[Health] The Infectious Diseases Thread

[gilraen]

One thing I think might allow us to re-open for business, and I think is also something reasonably possible, is that the capacity of hospitals to handle a larger patient load is increased enough to make everyone confident that surges in cases aren't a deal breaker. A place like NYC is probably too populated for that to work, but what about other areas of the country? I can foresee a time when state governors announce that their state is prepared to handle X thousands of cases and let's get started on rebuilding the economy. I think that's likelier to happen sooner than developing a vaccine or herd immunity.

Hospitals can't afford excess capacity. Many hospitals can't afford even the capacity that they have - rural hospitals are closing by the dozen, hospital systems are consolidating, and even for-profit hospitals can't always turn a profit. Believing that they would suddenly open new ICU wings with empty beds and ventilators ready to go in case of a surge is beyond naive.

[Paingod]

Encouraging people to go back to work where death is on the spectrum of outcomes - even with a fully functioning hospital system - is ethically questionable.

I totally agree. The job I have is with a medical clinic serving eye care needs. I asked our staff on hand what they had last week and it was legit eye emergencies. One guy had gotten a metal shard in his eye. Another had post-op care that needed to be performed. A third was another emergency service.

We're not doing anything non-essential right now, really. Saving people from having to go to emergency rooms where they may see someone who's not an eye care specialist. I'm only back because I mean they pay back less of a loan, I guess. I really don't see us throwing open the doors at the end of the month and inviting our patient base - from 4 year old kids to 105 year old seniors - to come on back in droves. Not for a long time.

I'll take my paycheck, though, and ride it out for now.

[dbt1949]

In what I consider an unusual move our governor has closed motels to out of state visitors.

[Kraken]

In what I consider an unusual move our governor has closed motels to out of state visitors.

MA shut down all lodging, including AirBnB, a couple of weeks ago. Wife and I were supposed to have left yesterday for a few days in the Berkshires, but everything we like to do is closed anyway.

[em2nought]

In what I consider an unusual move our governor has closed motels to out of state visitors.

So where are truck drivers without sleepers going to stay?

[Ralph-Wiggum]

Puts a vaccine in the spotlight, if 'herd immunity' is not likely to happen quicker.

More worryingly, it makes it questionable whether a vaccine would be effective. If the body doesn’t retain antibodies after a full blown infection, I’m guessing it wouldn’t after the administration of a vaccine either.

[LawBeefaroni]

In what I consider an unusual move our governor has closed motels to out of state visitors.

So where are truck drivers without sleepers going to stay?

Hotels.

[em2nought]

In what I consider an unusual move our governor has closed motels to out of state visitors.

So where are truck drivers without sleepers going to stay?

Hotels.

Thinking about it, motels should make better hospitals than hospitals in regard to this virus since each room has its own separate air conditioning system. I was watching a video of Russians building a hospital to treat covid-19 patients, and the construction was more akin to a motel. No inside hallways, access to each room was from an open air exterior corridor.

[Jeff V]

This morning I walked into the office and a masked bandit points a gun straight at my forehead. "Take my wallet, please!" I offer but she just sneered and said, "I don't want your wallet, I only want your temperature" and then pulled the trigger. I was then tagged with a green dot and sent on my way.

Word is they are going to be distributing masks and making wearing them mandatory. I'll have to work elsewhere because I can't do my job with foggy glasses.

[LawBeefaroni]

I was then tagged with a green dot and sent on my way.

My ID has a dot sticker on it with "3/19". It's hanging in my closet because that's the last time I went to the office.

[em2nought]

Saw mention of a study out of somewhere in Europe saying far less likely to transmit covid-19 by hand than by being in close proximity to other people. Can't find it at the moment though.

While looking for the above, I found this

A new study has found coronavirus can be spread through the shoe soles of hospital workers and patients.

https://www.news.com.au/lifestyle/healt ... 126453d394

[raydude]

And in the US, all the blah about rights and stuff means someone may just decide their right to have a good time trumps common sense.

Don't you mean "Trumps common sense"?

[disarm]

Saw mention of a study out of somewhere in Europe saying far less likely to transmit covid-19 by hand than by being in close proximity to other people. Can't find it at the moment though.

While looking for the above, I found this

A new study has found coronavirus can be spread through the shoe soles of hospital workers and patients.

https://www.news.com.au/lifestyle/healt ... 126453d394

This is why I wear thigh-high leg covers, that I put on before entering the ICU, every time I go to intubate a patient. When I'm done, covers come off before I leave the patient room, and I clean my shoes as I'm walking off the unit. When I get home, those shoes come off as soon as I get out of my car, I leave them in the garage, and immediately wash my hands before touching anything else. I've assumed from the start that shoes are just one of many ways we're all carrying this around.

[Unagi]

People say he’s crazy
He got copper on the soles of his shoes
Well that's one way to lose these
Virus dudes…

[Kasey Chang]

This may belong in the R&P...

Did China REQUIRE a public thank you for the "private" donation of COVID_19 supplies?

People were surprised when Mexico issued a very public thank you for masks and ventilators

[Jeff V]

So now that WFH deployments have dwindled to a trickle, my company is starting planning talks on how to reel them back in when it's safe to do so. Unlike the blatherings of His Royal Heine, they are NOT targeting May 1, but instead sometime in July.

[em2nought]

A new study has found coronavirus can be spread through the shoe soles of hospital workers and patients.

This is why I wear thigh-high leg covers, that I put on before entering the ICU, every time I go to intubate a patient.

Are you using these boxes too? I've seen where they've also been modified with a hole on the side that suction can be plugged into.

[pr0ner]

So now that WFH deployments have dwindled to a trickle, my company is starting planning talks on how to reel them back in when it's safe to do so. Unlike the blatherings of His Royal Heine, they are NOT targeting May 1, but instead sometime in July.

I have a "bet" with my boss that my agency will let us head back to the office by the end of Q3 of FY2020 (mid-late June). She's thinking Q4 at the earliest.

[hitbyambulance]

here to crush everyone's hopes, so sorry:

https://twitter.com/ryanstruyk/status/1 ... 88832?s=21

'CNN: A new study from Harvard researchers published today in the journal Science finds that "prolonged or intermittent social distancing may be necessary into 2022."'

[gameoverman]

Hospitals can't afford excess capacity. Many hospitals can't afford even the capacity that they have - rural hospitals are closing by the dozen, hospital systems are consolidating, and even for-profit hospitals can't always turn a profit. Believing that they would suddenly open new ICU wings with empty beds and ventilators ready to go in case of a surge is beyond naive.

I'm not talking hospitals as they are now. We have resources, in research, labor, and money. How can we best spend those resources to get the economy going ASAP?
1. Vaccine. The problem here is both this option looks to take a long time, but worse it's unpredictable. We can't work towards vaccine production on a specific date, it happens if it happens.
2. Treatment. Even if people get infected, if we could treat them then we could re-open for business. This option is also completely unpredictable and there is not even a guarantee that a treatment is possible.
3. Build new facilities, equipment, and draft every medical and nursing student halfways qualified to help. The goal is not to make the current system bigger, that would take too much time. The goal is to add tons of new facilities and personnel just for these virus patients. We don't need full scale hospitals built, we don't need new surgical rooms, new cancer treatment centers, new orthopedic facilities, we have all that. We need to be able to handle virus overflow, that's all.

I believe option 3, if chosen, is the one that could be done first. We'd need leadership to push this through like it was a race to the Moon again, I think that's the only thing holding us back.

[Victoria Raverna]

Hospitals can't afford excess capacity. Many hospitals can't afford even the capacity that they have - rural hospitals are closing by the dozen, hospital systems are consolidating, and even for-profit hospitals can't always turn a profit. Believing that they would suddenly open new ICU wings with empty beds and ventilators ready to go in case of a surge is beyond naive.

I'm not talking hospitals as they are now. We have resources, in research, labor, and money. How can we best spend those resources to get the economy going ASAP?
1. Vaccine. The problem here is both this option looks to take a long time, but worse it's unpredictable. We can't work towards vaccine production on a specific date, it happens if it happens.
2. Treatment. Even if people get infected, if we could treat them then we could re-open for business. This option is also completely unpredictable and there is not even a guarantee that a treatment is possible.
3. Build new facilities, equipment, and draft every medical and nursing student halfways qualified to help. The goal is not to make the current system bigger, that would take too much time. The goal is to add tons of new facilities and personnel just for these virus patients. We don't need full scale hospitals built, we don't need new surgical rooms, new cancer treatment centers, new orthopedic facilities, we have all that. We need to be able to handle virus overflow, that's all.

I believe option 3, if chosen, is the one that could be done first. We'd need leadership to push this through like it was a race to the Moon again, I think that's the only thing holding us back.

Getting back to work because of option 3 means you choose to sacrifice lives for economy. You try to minimize the cost in lives but still there'll be more death than not getting back to work.

Right now the CFR is about 4%. How much lower than that before it is acceptable sacrifice? 2%? About 6 millions death?

Death panels?

[Jeff V]

So now that WFH deployments have dwindled to a trickle, my company is starting planning talks on how to reel them back in when it's safe to do so. Unlike the blatherings of His Royal Heine, they are NOT targeting May 1, but instead sometime in July.

I have a "bet" with my boss that my agency will let us head back to the office by the end of Q3 of FY2020 (mid-late June). She's thinking Q4 at the earliest.

Unless they come out with a wildly successful vaccine by then, I expect Q4 to be when round two starts ramping up. That was even mentioned in the meeting today. I expect for now we'll keep stockpiling laptops, even old one that we'd normally be throwing out, just so future WFH scrambles are easier to manage.

[Alefroth]

I believe option 3, if chosen, is the one that could be done first. We'd need leadership to push this through like it was a race to the Moon again, I think that's the only thing holding us back.

It doesn't have to be a race to the moon level project. The UK has already done it- https://www.bbc.com/news/health-52125059

[Sudy]

Attended a family funeral on Sunday (non-COVID cause). The funeral home only allowed ten people to come. The room was empty except for two rows of chairs spread six feet apart. It truly felt like a strange dream... looking at others but being unable to embrace them. At the interment I took my mother's hand. I pray I didn't make her sick.

[disarm]

A new study has found coronavirus can be spread through the shoe soles of hospital workers and patients.

This is why I wear thigh-high leg covers, that I put on before entering the ICU, every time I go to intubate a patient.

Are you using these boxes too? I've seen where they've also been modified with a hole on the side that suction can be plugged into.

I haven't used one, but we've talked about it. We're taking other measures for now that should do an equally good job of mitigating risk.

[dbt1949]

With my claustrophobia they'd ave to put me under to get me to stay in something like that.

[raydude]

I think the weight of this pandemic is getting to me. I saw my youngest daughter with her headset on, attending her Zoom meeting with her teacher and some classmates. Then heard her talk about how "for Easter my mom and dad hid Easter eggs inside the house, and my sister and I had to find them. So we had our own little Easter egg hunt." I started to tear up and wonder how long we (generic we) can keep this stay-at-home thing going and what we'll look like when come out of it.

[Jag]

I think the weight of this pandemic is getting to me. I saw my youngest daughter with her headset on, attending her Zoom meeting with her teacher and some classmates. Then heard her talk about how "for Easter my mom and dad hid Easter eggs inside the house, and my sister and I had to find them. So we had our own little Easter egg hunt." I started to tear up and wonder how long we (generic we) can keep this stay-at-home thing going and what we'll look like when come out of it.

It's definitely easier with older kids. My boys are 16 and 19. They are content to sit in their rooms and stare at their phones, watch streaming stuff, chat with friends or play the occasional PS4 game. Otherwise I barely see them. They would much rather be out, especially the one in college, but they seem to be handling it ok so far.

[LawBeefaroni]

I think the weight of this pandemic is getting to me. I saw my youngest daughter with her headset on, attending her Zoom meeting with her teacher and some classmates. Then heard her talk about how "for Easter my mom and dad hid Easter eggs inside the house, and my sister and I had to find them. So we had our own little Easter egg hunt." I started to tear up and wonder how long we (generic we) can keep this stay-at-home thing going and what we'll look like when come out of it.

I'm not loving it but I am enjoying being home and seeing the kids play together. With a 6 year gap they tend to do their own things but now they have to make the effort to get along. A lot of screaming but there are some genuine good sibling moments.

I'm a social person but I'm perfectly fine being isolated. I'm just finding it difficult trying to conduct all my business remote. Some things are just better in person. Plus a getting contracts signed (the healthcare world still seems to run on a lot of wet ink) is a bitch.

[Paingod]

I think the weight of this pandemic is getting to me...

I sometimes wonder how our kids (9 & 11) are doing. They get along well enough, get outside for sun and play, but have had zero contact with friends directly. We also have to be cautious how we talk around them. The older one is understanding sarcasm now, but the younger one got on a web chat with classmates Monday and told them how "the US is winning at coronavirus because we have the highest numbers" ... oops. We had to explain how mommy and daddy were not saying that as a GOOD thing.

The closest brush I've had with the virus now is "a co-worker's husbands' co-worker" who has tested positive. The co-worker has been on self-quarantine this week and her desk has been sterilized. I wasn't here for the last two weeks, so I missed any chance of catching it from her if she has it. The other people in the office that sat 8 feet away from her in the same corral with no walls between them, not so much. Time will tell. The people who sat near her are planning to continue to come to work.

[em2nought]

So a customer thrust his hand at me for a handshake yesterday and I reluctantly did. While we're doing the paperwork the wife is telling me about his major surgery he'd just had, and then the sepsis he'd had afterward blah blah blah. Gahhhh, I felt a bit off last night. I hope it was the pork.

[ImLawBoy]

So a customer thrust his hand at me for a handshake yesterday and I reluctantly did. While we're doing the paperwork the wife is telling me about his major surgery he'd just had, and then the sepsis he'd had afterward blah blah blah. Gahhhh, I felt a bit off last night. I hope it was the pork.

Did you wash your hands with soap and water for at least 20 seconds immediately afterward?

[em2nought]

So a customer thrust his hand at me for a handshake yesterday and I reluctantly did. While we're doing the paperwork the wife is telling me about his major surgery he'd just had, and then the sepsis he'd had afterward blah blah blah. Gahhhh, I felt a bit off last night. I hope it was the pork.

Did you wash your hands with soap and water for at least 20 seconds immediately afterward?

As soon as I was able to break away from them. I have to say my hand washing has improved drastically since January. I've even watched video on the proper method to use. LOL

[ImLawBoy]

As long as you didn't touch your face in the time between the handshake and the washing, you should be fine I'd think.

[Paingod]

As long as you didn't touch your face in the time between the handshake and the washing, you should be fine I'd think.

Also: As long as you sterilized any surfaces you touched between that handshake and the hand washing. Washing your hands will kill the virus, but putting your hands back down on your contaminated desk puts it right back.

[malchior]

here to crush everyone's hopes, so sorry:

https://twitter.com/ryanstruyk/status/1 ... 88832?s=21

'CNN: A new study from Harvard researchers published today in the journal Science finds that "prolonged or intermittent social distancing may be necessary into 2022."'

I have a feeling this is just too long for the United States. We have people melting down after a month. Years? I don't think it is realistic.

[Smoove_B]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

[wonderpug]

Question: In the earlier conversation it was mentioned that if you ate a hamburger with the virus on it, you'd be ok because your digestive system would demolish the virus. If that's the case, how does the virus end up being detectable in feces?

[Isgrimnur]

You never go ass to mouth:

Hong Shan, MD, PhD, of Fifth Affiliated Hospital, Sun Yat-sen University, in Zhuhai, Guangdong Province, and colleagues noted that the gastrointestinal tract is a welcoming environment for the virus, also known as severe acute respiratory syndrome (SARS) CoV-2. "Our immunofluorescent data showed that the ACE2 protein, which has been proved to be a cell receptor for SARS-CoV-2, is abundantly expressed in the glandular cells of gastric, duodenal, and rectal epithelia, supporting the entry of SARS-CoV-2 into the host cell," the team wrote.

Among the key findings of the study, published online in Gastroenterology:

• A significant portion of coronavirus patients experience diarrhea, nausea, vomiting, and/or abdominal discomfort before the onset of respiratory symptoms
• Viral RNA is detectable in fecal samples from suspected cases, indicating that the virus sheds into the stool
• Viral gastrointestinal infection and potential fecal-oral transmission can last even after viral clearance from the respiratory tract

[Holman]

I read a report yesterday that projects all kinds of things out through 2025, using various assumptions to cover things we don't know about yet. The more I read and absorb, the less I'm confident we'll be going back to what we referred to as "normal" any time soon. Knowing that and how we need to collectively adjust is going to be...painful.

I know I'm going to feel weird shaking hands with anyone in the future, and I probably won't do it. I wouldn't be surprised to see a kind of casual nod and formal bow come into fashion.

Of course the real issue will be touching surfaces that others have recently touched. I don't know how it will be possible to prevent that. Maybe there will just be hand-sanitizer dispensers everywhere, and touching your face in public will become as taboo as scratching your butt.