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COVID-19 Check-in

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Comments

  • DvilleDawgDvilleDawg Posts: 2,699 ✭✭✭✭✭ Graduate

    We have people from France in our offices all the time, and now we get a lot from Germany. Those people love to smoke. Our site made a smoking area away from where everyone goes in and out of the main building and the French pitched a fit about it because they thought they should just be able to light up anywhere and any time they desire. You sit beside one of them in a meeting and all that stale smoke and then they aren't big on daily baths, it is awful.

  • pgjacksonpgjackson Posts: 18,794 ✭✭✭✭✭ Graduate

    With literally 1/2 of the known cases in the US coming out of NY, is it a matter of NY testing more people or is there a serious issue up there?

  • razorachillesrazorachilles Posts: 1,273 ✭✭✭✭✭ Graduate

    One recent COVID-related change that already has the potential to dramatically change the way healthcare consultations with physicians and NPs is in the area of telehealth. Some may have missed this detail in one of the daily COVID debriefs last week:

    In short- the FDA has agreed to cover telehealth (Zoom, Skype, Facetime, etc.) under Medicare & Medicaid, as well as halt HIPPA violation enforcements as it pertains to use of electronic devices by physicians.

    Essentially - rather than having at-risk patients travel to the doctor for regular check ins for blood pressure monitoring, review blood level readings monitored at home, etc., this can now be done via a phone or tablet from the patient's home.

    Telehealth options have been in use in some forms for over a decade in the US but a key sticking point has been between health care providers and insurers, with the latter reluctant to compensate the providers for the full price charged to their customers for an in-office visit. The impact post-COVID crisis could be long-lasting with consumers getting a taste of this new way of receiving healthcare services (and preferring in some cases not having to go to the doctor in person).

  • YaleDawgYaleDawg Posts: 7,269 ✭✭✭✭✭ Graduate

    Testing is still important but it's more important towards the beginning of an outbreak. If you can identify the infected early in an outbreak, do rigorous contact tracing, and isolate all of them it goes a long way in preventing widespread transmission. Places like New York are past containment and have moved towards mitigation as well as revamping hospitals to deal with an influx of patients. However, a good portion of the country can still try to contain the virus using testing and contact tracing.

  • CaliforniaDawgCaliforniaDawg Posts: 674 ✭✭✭✭✭ Graduate

    I think there are a few things going on:

    1. New York has a higher population density than other states and so the virus can spread more easily
    2. New York City has three international airports and is a center of international business and so the virus got brought to NYC from China and/or Europe multiple times by people passing through or living there
    3. You have milions of people commuting from large offices with thousands of people and so the virus spread super rapidly. If say one office of 500 got infected and 250 (or whatever the number I'm just makking this up) peole got it and then those 250 went to the suburbs and their church or synagogue, to a restaurant, etc., etc. then that group gets it and then that group becomes another node of spread.

    In addition to that, across the country, there are enough people on the left and the right of things who for one reason or another are defying social distancing norms and so New York, like most of the US, is taking one step forward and two steps back. Until we all do it for 3 weeks, this **** social distancing will go on and on. It's like the kid who keeps misbehaving in class while the rest of the class is waiting to go to recess, but you have to wait for that last kid to behave before everyone can go out.

  • CaliforniaDawgCaliforniaDawg Posts: 674 ✭✭✭✭✭ Graduate

    Yep, that is the strategy California has taken and why I can't get tested. I still feel like I have a small child sitting on my chest with each breath, but I will never know if it is Covid-19 unless I get bad enough that I have to go to the ER as the testing strategy has changed from containment to identifying how to treat a critical patient. In other words, testing in California is now about mitigation. More testing in New York might help people be sure that they have to self-quarantine, but widespread testing only helps with containment. Once you get beyond containment to triage, it's about mitigation.

  • YaleDawgYaleDawg Posts: 7,269 ✭✭✭✭✭ Graduate

    Yeah at this point anyone with symptoms in those population centers being hit hardest are considered positive and told to self isolate for two weeks and only come in during emergencies. Same thing happening in southwest CT at the beginning of the outbreak where a lot of people commute to NYC. CT was only doing 20 tests a day in the state lab, so they just told everyone to assume they had COVID-19 if they had a fever and cough. It was ridiculous.

  • pgjacksonpgjackson Posts: 18,794 ✭✭✭✭✭ Graduate

    Has anyone published hospitalization numbers? We know the confirmed case, and we know death. The WHO and CDC publish that daily. What we don't know is how many are currently hospitalized. Since the big concern is overwhelming hospitals I think that would be important info...moreso than just raw "positives". That 60,000 confirmed US cases includes people who were confirmed early (Jan and Feb) and probably are over it now. It's not a "current" number, it's cumulative. And of that 60,000 about 80% need no medical assistance. So, what is the actual impact on the US health care system right now today?

  • YaleDawgYaleDawg Posts: 7,269 ✭✭✭✭✭ Graduate
    edited March 2020

    So right now NYC says 12% of active cases require a hospital bed and 3% require an ICU bed. They have over 21,000 cases so I just took a few thousand off and did a little math based on the hospitalizations doubling every two days which has been the norm. With 5,000 normal beds and 3,000 ICU beds they would have run out of beds in about a week (This is back of the envelope math with what I could find so take it with a huge grain of salt). Good news is the hospitalization rate as dropped to doubling every four days instead of every two which gives them more time to prepare if it holds the next couple of weeks.

    Edit: this assumes all beds are empty and being used exclusively for COVID-19 patients.

  • pgjacksonpgjackson Posts: 18,794 ✭✭✭✭✭ Graduate

    Interesting. 3,000 ICU beds in NYC for a population of 8.5 million seems low. I'm sure they have whatever amount is required by state/federal law or regulation...but it still seems low.

  • Canedawg2140Canedawg2140 Posts: 1,832 ✭✭✭✭✭ Graduate
    edited March 2020

    Lots of tragic stories with this. Lots of heroes everywhere that we will never hear about. Thankful for the nameless heroes who are making us safer.

    Quiet, beautiful day here. Got a pic of this guy from a few days ago. Pretty sure I won't have to social distance from him in about a week, so that's a positive. Saturday is actually youth day, so if I can talk my 16 yr old into getting out of the bed, we may go listen to him gobble at daylight... About a 8% chance of her complying.

  • Bulldawg1982Bulldawg1982 Posts: 4,573 ✭✭✭✭✭ Graduate

    No kidding. Sounds ridiculously low. Not sure how true it is but I read somewhere that there are only 300,000 beds for the whole country. That sounds really low to me also.

  • YaleDawgYaleDawg Posts: 7,269 ✭✭✭✭✭ Graduate

    "New York has roughly 54,000 total hospital beds, and 3,100 ICU beds. The New York City region, defined as New York City along with Westchester, Rockland, Orange and Putnam counties, has 36,000 beds and 2,100 ICU beds, according to the New York State Department of Health."

    Well I misread the regular beds, so sorry about that. I also gave ICU beds for the entire state instead of just NYC.

This discussion has been closed.