So effectively a large portion of hospital profit is based on the idea that patients who go may have issues but don’t really need to be there - at least not immediately?

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56 minutes ago, Buzzrock said:

Regarding opening back up: I feel like everyone ignores the elephant in the room which is age. This thing is not nearly as big a deal for those under 60 as over. If everyone over 60 could SiP place I feel like the world could largely go back to normal. Yes a lot of people would get it but it would be more like flu season than a deadly virus. There would be exceptions of course.

But it seems like we want to treat everyone like they are the same.

You're right, but the hospitalization level, even for those folks that are younger than 60, is still high. SiP for 60+ combined with everyone else adhering to social distancing  and things like masks (probably also keeping large gatherings to a minimum) may be a good enough combination in lieu of an efficient testing and isolation system. Hell, the fatality rate that we've seen for those that are younger than 60, while low on an absolute basis, still appears to be several times higher than the typical flu. 

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The meat packing plant outbreak in Nebraska has been blowing up, the county it is in has tripled cases in 4 days and is almost caught up to Omaha at this point. The local has hospital has its tent ready, and has rigged up spare vents after filling up the regular ones and transferring where it could. https://www.omaha.com/livewellnebraska/our-resources-are-being-tested-grand-island-hospitals-icu-is-filling-up-fast/article_b2d1cf40-c2b1-5688-8059-af65a0cdd330.html

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5 minutes ago, Liquor and Poker said:

So effectively a large portion of hospital profit is based on the idea that patients who go may have issues but don’t really need to be there - at least not immediately?

Hell yes.  You go to the barber, you get a haircut.  That’s our saying for surgeons.  Imaging can look like shit with very few symptoms.  You go to 2-3 surgeons, someone will cut on you.  

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14 minutes ago, Liquor and Poker said:

So effectively a large portion of hospital profit is based on the idea that patients who go may have issues but don’t really need to be there - at least not immediately?

volumes? yes - you wouldn't believe how often people go to the ER with very very minor things

profit? nope. low level ER visits don't pay jack. 

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43 minutes ago, gmr548 said:


There are way too many 60+ that would not abide by that order if the rest of society is doing it's thing. There are also a lot of dumbfuck under 60s that would go see relatives and what have you. Finally, if the virus is allowed to run essentially unchecked through the under 60 population, you're still going to get a ton of hospitalizations and critical care patients that would stress the system just due to thr sheer size of the population. Even five percent of the under 60s needing hospital care is a very large amount of people. And you'd have your hospitalizations from things like car crashes coming back up.

I get where people are coming from when they say this but it seems unrealistic.

If we opened up society for under 60, it would unreasonable to say that people under 60 need to completely avoid the 60+ crowd for an indefinite amount of time. Sure we might be able to figure out a way to isolate people that live in senior communities or homes but I don't believe most of the 60+ live in those communities.  Not too mention that the workforce has many 60+ people.

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2 minutes ago, Nice Guy Eddie said:

If we opened up society for under 60, it would unreasonable to say that people under 60 need to completely avoid the 60+ crowd for an indefinite amount of time. Sure we might be able to figure out a way to isolate people that live in senior communities or homes but I don't believe most of the 60+ live in those communities.  Not too mention that the workforce has many 60+ people.

The 60+ crowd is roughly a quarter of our population. And half that number is between 60 and 70 (the folks likely to still be working). 

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35 minutes ago, Dahobbs said:

You're right, but the hospitalization level, even for those folks that are younger than 60, is still high. SiP for 60+ combined with everyone else adhering to social distancing  and things like masks (probably also keeping large gatherings to a minimum) may be a good enough combination in lieu of an efficient testing and isolation system.

Isn't this what Sweden is/was doing? 

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2 minutes ago, Chapo said:

Isn't this what Sweden is/was doing? 

Sort of? Sweden appears to be suggesting social distancing policies and better hygiene, but avoiding government fiat. That said, I haven't seen anything about Sweden encouraging the use of masks or of a real SiP for those 60+. Their reporting is also a bit funky, you can see everything is going in wave-like pattern (up, down, up higher, down, etc.), so it makes it a bit difficult to gauge how effective they have really been in flattening the curve. But, the general trend does suggest some success in slowing the doubling period from 2-4 days to closer to 7 days. We'll probably get a better feel for it over the next week. Another thing to keep in mind, Sweden already has a higher per capita fatality rate than the United States. 

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9 hours ago, bigup2dahorns said:

When elective surgeries/procedures get turned back on it will be huge for medical practices who utilize surgery centers. Lots of patients will want to have their surgery (not at a hospital).

Have a good friend who owns a medial billing service. He's had to shut down, and furlough all his employees. He's filed for PPP.  His work is about 95% off.

Edited by Onboard 2.0
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13 hours ago, SHOOTER12 said:

Hard to believe but I had never watched it until 5 or 6 years ago, by now I've probably watched it 20 times or more.

Damned great movie.

Little Homesick's first name is Jett.

Edited by Homesickhorn
Responding to a couple of 12hr old posts.
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1 hour ago, Nice Guy Eddie said:

One question is whether the hospitals/doctors can manage an overload of patients for non-covid-19 issues. The demand will be there upon full reopening, the question is more whether a doctor or hospitals staff can or will do anything to deliver the needed supply. Just how busy can that operating room be? Has covid prep created more hospital beds?

I have a huge backlog of patients needing elective surgery but I don't expect them to all come beating down our door at once. Some of them are definitely eager because they are still calling to ask us when their procedure can be done, which of course we are currently telling them we don't know. Others will be hesitant, which will truthfully be the right call for certain people depending on their COVID-19 risk situation and the necessity of the planned surgery. It's a complicated risk-benefit scenario.

I also have a huge backlog of patients for whom we have delayed "non-urgent" follow-up exams in clinic. Some of those exams can safely be pushed out 1-2 months, but there comes a point at which the risk of an adverse medical problem outweighs their risk of contracting COVID-19. Those follow-up times were originally chosen for specific reasons so we can't leave them on hold forever and expect everyone to magically be fine when the dust settles. It will probably be a challenge to motivate some of those people to show up.

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6 minutes ago, wild_turkey said:

I have a huge backlog of patients needing elective surgery but I don't expect them to all come beating down our door at once. Some of them are definitely eager because they are still calling to ask us when their procedure can be done, which of course we are currently telling them we don't know. Others will be hesitant, which will truthfully be the right call for certain people depending on their COVID-19 risk situation and the necessity of the planned surgery. It's a complicated risk-benefit scenario.

I also have a huge backlog of patients for whom we have delayed "non-urgent" follow-up exams in clinic. Some of those exams can safely be pushed out 1-2 months, but there comes a point at which the risk of an adverse medical problem outweighs their risk of contracting COVID-19. Those follow-up times were originally chosen for specific reasons so we can't leave them on hold forever and expect everyone to magically be fine when the dust settles. It will probably be a challenge to motivate some of those people to show up.

I'd say if they don't weigh the risk of getting a follow up an important, and delayed appt. over the potential for contracting Covid 19 there's not a lot you can do other than to spell out what procedures you practice is doing to mitigate the changes of catching it in your offices.  

I'd say having someone create a strong protocol, and putting that into a letter to all patients would be a very helpful and reassuring first step.

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17 hours ago, SydneyCarton said:

I saw some folks this weekend railing against the fascism involved in the idea of making folks get antibody tests and then giving them a certificate/badge on their phones for if they’ve passed. Just hundreds of comments on a Channel 2 website article. Equating it to wearing a Jewish star. Just blows my mind. And so much anger in the comments.  I don’t think we’ve focused that much on the percentage of people who will refuse to get tested period in any capacity. 

If internet commentary were ever a representative sample we'd already be long extinct.

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Seems like given the lack of reliable data on infections and deaths, the best approach to reopening would be to use hospitalization rate as the measure.  Any county where the hospitalization rate is increasing should be on lock down.  Any county with stable or decreasing rates should be opened up after Memorial Day.  Supplement that with nationwide guidance on large gatherings, wearing masks, extra caution for elderly/compromised, and it will probably be fine.  I also think severely limiting international flights (with mandatory pre-boarding temperature checks) would be good.

We need antibody testing everywhere.  It’s insane to me that it isn’t a higher priority.

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10 hours ago, DDD Dad said:

 

13 hours ago, EuroHorn said:
How do they know it came from a dead body and not just picked up from someone or somewhere else?

 

Not sure why this is news. We have known for some time that the virus can survive on surfaces for hours if not days.

 

Are they suggesting it might be shedding into the air rather than surface transmitting?

 

Maybe this dude was into necrophilia?

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4 hours ago, Onboard 2.0 said:

Shit, then we're an anti body donor base the likes of which has never been seen on the planet.

If the antibodies can be given through sperm, then Surly may just save the planet!

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2 hours ago, gmr548 said:


There are way too many 60+ that would not abide by that order if the rest of society is doing it's thing.

i'm 49, my husband 66...i can just imagine...'sorry honey, you have to stay home, i'll be back by midnight, love you, kiss kiss!' 😂

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8 minutes ago, Casual Encounter said:

Are we sure? It’s not like they’re able to post an update.

maybe at some point we can do a comparison of posters that posted on a somewhat regular basis before March. the ones that completely stopped posting after all this, we claim them as dying from the corona. if you are on the list and didn't die, you can post to get yourself take off, or you can leave yourself so people will mourn you.

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10 minutes ago, po elvis said:

maybe at some point we can do a comparison of posters that posted on a somewhat regular basis before March. the ones that completely stopped posting after all this, we claim them as dying from the corona. if you are on the list and didn't die, you can post to get yourself take off, or you can leave yourself so people will mourn you.

and the first surly COVID casualty was... NowThis.

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2 hours ago, gmr548 said:

There are way too many 60+ that would not abide by that order if the rest of society is doing it's thing. There are also a lot of dumbfuck under 60s that would go see relatives and what have you.

I think at a certain point society has to do its collective best effort to inform everyone of the risks and then let individuals take that into account and make their own personal decisions. We allow people make all kinds of other decisions that are potentially negative towards their health - tobacco use, alcohol consumption, obesity, tanning beds, riding motorcycles, Filipino girlfriends prostitutes, etc. You can't save everyone from themselves.

I personally don't think there should be an absolute age cutoff. Age guidelines perhaps, but there will be 35 year old people who need to stay at home and there will be 65 year old people who are healthy with no risk factors other than age, and they may feel their need to return to work outweighs the risk.

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Send a cop to everybody's house to administer a fitness test. Test will be whether you can outrun the cop for a block. If you can't outrun the cop, sit your fat ass in front of the computer at home and spank it until next month. Can you bribe the cop? I don't know, can you? That's not my money on the ground, officer.

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4 minutes ago, wild_turkey said:

I think at a certain point society has to do its collective best effort to inform everyone of the risks and then let individuals take that into account and make their own personal decisions. We allow people make all kinds of other decisions that are potentially negative towards their health - tobacco use, alcohol consumption, obesity, tanning beds, riding motorcycles, Filipino girlfriends prostitutes, etc. You can't save everyone from themselves.

I personally don't think there should be an absolute age cutoff. Age guidelines perhaps, but there will be 35 year old people who need to stay at home and there will be 65 year old people who are healthy with no risk factors other than age, and they may feel their need to return to work outweighs the risk.

Well said. 

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I think at a certain point society has to do its collective best effort to inform everyone of the risks and then let individuals take that into account and make their own personal decisions. We allow people make all kinds of other decisions that are potentially negative towards their health - tobacco use, alcohol consumption, obesity, tanning beds, riding motorcycles, Filipino girlfriends prostitutes, etc. You can't save everyone from themselves.
I personally don't think there should be an absolute age cutoff. Age guidelines perhaps, but there will be 35 year old people who need to stay at home and there will be 65 year old people who are healthy with no risk factors other than age, and they may feel their need to return to work outweighs the risk.


In general I don't disagree, but in this case you absolutely cannot individually compartmentalize the risk. Something I do or don't do may be relatively low risk for me, but can significantly increase risk for others.
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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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