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


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21 minutes ago, ChiTownDoc said:

Shit is incredibly bad in nursing homes.  Several states are giving info on how to fill out death certs now.  Basically dozens of patients here in Chicago have died of C19 but they just had viral pneumonia listed.  Their roommate could test positive and still be alive but the dead guy still wasn't getting a C19 diagnosis.  That's why I've maintained the numbers are underreported by a lot - unlike the conspiracy nutters who think the entire medical community is organizing to put more C19 on death certs.

Hospitals and your average family practice group along with most specialties are getting ass raped during this plague yet the nutters think we want to play up C19 even more.  Fucking idiots will always believe what they want...

I think you are missing the point of the article.  yes he says that the hospital had to offer the information.  I'm sure if a patient was positive(tested) for covid the hospital would tell them and it would be on charts.  It looks like the hospitals told the nursing homes the patients were infected but the REAL problem is the order that the nursing home HAD to take the infected patient.  that is dumb on all kinds of levels.

of course, it looks like this order was only NY.  not sure if any other states had a similar order.

Edited by dcar00
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2 minutes ago, dcar00 said:

I think you are missing the point of the article.  yes he says that the hospital had to offer the information.  I'm sure if a patient was positive(tested) for covid the hospital would tell them and it would be on charts.  It looks like the hospitals told the nursing homes the patients were infected but the REAL problem is the order that the nursing home HAD to take the infected patient.  that is dumb on all kinds of levels.

of course, it looks like this order was only NY.  not sure if any other states had a similar order.

Full disclosure: I didn’t even read the article.  Lol.  Just saying NH are really bad.  No opinion on the article.  

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2 hours ago, RDCanecutter said:

I ain't gonna lie: I would love to mindlessly amble into an Applebee's, order a bunch of heart attack appetizers, drink some weird-ass oversized draft mug, and peruse entrees that would feed a normal family for a week. And I'd let Tiphanae upsell me some diabetes pie.

puking_brian.gif

Edited by Brian Fantana
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4 hours ago, Enchubben said:

Not just some. A very large percentage. That post earlier in the prison environment showed 96%. And you gotta figure that’s about as bad of a scenario in close quarters as you’re gonna get.

I take an immunosuppressive drug every six weeks-remicade- and as a result I pretty much catch every cold that ever comes my way.   Maybe I am immune?  I’m going to operate on that assumption.

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2 hours ago, Loco said:

Ecuador...  heat/humidity, etc... damned that just sucks

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One factor likely included here is that people are also avoiding hospitals. Rates of ER visits for things like heart attacks, strokes, appendicitis, etc. are down. Those things didn't just stop happening. Hospitals have been clearing out patients as fast as possible, which is likely to lead to increased errors in care.

Obviously that doesn't explain the entirety of the spikes and this is probably a generally good way to look at it. Just an angle to keep in mind.

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48 minutes ago, Sbbruin said:

I take an immunosuppressive drug every six weeks-remicade- and as a result I pretty much catch every cold that ever comes my way.   Maybe I am immune?  I’m going to operate on that assumption.

Sbbruin.... we hardly knew ye.........

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11 minutes ago, Surly Bevo said:

Based on CDC site https://gis.cdc.gov/grasp/fluview/mortality.html

Texas shows 57,225 deaths through first 14 weeks of 2020 (week 14 last week fully compiled)

compared with

57,092 in first 14 weeks of 2019

60,102 first 14 weeks of 2018

55, 927 first 14 weeks of 2017

Now yea...NY state, way up this year.

The CDC data lags very badly though.  

But we have been thankfully spared the experience in NY and elsewhere.  About 20-30 people per day in Texas are dying with COVID over the last week or so, and most of these are very old.  About 500 die per day of all causes in Texas in a normal year.  

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6 hours ago, clapclapclap said:

I thought they banned wet labs?

 

I have wondered if there might be some immunity in the Philippines, Indonesia and nearby countries where the disease has not caused the expected number of deaths.  Lack of testing is certainly a big reason why the number of cases is low. I wonder if other coronaviruses have circulated in this part of the world perhaps related to eating bats.

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3 hours ago, ChiTownDoc said:

Full disclosure: I didn’t even read the article.  Lol.  Just saying NH are really bad.  No opinion on the article.  

Fair enough.  amazingly, NY authorities seem to want to pour gasoline on the NH fire you pointed out.

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2 minutes ago, dcar00 said:

Fair enough.  amazingly, NY authorities seem to want to pour gasoline on the NH fire you pointed out.

Lots of head scratching behavior for SNF’s.  For example there’s facilities that only take short term patients.  Instead of flagging those many C19 patients are being discharged to traditional nursing homes with lots of long term care residents.  I’d be pissed if I had family at any of these.  

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Serious question as I’ve never had a family in a nursing home:

does anyone check out of nursing homes? Or is this strictly a place where you go for care until such time as you die?  What’s a typical stay in a nursing home run (ie how long is the average person in there?) 

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8 minutes ago, Wulaw Horn said:

Serious question as I’ve never had a family in a nursing home:

does anyone check out of nursing homes? Or is this strictly a place where you go for care until such time as you die?  What’s a typical stay in a nursing home run (ie how long is the average person in there?) 

I think a few people check out when recovering from something like a broken hip or something like that, but otherwise not really. One of my grandfathers went in after he lost his first leg to diabetes, and subsequently lost his other. He was in for about 8 years, my other Grandfather went in with Parkinson’s, heart failure, macular degeneration, diabetes, and bladder cancer, he lasted 6 weeks, but that’s more of a testament to my grandmother’s stubbornness and home health aides. My other grandmother spent about 18 months in with increasing dementia before passing. 

Edited by Royalfan5
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11 minutes ago, ChiTownDoc said:

Lots of head scratching behavior for SNF’s.  For example there’s facilities that only take short term patients.  Instead of flagging those many C19 patients are being discharged to traditional nursing homes with lots of long term care residents.  I’d be pissed if I had family at any of these.  

Highly lucrative, shady af business. 

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Serious question as I’ve never had a family in a nursing home:
does anyone check out of nursing homes? Or is this strictly a place where you go for care until such time as you die?  What’s a typical stay in a nursing home run (ie how long is the average person in there?) 

Usually no. at least that’s the case with my relatives. But usually if you’re not in grave condition it’s pretty cozy living in the normal life. Right now I’m sure it’s anything but that
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6 minutes ago, Wulaw Horn said:

Serious question as I’ve never had a family in a nursing home:

does anyone check out of nursing homes? Or is this strictly a place where you go for care until such time as you die?  What’s a typical stay in a nursing home run (ie how long is the average person in there?) 

Both my paternal grandparents checked out of nursing homes in their 80’s.  He was 8 years her senior.   Grandfather fell and broke multiple bones.  Grandmother broke her femur slipping while getting out of an assistance wheelchair when visiting him when he was dying later in life.  She actually had another 5 or 6 fairly good years after release from nursing home.  To be honest I didn’t think either would check out during those stays.  Grandpa died later in a nursing home and his last 6 months were essentially torture. 

End of life sucks all kinds of ass.  But thats another thread.

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19 minutes ago, Wulaw Horn said:

Serious question as I’ve never had a family in a nursing home:

does anyone check out of nursing homes? Or is this strictly a place where you go for care until such time as you die?  What’s a typical stay in a nursing home run (ie how long is the average person in there?) 

Most rehab patients go to nursing homes these days.  They have a rehab unit.  It’s why cardiologists etc round at the better SNF’s.  Skilled nursing facilities.  Those length of stays are up to 100 days but usually 1-2 months on longer side.  
 

edit: those units in same nursing homes we are discussing but are not like grandpas we send there to live out their final years.  

Edited by ChiTownDoc
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9 minutes ago, ChiTownDoc said:

Most rehab patients go to nursing homes these days.  They have a rehab unit.  It’s why cardiologists etc round at the better SNF’s.  Skilled nursing facilities.  Those length of stays are up to 100 days but usually 1-2 months on longer side.  
 

edit: those units in same nursing homes we are discussing but are not like grandpas we send there to live out their final years.  

In my limited experience, SNFs are a death trap, worse than nursing homes because patients are usually still convalescing. More often than one may imagine, patients get readmitted to the hospital from the SNF and are usually falling to pieces.

In particular, I don't trust Kindred Hospital SNFs in the greater Houston area.

Edited by UDontKnow
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8 minutes ago, Dbeasy said:

The shelter in place and social distancing clearly has shutdown the spread of corona for a lot of states, including Texas. It seems to have worked really well. The next three months will be key to watch.

Yep. Ignore the loons, open up as caseload and testing capacity allow, and as a society continue to be mindful about distancing. Be prepared for shutdowns in the fall to some extent. Do those things and we can make the best of the situation.

Of course, that may be a long way from reality, but a boy can dream.

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1 hour ago, bschoolprof said:

The CDC data lags very badly though.  

But we have been thankfully spared the experience in NY and elsewhere.  About 20-30 people per day in Texas are dying with COVID over the last week or so, and most of these are very old.  About 500 die per day of all causes in Texas in a normal year.  

Also one other thing about this..500 per day generally true but that is skewed higher until about April.  More like 550-600 per day during those first 3 or 4 months

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19 minutes ago, UDontKnow said:

In my limited experience, SNFs are a death trap, worse than nursing homes because patients are usually still convalescing. More often than one may imagine, patients get readmitted to the hospital from the SNF and are usually falling to pieces.

In particular, I don't trust Kindred Hospital SNFs in the greater Houston area.

Yes - but thing have changed a lot...for the better.  PDPM was new payment model in Oct 2019.  SNF's can't just keep getting paid to let medicare patients rot a full 100 days.  Also hospitals are now at risk for many medicare patients.  So overall cost or poor outcomes hit the hospitals - and they form networks to send the majority of patients to their tier 1 SNF's.  So SNF's are vested in outcomes now.  We run postacute networks for several major hospitals systems all over the country.  Outcomes are our entire business.  

But things are still in flux and it will take years to shed the old reputation.  The SNF is really the new hospital.  Very few patients stay in a hospital more than 3 overnights if they're stable.  During my intern year these were all the patients that sat in the hospital for 3 weeks.  Things have changed a lot.  And in a relatively short period of time. 

Edited by ChiTownDoc
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I'm going to go out on a limb and say that Texans are pretty awesome but I seriously doubt we were just fucking kick ass SIP practitioners compared to NY, NJ, LA, etc.  There are obviously other factors in play (that have been discussed before) that need to be figured out a bit better as to why TX, CA, etc avoided the assbeating in round one.  

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1 minute ago, Surly Bevo said:

I'm going to go out on a limb and say that Texans are pretty awesome but I seriously doubt we were just fucking kick ass SIP practitioners compared to NY, NJ, LA, etc.  There are obviously other factors in play (that have been discussed before) that need to be figured out a bit better as to why TX, CA, etc avoided the assbeating in round one.  

Less dense and I think weather plays a role.  LA has been nothing compared to NYC or even Detroit until a very recent flare up.  PHX/Scottsdale has not been very strict compared to Chicago for social distancing scores but they have MUCH fewer cases and Phoenix suburbs look a lot like Chicago's suburbs.  Although we are fatter here...and that's a serious issue. 

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15 minutes ago, ChiTownDoc said:

Less dense and I think weather plays a role.  LA has been nothing compared to NYC or even Detroit until a very recent flare up.  PHX/Scottsdale has not been very strict compared to Chicago for social distancing scores but they have MUCH fewer cases and Phoenix suburbs look a lot like Chicago's suburbs.  Although we are fatter here...and that's a serious issue. 

I think mass transit has a lot to do with it as well (or in addition to population density). 
 

NYC has over 5 million people cram on the subway each day

Houston only has over 6 million per month across all transit forms 

Dallas appears to be about the same as Houston

Paris, which is closer to NYC than Dallas or Houston in terms mass transit, has a per capita case and death rate similar to NYC  

(https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-collapse-in-three-charts/)

https://www.ridemetro.org/Pages/RidershipReport-092019.aspx

https://www.dart.org/about/dartfacts.asp
 

https://www.google.com/amp/s/www.nytimes.com/interactive/2020/world/europe/france-coronavirus-cases.amp.html

Edited by UT_OB1
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5 minutes ago, UT_OB1 said:

I think mass transit has a lot to do with it as well (or in addition to population density). 
 

NYC has over 5 million people cram on the subway each day

Houston only has over 6 million per month across all transit forms 

Dallas appears to be about the same as Houston

(https://nyc.streetsblog.org/2020/03/23/the-subway-ridership-collapse-in-three-charts/)

https://www.ridemetro.org/Pages/RidershipReport-092019.aspx

https://www.dart.org/about/dartfacts.asp

True but after the initial outbreak in early March, NYC’s public transit system has barely been used.  

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26 minutes ago, gmr548 said:

Who is the we here? DFW and Houston are easily the fattest of the top US metros.

 

I was comparing Chicago to Scottsdale...

Edit:  Less dense and I think weather plays a role.  LA has been nothing compared to NYC or even Detroit until a very recent flare up.  PHX/Scottsdale has not been very strict compared to Chicago for social distancing scores but they have MUCH fewer cases and Phoenix suburbs look a lot like Chicago's suburbs.  Although we are fatter here...and that's a serious issue. 

Edited by ChiTownDoc
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On 4/24/2020 at 12:12 PM, Bozo_Casanova said:

Right, because if we do that we'll never get zoonotic illnesses again, except for:

animal flu

anthrax

bird flu

bovine tuberculosis

brucellosis

Campylobacter infection

cat scratch fever

cryptosporidiosis

cysticercosis

encephalitis from ticks

enzootic abortion

erysipeloid

fish tank granuloma

giardiasis

glanders

hemorrhagic colitis

hepatitis E

hydatid disease

Leptospirosis

listeria infection

louping ill

Lyme disease

lymphocytic choriomeningitis

malaria

orf infection

parrot fever

pasteurellosis

plague

Q fever

rabies

rat-bite fever

ringworm

Rocky Mountain spotted fever

Salmonella and E. coli infections

streptococcal sepsis

swine flu

toxocariasis

toxoplasmosis

trichinellosis

tularemia

West Nile virus

zoonotic diphtheria

 and many more!

That gotdamn Ted Nugent, I knew that mother fucker was behind this shit.

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1 minute ago, gmr548 said:

Derp. I got my wires crossed there with the quote referencing Texas. TIL I am illiterate.

All good, Chicago and the major Texas cities are all fat.  Some may be less fat than others, but unlike PHX, Denver, etc...they're not considered active/healthy by anyone. 

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I was comparing Chicago to Scottsdale...
Edit:  Less dense and I think weather plays a role.  LA has been nothing compared to NYC or even Detroit until a very recent flare up.  PHX/Scottsdale has not been very strict compared to Chicago for social distancing scores but they have MUCH fewer cases and Phoenix suburbs look a lot like Chicago's suburbs.  Although we are fatter here...and that's a serious issue. 


Fewer
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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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