[Health] The Infectious Diseases Thread

[Hrothgar]

We got an email from the owners of our clinics (eye care) and they basically said "We're staying open. If you feel unsafe with that, feel free to eat your PTO. If you get sick, stay home and eat your PTO. If you get sick at work and we have to close an office, you're eating your PTO. If the CDC closes us, guess what, eat your PTO."

I'm not sure how they'll tell if someone got sick from one of the clinics or from one of their associates outside the office. Their plan is the very definition of why many Americans are going to continue working anywhere they can during this. Most of the employees are hourly, and most likely have less than 2 weeks of accrued time off. No one can afford to not go to work with no other alternative.

I still think what they're doing is irresponsible since the majority of our patients are 65+

Both physical therapy clinics I've been to in the past couple of years have sent me emails saying they're staying open.

My 76 year old mother is going to a hand doctor appointment today.

Health care isn't closing down anywhere.

We've cancelled all non urgent/emergent appointments on the outpatient side. Elective surgeries are postponed. This is mostly to handle the [expected] influx of potential Covid-19 patients.

Yes, werte still open, as we always are, but in a much different way right now.


The ED is surrounded by tents right now, looks like a staging area out of Resident Evil.

I'd really start panicking if you see Umbrella Corporation logos everywhere.

You mean like this:



It's from Twitter, so it's fake. It purports to show the Wuhan Virology Institute, but Snopes points out it's a Shanghai biotech company with an apparently odd sense of humor.

[Kurth]

I'm posting now from my hospital call room in Hartford, CT, where I'm covering the night for the anesthesia department. Earlier tonight, I had to intubate (place a breathing tube) in a 20yo kid who was suspected to have COVID when he arrived to the hospital 11 days ago. He tested negative on 3/7 and shouldn't be infected now because he hasn't gone outside the ICU since then...but he has a fever of 102 now and is in a room not more than 75 feet from our hospital's one test-positive COVID patient, and several others in isolation awaiting test results. I sure hope someone working in that ICU didn't carry it to his room because he's not deemed high-risk enough to warrant letting us use some of the very limited supply of N95 masks...the ones that are locked away because hospital employees keep stealing them.

My department is the first to be called when these patients need to be intubated, and they barely have enough equipment to protect us already. The anesthesiologist who intubated the first patient to test positive here is now quarantined at home because he's not feeling well, and more of our staff are calling out every day either because of illness or lack of childcare during our school closures. My wife is a physician assistant, but she may have to stop working soon to care for our kids. Why? Because noone feels comfortable coming into our home to help when I'm going in and out of the hospital every day...they think it's too risky, and I can't blame them.

And this is only the beginning...

I feel for you. Healthcare workers are truly on the frontlines of this thing.

My sister is an ER doc. She's going to be intubating COVID-19 patients left and right if things progress as expected. She's got a young family, and our parents (mid-late 70s) provide a lot of childcare support for her. I don't see how she can possibly keep seeing my parents as this thing progresses - especially since my father is a late stage lymphoma survivor with a compromised immune system. I'm really worried about her and my parents.

Yet, strangely, she and I are totally not seeing eye-to-eye about the dangers. She tells me she's taking all precautions, but she also thinks the reaction is largely "alarmist" and told me last night, "stop being crazy step back this is not a lethal contagion." I feel like she's really downplaying things. I hope she's right, but nothing I read -- here and elsewhere -- suggests she is.

[stessier]

Yet, strangely, she and I are totally not seeing eye-to-eye about the dangers. She tells me she's taking all precautions, but she also thinks the reaction is largely "alarmist" and told me last night, "stop being crazy step back this is not a lethal contagion." I feel like she's really downplaying things. I hope she's right, but nothing I read -- here and elsewhere -- suggests she is.

In one sense she seems to be right - with the proper care, this doesn't have to be lethal. The question is how long people will have access to proper care.


I'm beginning to think they are going to manage this by hot-spots rather than statewide/nationwide policy. I'm beginning to get doubtful we'll have the nationwide holiday after all. Unless there is a big spike in deaths or a public relations nightmare, I don't see everyone unifying behind more than that.

[Jeff V]

My wife is surprisingly concerned, pointing out that since I'm diabetic and have high blood pressure, I'm at elevated risk for a pushing-daisies outcome if I catch it. She raised concerns this morning when I mentioned I would stop at the Korean supermarket in my endless quest for toilet paper.

[Smoove_B]

Yet, strangely, she and I are totally not seeing eye-to-eye about the dangers. She tells me she's taking all precautions, but she also thinks the reaction is largely "alarmist" and told me last night, "stop being crazy step back this is not a lethal contagion." I feel like she's really downplaying things. I hope she's right, but nothing I read -- here and elsewhere -- suggests she is.

I mean this with all due respect - but this is a perfect example of private health mentality vs public health mentality. On a per-patient (individual) basis, we're absolutely not broadly concerned. On a community (public health) level, we're terrified because we know what will be happening at a community level is going to directly impact patient level. All my knowledge/training/skill/experience is focused at a community level. Your sister is skilled/trained/experienced at a patient level. Public and private heath have been at odds for 30+ years and not much has changed (for the better, broadly) in the last decade. Sure, some communities have started building bridges, but we're no where close to where we should be.

Regardless, I have genuine concern for front-line medical workers right now. They're at high risk and if they get wiped out, our ability to respond to this is diminished even more. They're going to be grappling with personal/family/professional decisions that they've likely never considered.

[msteelers]

My wife works at a vets office. This morning they finally started following some new procedures to keep people from piling up in the lobby. Essentially, customers are to call in once they are parked. If they are picking up medication, then a receptionist (my wife) will bring the meds out to them. If it's for an appointment, a tech will come out to get them once it is their turn.

We also got an automated message from the OBGYN today. Our first baby appointment is scheduled for 3/25. They said we will still have the appointment, but I'm not allowed to be there. Only the mother is allowed into the office. I'm really not thrilled with this, but my wife is very upset over it. Hopefully we can video chat me in from the parking lot, but we usually get terrible reception no matter where we are, and medical buildings tend to be worse than others.

In other news, I'm taking a massive hit everywhere professionally. I run an entertainment company for bars/restaurants. Yesterday we canceled all events for at least the next 15 days, but we know it's going to be far longer than that. Governor DeSantis finally closed all bars and nightclubs for 30 days in Florida, and ordered that restaurants only use 50% capacity, making sure there is 6-feet between tables. We're working on ways to move our trivia events online. We think we have a fairly cool way to do it, the question is going to be all about getting enough eyeballs on it where we can then turn around and get it sponsored by some of our venues who are still open in a limited capacity.

On the wedding DJ front, all events through April have been canceled, and we're fully expecting all of May's events to be canceled as well. A lot of venues are shutting down all events for 8 weeks. I'm dealing with panicked brides left and right. I feel terrible for them. Our policy is that if they tell us the new date we will do everything we can to be available. We're not going to charge or penalize them at all. So far everything has worked out. I really hope we don't run into a situation where we are unavailable for the new date though.

As I mentioned earlier, I was in full on panic mode Sunday night and throughout Monday. I couldn't sleep, and didn't know how we could get through this. Ironically enough, it was like a huge weight was lifted off of my shoulders when we canceled all of the events. It was a terrible move for our business, but obviously the right move overall. At least there's some comfort in that I guess.

[Paingod]

I would be curious to see where this site is getting it's data from. I've been trying to stay informed of what's going on in Maine, but the numbers are so slow to come out. This map, though, shows 32 active cases. A huge jump from the 17 this morning.

[Daehawk]

That map shows TN as about 58. Theres been some here for well over a week now yet it still says no recovered no deaths. So what are they then? Still sick after over a week?

[Paingod]

That map shows TN as about 58. Theres been some here for well over a week now yet it still says no recovered no deaths. So what are they then? Still sick after over a week?

I believe they say this has...

• 3-11 day incubation period
• Up to 14 days from exposure to see if you're clear
• Up to 6 weeks to full recover if infected

It stands to reason we'll see a lot more deaths before we see a recovery number that matches or exceeds it. Just look at Italy. 2,500 deaths, 2,950 recovered.

[gilraen]

That map shows TN as about 58. Theres been some here for well over a week now yet it still says no recovered no deaths. So what are they then? Still sick after over a week?

Without a second test or at least a follow-up doctor visit or something like that, I would imagine they don't have a good way of tracking recoveries.

[Daehawk]

6 weeks? Ouch. I wonder if you can get reinfected then.

[stessier]

That map shows TN as about 58. Theres been some here for well over a week now yet it still says no recovered no deaths. So what are they then? Still sick after over a week?

Yes.

[stessier]

6 weeks? Ouch. I wonder if you can get reinfected then.

Last I heard, they aren't sure.

[Lorini]

My wife works at a vets office. This morning they finally started following some new procedures to keep people from piling up in the lobby. Essentially, customers are to call in once they are parked. If they are picking up medication, then a receptionist (my wife) will bring the meds out to them. If it's for an appointment, a tech will come out to get them once it is their turn.

We also got an automated message from the OBGYN today. Our first baby appointment is scheduled for 3/25. They said we will still have the appointment, but I'm not allowed to be there. Only the mother is allowed into the office. I'm really not thrilled with this, but my wife is very upset over it. Hopefully we can video chat me in from the parking lot, but we usually get terrible reception no matter where we are, and medical buildings tend to be worse than others.

In other news, I'm taking a massive hit everywhere professionally. I run an entertainment company for bars/restaurants. Yesterday we canceled all events for at least the next 15 days, but we know it's going to be far longer than that. Governor DeSantis finally closed all bars and nightclubs for 30 days in Florida, and ordered that restaurants only use 50% capacity, making sure there is 6-feet between tables. We're working on ways to move our trivia events online. We think we have a fairly cool way to do it, the question is going to be all about getting enough eyeballs on it where we can then turn around and get it sponsored by some of our venues who are still open in a limited capacity.

On the wedding DJ front, all events through April have been canceled, and we're fully expecting all of May's events to be canceled as well. A lot of venues are shutting down all events for 8 weeks. I'm dealing with panicked brides left and right. I feel terrible for them. Our policy is that if they tell us the new date we will do everything we can to be available. We're not going to charge or penalize them at all. So far everything has worked out. I really hope we don't run into a situation where we are unavailable for the new date though.

As I mentioned earlier, I was in full on panic mode Sunday night and throughout Monday. I couldn't sleep, and didn't know how we could get through this. Ironically enough, it was like a huge weight was lifted off of my shoulders when we canceled all of the events. It was a terrible move for our business, but obviously the right move overall. At least there's some comfort in that I guess.

Uncertainty is a stresser. Now that you know what's going to happen you can do much better planning, even if it is to have to close your doors, which I really hope doesn' have to be. It's amazing how many businesses depend on crowds. I've always known about sports, but restaurants and bars need crowds as well. And conventions and all kinds of other activities that don't immediately come to mind. I hope they can all come through intact.

[Paingod]

6 weeks? Ouch. I wonder if you can get reinfected then.

Shakes the magic 8 ball. Uncertain.

According to that article, they're leaning towards "You're immune if you survive" but aren't 100% certain yet.

[A nonny mouse]

(I bought a reusable enema kit, suppositories, toothpaste, and beer - looked like I was having a weird party, but my oldest son has interesting GI requirements.)

This made me giggle uncontrollably. No idea why. Thanks, I needed that.

Did your son enjoy the beer?

[Combustible Lemur]

I'm posting now from my hospital call room in Hartford, CT, where I'm covering the night for the anesthesia department. Earlier tonight, I had to intubate (place a breathing tube) in a 20yo kid who was suspected to have COVID when he arrived to the hospital 11 days ago. He tested negative on 3/7 and shouldn't be infected now because he hasn't gone outside the ICU since then...but he has a fever of 102 now and is in a room not more than 75 feet from our hospital's one test-positive COVID patient, and several others in isolation awaiting test results. I sure hope someone working in that ICU didn't carry it to his room because he's not deemed high-risk enough to warrant letting us use some of the very limited supply of N95 masks...the ones that are locked away because hospital employees keep stealing them.

My department is the first to be called when these patients need to be intubated, and they barely have enough equipment to protect us already. The anesthesiologist who intubated the first patient to test positive here is now quarantined at home because he's not feeling well, and more of our staff are calling out every day either because of illness or lack of childcare during our school closures. My wife is a physician assistant, but she may have to stop working soon to care for our kids. Why? Because noone feels comfortable coming into our home to help when I'm going in and out of the hospital every day...they think it's too risky, and I can't blame them.

And this is only the beginning...

I feel for you. Healthcare workers are truly on the frontlines of this thing.

My sister is an ER doc. She's going to be intubating COVID-19 patients left and right if things progress as expected. She's got a young family, and our parents (mid-late 70s) provide a lot of childcare support for her. I don't see how she can possibly keep seeing my parents as this thing progresses - especially since my father is a late stage lymphoma survivor with a compromised immune system. I'm really worried about her and my parents.

Yet, strangely, she and I are totally not seeing eye-to-eye about the dangers. She tells me she's taking all precautions, but she also thinks the reaction is largely "alarmist" and told me last night, "stop being crazy step back this is not a lethal contagion." I feel like she's really downplaying things. I hope she's right, but nothing I read -- here and elsewhere -- suggests she is.

My mom is a retired ER, School nurse, she had a similar feeling. She was very meh about the whole thing until it hit home that her, my dad, his mom, all of her sisters, and my wife's parents are ALL in the most vulnerable with underlying dangers group, and the hospital bed problem. She's still the calm ambivalent voice in the storm but you can tell it's on purpose now.

Sent from my SM-N975U using Tapatalk

[LordMortis]

For the twitter inclined, my friend with a Phd in the physics of Virii has recommended this feed.

https://twitter.com/gertrudrey/status/1 ... 1849128960

Take it or leave it.

[Daehawk]

TN now has 73

UPDATE: Tennessee's COVID-19 case count has gone up to 73 as of Tuesday, according to the Tennessee Department of Health.

Some 352 people have been tested by the state, 330 of those being negative. Commercial and private labs have confirmed 51 cases, bringing the total to 73.

None in my county....well none tested and confirmed.

Oh almost forgot. You know that nursing home where all those people got sick and some died up in Washington?...Life Care Center. Ya they are headquartered here in my town. They built a big fine nursing home in the late 70s or early 80s. Known people in it. Over time they have built onto it until it is HUGE. its bigger than 2 or 3 malls and they then added those condo like apartments to another area. Look like little houses. Then about 12 years ago or so they bought the old dead mall and turned that into their offices. I wonder how bad it is in their places here.

[dbt1949]

Nothing in my neck of the woods.
But if I do perchance get it there's a 97% chance I'll get over it.

[stessier]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

[Lorini]

Trader Joe's tells seniors that there will be a special time for them and then claims they didn't say it

That's truly screwed up. They better have an apology for those people.

[Jag]

Drove past a nursing home across from my office on my way back from lunch today and saw a bunch of news crews out front....and

Two dead from coronavirus at Fort Lauderdale assisted living facility, mayor says

Not great. Don't think I'll be eating local again.

[Smoove_B]

https://twitter.com/hofrench/status/1240016367300075523

The number of cases in NYC is approaching 1000. The city now says it is considers a shelter-in-place order within the next day or two.

[gameoverman]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

If that's true how did it figure out how to get out of China AND track down Tom Hanks AND find me in Glendora, CA?

[mori]

I know it is getting real for a lot of people now so my slice of life means little especially with shelter in place orders coming. Everyone at work is still expected to show up for work. Day 2 of intense cleaning. I sterilize a surface and 5 minutes later another person sterilizes the same surface. Getting a lot of spring cleaning down. Hopefully all this house cleaning rubs off on some of my coworkers. Couple of company edicts came out that had me shaking my head. They are splitting us off in teams. Totally unfeasible as we are all in each others shit all the time, using the same tools, and needing to confer with one another constantly. It is the nature of our work. If one person on the team gets it, everyone on that team is ordered to stay home. Even though that person was in contact with every other employee in the facility. At least they are trying to think of ways to keep the place open. Another is that we have closed the facility to all nonemployees. So FedEx, UPS, Amazon, janitorial,uniform and vending services are ordered to drop their stuff off at the door and call a number. No sales visits allowed. But USPS ignored all that and marched right in .

[Enough]

For the twitter inclined, my friend with a Phd in the physics of Virii has recommended this feed.

https://twitter.com/gertrudrey/status/1 ... 1849128960

Take it or leave it.

Followed, thanks!

Sent from my Pixel 2 XL using Tapatalk

[Blackhawk]

So, here's a question (if there is even a definitive answer yet): We have an elderly 'high risk' relative we semi-care for. She lives elsewhere, but we run most of her errands and such. If we were to get sick, one or all of us, how long from the first cough would it take before we would be able to help her out again? I need to get plans in place in case we get sick, and I'm trying to figure out how long to plan for.

[gameoverman]

For the twitter inclined, my friend with a Phd in the physics of Virii has recommended this feed.

Take it or leave it.

The thing that interested me in that was that it won't burn out until we get herd immunity, and that's around 70%. That immunity comes via exposure to the virus(the hard way) or via vaccine(the easy way). Since there's no vaccine, basically we all have to get it and get over it. That means the earlier huge effort at containment was kind of a waste of time and effort. Once it got out of China it's all about herd immunity. It still doesn't mean we want lots of people getting sick at once, but it puts a new light on how this was going to play out from the beginning. This 'flatten the curve' thing should have been pushed by world leaders from around mid January, instead of pushing for containment.

[disarm]

We received word from the large, multiple-hospital healthcare system for which I work in CT that they will be postponing all elective surgical procedures effective this Thursday and lasting until 4/15. They published very specific criteria for defining procedures as either 'emergent,' 'urgent,' or 'elective,' and included a pretty comprehensive list delineating what will currently be allowed by surgical speciality. It's a pretty impressive document that shows someone has put in a great deal of effort over the last few days, and starts with a few guiding principles for what will be allowed; anything else is being rescheduled...

1. Cancer surgery – both diagnostic and therapeutic
2. Cases where delay can result in acute loss of function - examples include spinal surgery to alleviate cord compression
3. Acute life or limb threatening condition (i.e. unstable angina, peripheral arterial disease with tissue loss)

I've been saying we needed this days ago, but while a big part of me applauds the decision and knows how important this is at this time, it now puts me (an anesthesiologist) in an interesting position. If surgery isn't happening, my group doesn't generate revenue, and we can't be paid normally...but when I do go to work, I'm at high risk for exposure. With dramatically less work to do, we'll probably be having a few stressful days working, mixed with a few days off every week. The one comfort through it all is knowing that I do have a fair bit of money tucked away to fall back on... can't imagine what it's like, and have a huge amount of sympathy, for those who aren't so lucky.

Life is getting very interesting...

[Victoria Raverna]

COVID-19 death rate is getting higher. It is now over 5%.

[Daehawk]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

Not sure I get your post. Mine was about how crappy they take care of their customers and just how nasty their nursing homes are as a company.

[Zaxxon]

Thoughts on ordering contactless delivery for meals? We've been eating in 100% of the time, and plan to keep it up. But I received a plea from a local restaurant essentially saying if everyone does that, the entire local industry will be toast by the time this blows over, and that they as a restaurant deal with cross-contamination daily, etc.

I'm pretty sure the safe answer is don't do it, but this seems like a humanitarian/societal question, as well. Is there a 'safe enough' way to do this?

[Defiant]

Thoughts on ordering contactless delivery for meals? We've been eating in 100% of the time, and plan to keep it up. But I received a plea from a local restaurant essentially saying if everyone does that, the entire local industry will be toast by the time this blows over, and that they as a restaurant deal with cross-contamination daily, etc.

I'm pretty sure the safe answer is don't do it, but this seems like a humanitarian/societal question, as well. Is there a 'safe enough' way to do this?

One thing you can do that someone else suggested is (if you can afford it) buying a gift card to use after things return to normal.

[Smoove_B]

Ordering for delivery/pickup is extremely low risk, at least according to the materials being distributed in my state. Delivery is ideal - they ring the doorbell and leave it. If they can coordinate pickup curbside or in the entrance to minimize patrons milling about inside (by giving you a time and staggering arrivals), also fine.

The danger would be a delivery person coughing/sneezing in your face as you pick up bag of food. There is no demonstrated risk from eating food or handling packaging. We'd also like to believe sick food workers wouldn't be in the kitchen, but even if they're asymptomatic nothing suggests foodborne risk in the items being served -or- in the delivery/package materials.

I said it earlier but my plan is to do takeout (I have to pick up, no delivery available) until that is no longer an option.

[Daehawk]

14 year old Scrubs clip.

[wonderpug]

Thoughts on ordering contactless delivery for meals? We've been eating in 100% of the time, and plan to keep it up. But I received a plea from a local restaurant essentially saying if everyone does that, the entire local industry will be toast by the time this blows over, and that they as a restaurant deal with cross-contamination daily, etc.

The restaurant needs to come to terms with delivery and take-out becoming the new norm for months. If it's not mandatory in your region now, it will be soon.

[Zaxxon]

Thoughts on ordering contactless delivery for meals? We've been eating in 100% of the time, and plan to keep it up. But I received a plea from a local restaurant essentially saying if everyone does that, the entire local industry will be toast by the time this blows over, and that they as a restaurant deal with cross-contamination daily, etc.

The restaurant needs to come to terms with delivery and take-out becoming the new norm for months. If it's not mandatory in your region now, it will be soon.

They definitely are, but that doesn't mean sufficient numbers of people are taking them up on it. Based on Smoove's reply, it sounds like we should be

[Alefroth]

I wonder how bad it is in their places here.

You understand the virus has no intelligence behind it, right?

Not sure I get your post. Mine was about how crappy they take care of their customers and just how nasty their nursing homes are as a company.

What makes you think the Kirkland center was crappy and nasty?

[Smoove_B]

They definitely are, but that doesn't mean sufficient numbers of people are taking them up on it. Based on Smoove's reply, it sounds like we should be

I shared his Twitter earlier, but this guy taught me everything I know about communicable disease theory. He's probably most famous for his "5 second rule" study on food safety, but he knows lots of stuff.

https://twitter.com/bugcounter/status/1 ... 7917514754

(the question that started it)

Say more on this! You're not worried about the food being contaminated by kitchen staff? Is hot food better to order than cold?

He does all kinds a media, hosts a podcast, travels around the US...he's the real deal.