Coronavirus: When should we be concerned?

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Fri Jun 12, 2020 11:58 pm

Just so we’re clear, the study showing the viral particles on the outside of the mask was retracted. Their results were bogus and unreliable.

Please disregard the misinformation per usual folks.

https://retractionwatch.com/2020/06/01/ ... 19-spread/

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Nodack
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Re: Coronavirus: When should we be concerned?

Post by Nodack » Sat Jun 13, 2020 5:13 pm

Every day I type ‘az covid cases’ into Google. The graph is looking like aapl after they came out with their first mp3 player.

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Mori Chu
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Re: Coronavirus: When should we be concerned?

Post by Mori Chu » Sun Jun 14, 2020 8:18 am

I think this thread really sums up what is wrong in this country right now. You have one "side" full of experts, actual medical professionals, and folks sharing carefully sourced and researched articles and studies, all saying that the virus is deadly, that we need to isolate, to wear masks, to contact trace, to take it seriously. And you have another "side" sharing rumors, conspiracy theories, and random YouTube videos saying that the virus ain't so bad and it's all a hoax.

A large portion of our country has fallen into a state where they are almost impervious to the input of factual information. Their information diet consists of questionable social media (Facebook, Twitter, etc.) content and videos by paranoid and conspiratorial YouTube video accounts peddling content with either no data, no sourcing, questionable or misinterpreted data sourcing, and so on. They won't accept the word of experts and scientists and doctors and data. How can you reason with such people? If you think the notion of truth and expertise is fake, how can you ever be reached, be taught, be enlightened?

I pity such people. I don't think it is much use to try to convince them, but I do think it's good to debunk their misinformation so that nobody else reading these threads gets drawn in by the falsehoods.

JeremyG
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Re: Coronavirus: When should we be concerned?

Post by JeremyG » Sun Jun 14, 2020 9:55 pm

In2ition wrote:
Fri Jun 12, 2020 10:51 pm
specialsauce wrote:
Fri Jun 12, 2020 8:53 pm
In2ition wrote:
Fri Jun 12, 2020 2:44 pm
specialsauce wrote:
Fri Jun 12, 2020 1:44 pm
In2ition wrote:
Fri Jun 12, 2020 10:24 am


Here is the problem. Myself personally, is not questioning what sauce is saying in his own experience. I'm also not questioning his morals, intentions, motives, experience or expertise. Specialsauce, I think you're a good dude and have no reason to question you. What JeremyG presented was experience from other DOCTORS and NURSES that are on the front lines, and in some cases more so that any hospitals in AZ. We should believe that all other DOCTORS and NURSES that report different experiences to what Sauce is reporting should be discarded as bs and made up? Is that what you're saying AIG?

I have a friend that is a nurse that works in the ER that says that their hospital in Phoenix is not even close to capacity or overrun, like is being reported by ABC15 and then passed on by multiple national media people, including Rachel Maddow. Not only that, but they asked their own friends that work in other hospitals around the valley and they are saying the same thing, but that doesn't mean I don't believe what Sauce is saying. I'm sure he's seeing some nasty sh!t in regards to the virus. Should I disregard my own friend's first hand experience too?
What ER. I work at two level 1 trauma centers. I have friends working at every major ED in Phoenix.
I'm not going to "out" them. It's not like an ER nurse has as much power or pull as an ER Dr.
Ok dude, whatever. How are you “outing” her by telling me the hospital? I don’t need to know her name. You know how many nurses work in a hospital? That’s fine. She works in the only ER in town that doesn’t see Corona apparently, a mystical place.
I'm sure they see it, but not as much as where you are I guess. What's so hard to believe about that? You think me saying this is what I got from them is discounting what you're going through? If that's how you feel, I'm sorry. I'm not trying to diminish what you have to deal with.
Maricopa County ERs on average saw 1.32 suspected COVID visits per hour this week, so if many of the ERs were busy it would only make sense that some would be pretty slow.

JeremyG
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Re: Coronavirus: When should we be concerned?

Post by JeremyG » Sun Jun 14, 2020 10:02 pm

If anyone wants to know the real science and data with regard to masks, read this: https://www.cidrap.umn.edu/revised-mask-transcript-6220 (which is a transcript of Dr. Osterholm's podcast, found here: https://www.cidrap.umn.edu/covid-19/pod ... l-ep-masks)


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Re: Coronavirus: When should we be concerned?

Post by JeremyG » Sun Jun 14, 2020 10:25 pm

I wish people would stop putting words in my mouth. I've never said it's not real, I've never said it's not dangerous, and I've never said people should not take precautionary measures.

I am only trying to provide a counterbalance to all of the nonsense being spewed by many media/government voices. I did appreciate this quote the other day from AZ state health director Dr. Cara Christ:
"We are not going to be able to stop the spread, and so we can’t stop living as well."

https://apnews.com/31d4645e75a13e4cc13ae199328f2c5f
As virologist William Haseltine stated:
"This virus is going to respond to whatever we do to control it. We make a drug, it is going to resist it. We make a vaccine, it is going to try to get around it. We stay at home, it is going to figure out how to hang around longer."

https://www.cnn.com/2020/06/12/health/c ... index.html
A huge danger in telling people to wear masks is that they will think they can be in much more close contact with people than they would otherwise (and all the while, the mask is not protecting them: https://www.cidrap.umn.edu/sites/defaul ... 2.20_0.pdf)

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Re: Coronovirus: When should we be concerned?

Post by JeremyG » Sun Jun 14, 2020 10:53 pm

I agree 100% with specialsauce:
specialsauce wrote:
Tue Mar 24, 2020 10:20 am
Nodack wrote:
Mon Mar 23, 2020 10:01 pm
What about surgical masks? Are they close? 50 for $22.

Thanks Dack. That’s what the CDC and therefore our local admin is telling us to wear. The virus is smaller and one would presume can get through those masks, therefore in close encounters you would think you need an N95 mask that filters out smaller particles. The whole world is pictured wearing these but the CDC (100% I believe because of the shortage here and therefore spin control) says totally unnecessary unless you’re doing a high risk procedure. They’re even telling us to make a homemade mask or use a bandana SMH.
specialsauce wrote:
Tue Mar 24, 2020 12:50 pm
It’s a lot more complex than saying “spit.” Yes a surgical mask does offer good protection from a massive wad that carries a huge viral load. However! You see large droplets, but the tiny aerosolized particles are smaller than what you can see. They stay in the air for 3 hours after you cough, sneeze, use a nebulizer treatment, Cpap machine. You can’t see them. And they will go through the surgical mask, literally. It’s like you have guard rails but a small animal can squeeze through.

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Mon Jun 15, 2020 8:30 am

Told myself i wouldn’t respond and be baited if you posted garbage again, but I think the podcast you posted is actually credible and raises a lot of valid questions. I’ll get to that.

Your post regarding the surgeon general as well as my quotes are taken from quite a while back. You’re not stupid, you’re just intentionally and incredibly good at finding ways to try and make a point regardless of validity.

This is a completely new disease, and since January we have been simultaneously having to learn about it, diagnose, treat, and educate the masses.

Obviously much has changed over the course of the last 6 months.

The surgeon generals message was in February- he had one agenda in mind: preservation of PPE. Healthcare workers could not get their hands on PPE at that time. In addition, the disease wasn’t widespread, certainly not as prevalent, and mask wearing was erratic. These were all reasons behind his message. He changed his tune once the disease spread.

My message re N95s stands. I still think they offer the best protection. I wear a p100 reusable face mask through the entirety of my shifts. Not all my colleagues do, but it’s a decision I’ve made for myself.

This ties the podcast in. The truth is that we don’t have high quality evidence showing the effectiveness OR the ineffectiveness of surgical masks and especially cloth masks in transmission.

We are learning a whole lot about this illness. We do know historically that surgical masks are effective in droplet control. We also know (and your podcast mentions) that chance of infection transmission is a product of viral load exposure x time. So what does that mean?

If you’re standing next to someone and are speaking for an hour, that’s a low viral load for a long time. You will be at risk.

If you’re standing next to someone and they let out a big sneeze, that’s a large viral load coming your way. You’re most likely going to get infected.

This is where the concept of these masks come in. The concept is that if both parties are wearing masks, then the mask will at least grab the droplets and not allow for leakage, while allowing some aerosolized particles through, and that the same goes for the healthy individual.

If you reduce the viral load exposure, you make it less likely for the transmission AND if you do get it, lower severity of illness.

Now I will tell you I still wear an N95 because I am wary of aerosolized particles at work. But walking in the grocery store, not being exposed to an individual for a prolonged period of time, with everyone wearing masks is a different story. The CDC, WHO, and just about every organization has come to believe that this illness is MOSTLY spread through large droplets. Yes it can aerosolize but that is a secondary mode of transmission.

I can tell you our standard in the hospitals statewide is still to wear surgical masks unless performing aerosolizing procedures. We have had voluntary employee testing and have found only 1% and change of our employees have been infected, which obviously shows we’re doing something right. The staff I know personally that got infected was in the early times of the pandemic where they weren’t wearing masks unless patients had respiratory complaints.

An interesting observational report is at Great Clips where 2 stylists tested positive and potentially exposed 140 people. This is by no means a controlled study but they did require all stylists and customers to wear masks. None of the 140 clients they exposed tested positive as of yet https://www.google.com/amp/s/amp.kansas ... 90216.html

The bottom line is to protect yourself. You are correct, this virus isn’t going away any time soon. You’re completely incorrect in concluding that we might as well just live with it.

Protect yourself. You can’t wear a mask and just have a big house party. I don’t think you can wear a mask and go to a concert with tons of people standing around for hours in a closed environment. Wear a mask so that ithe occasion you do go shopping, or walk by others at the mall, or Home Depot, your viral load exposure is significantly reduced, and your time exposure is already low, so you will likely be fine.

I would make a great attempt to purchase surgical masks over cloth masks- yes.

So yes I think the podcast you shared was the first intelligent piece of material you have presented and contributed to this group. Do not come in here with the CO2, bacteria spontaneously growing in the mask bullshit. Healthcare workers are wearing masks for 12+ hours per day and we’re fine. You can wear a mask for the 30 minutes you’re at a store.

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In2ition
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Re: Coronavirus: When should we be concerned?

Post by In2ition » Mon Jun 15, 2020 9:14 am

There is talk that we may not have fans for the entire '20-'21 season and that may be for the NFL too. If that's the case, will sporting events and concerts ever come back?
"30 wins would be an extremely disappointing season" yeah, I said it and I mean it.

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ShelC
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Re: Coronavirus: When should we be concerned?

Post by ShelC » Mon Jun 15, 2020 9:37 am

Thanks Sauce. I can't imagine anyone thinking a mask doesn't do any good in this situation or worse, could cause more harm from wearing it. We're not doctors or medical professionals wearing them for hours on end and as long as you're using fresh masks, washing your hands and keeping your distance the overall infection rate seems pretty low. I was interested learning more about masks and their effectiveness - obviously the N95s are the best but was curious about the blue surgical masks vs cotton facemasks/homemade facemasks. Read thru these articles yesterday and they seemed to have good info. The Yahoo article gave some infection rates for wearing a mask vs not wearing one along with social distancing vs not and had examples from the breakout on the USS Roosevelt.

https://healthnewshub.org/health-news-h ... e-is-each/

https://www.healthline.com/health/coron ... how-to-use

https://www.yahoo.com/news/effect-great ... 09416.html

I've been wearing neck gaiters folded over twice along with a blue medical/surgical facemask over the top of it. The blue surgical mask doesn't fit tightly enough my face so I like the extra layer covering the rest of my face and around my neck and throat. The gaiter material isn't super thick (think it's nylon) but it's breathable which is why I fold it over for an extra layer or two under the mask.

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Superbone
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Re: Coronavirus: When should we be concerned?

Post by Superbone » Mon Jun 15, 2020 6:29 pm

In2ition wrote:
Mon Jun 15, 2020 9:14 am
There is talk that we may not have fans for the entire '20-'21 season and that may be for the NFL too. If that's the case, will sporting events and concerts ever come back?
Why wouldn't they?
Wormwood/Superbone 2019/2020 season bet: Suns win < 30 games, Wormwood wins, else 'Bone wins. 1 month avatar shame starting July 1st of winner's choosing. (Note: Requires full 82 game season.)

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Mon Jun 15, 2020 8:03 pm

Superbone wrote:
Mon Jun 15, 2020 6:29 pm
In2ition wrote:
Mon Jun 15, 2020 9:14 am
There is talk that we may not have fans for the entire '20-'21 season and that may be for the NFL too. If that's the case, will sporting events and concerts ever come back?
Why wouldn't they?
I can’t live in a world without sports

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Mon Jun 15, 2020 8:04 pm

ShelC wrote:
Mon Jun 15, 2020 9:37 am
Thanks Sauce. I can't imagine anyone thinking a mask doesn't do any good in this situation or worse, could cause more harm from wearing it. We're not doctors or medical professionals wearing them for hours on end and as long as you're using fresh masks, washing your hands and keeping your distance the overall infection rate seems pretty low. I was interested learning more about masks and their effectiveness - obviously the N95s are the best but was curious about the blue surgical masks vs cotton facemasks/homemade facemasks. Read thru these articles yesterday and they seemed to have good info. The Yahoo article gave some infection rates for wearing a mask vs not wearing one along with social distancing vs not and had examples from the breakout on the USS Roosevelt.

https://healthnewshub.org/health-news-h ... e-is-each/

https://www.healthline.com/health/coron ... how-to-use

https://www.yahoo.com/news/effect-great ... 09416.html

I've been wearing neck gaiters folded over twice along with a blue medical/surgical facemask over the top of it. The blue surgical mask doesn't fit tightly enough my face so I like the extra layer covering the rest of my face and around my neck and throat. The gaiter material isn't super thick (think it's nylon) but it's breathable which is why I fold it over for an extra layer or two under the mask.
Thanks Shel. One word is that first article talks about the same study from South Korea that was retracted.

I’m glad you’re doing what you can to protect yourself and others.

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Mon Jun 15, 2020 8:06 pm

Dear Arizona,

I’ve spent the last five years completing my medical training at some of the finest hospitals in the Valley. In that time, I’ve seen incredible cases, with some great saves as well as my fair share of death. It all pales in comparison to the last three months of my career. I’ve spent the better part of that time in the ICU dealing with Covid-19. The physical, mental and emotional toll of this pandemic has been heavy on me, as it has my colleagues. I see it in their eyes. In the tones of their voices. Something has changed. It’s not just profound fatigue, it’s resignation. Resignation to the fact that patients continue to pile in, at an exponentially increasing rate. That some of these patients are the sickest that we’ve ever seen. To the fact that our community has seemingly abandoned us and many are convinced that one of the most difficult & turbulent periods of modern history is somehow a hoax or conspiracy. The irony of being called a healthcare hero does seem to echo rather hollowly. That voices of medicine, science & reason are being drowned out by the incessant nonstop drone of conflict, division and partisanship.

The system was never designed for a pandemic, that much is clear. That is a discussion for another time. The Governor’s statements and actions have been a matter of grave consternation to healthcare workers all over the state. Nero fiddles as Rome burns. The number of cases in AZ have climbed by nearly 300% since May 1st and have roughly doubled since Memorial Day, according to data from Hopkins. In the last twenty four hours, there have been 1014 new cases. For a moment, please try to fathom the kind of stress that is placing on our healthcare system. Our ICU’s are almost full. AZ hospitals are at above 80 percent capacity at this time. Clinical staff are stretched thin everywhere. The thing with these patients is that they consume a ton of resources and manpower because of how sick they are. They also have very protracted hospital courses. The average patient usually requires 3-5 days to come off the vent. Covid patients require weeks to wean off the vent which creates a myriad of associated issues. Severe deconditioning, delirium and multiorgsn failure are commonplace. These patients often require deep sedation. Unfortunately many IV infusions typically used in the ICU such as Fentanyl, Nimbex are in shortage on a global scale. Hospitals have dealt with drug shortages for decades and the influx of critically ill patients has made it much worse. I continue to pray that I will never have to keep someone awake on the ventilator due to a lack of medication availability like other colleagues in Covid hotspots have. Non critical care nurses are being trained to bolster our nurses. Similarly, physicians from all specialties prime themselves to practice a type of medicine that they may not have signed up for. I keep hearing people talk about a second wave that is going to hit but we’re still floundering in the first one.

To my fellow citizens who feel that it is okay to ignore the warnings of health officials, doctors and scientists by refusing to wear masks, social distancing and other basic measures; please for a moment, consider the repercussions of your actions. Yes, you are young and healthy and you will likely have a mild illness but are you willing to put your elderly grandparents at risk? Or your parents who most likely will have some form of comorbidity that will increase their susceptibility to severe illness. Or a younger sibling who may have asthma. If you are a parent, are you willing to risk exposing your child to Covid, especially as more and more cases of a syndrome known as Pediatric Multisystem Inflammatory Syndrome (PMIS) are being reported. Also, please recognize that being young and healthy does not mean you will not contract a severe infection. This is not a hoax. There is no financial incentive for physicians, nurses and other healthcare workers in this. There is no magical drug for Covid-19 regardless of what politicians and Big Pharma tout. At the end of the day, if your loved one ends up in my ICU and requires intubation, mechanical ventilation, ECMO, CRRT or other invasive therapies, will you be able to resign yourself to the fact that you will not be able to come into the hospital and hold their hand or tell them you love them? Can you accept the fact that if despite all our efforts, we fail and your loved one dies, a stranger in a space suit will hold up an IPhone so that you can FaceTime for the last time before we proceed to take your loved one off life support? If you still believe this is a giant conspiracy, maybe consider volunteering at your local hospital or clinic to see what the ground realities are because nothing I say will be able to change your mind at this point. In the meantime, we will continue to weather the storm and brace for difficult days ahead.

Sincerely,

A tired Critical Care fellow



Words from an ICU fellow at Banner University- Phoenix.

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Indy
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Re: Coronavirus: When should we be concerned?

Post by Indy » Mon Jun 15, 2020 9:12 pm

Thank you for that sauce. I love the request that people thinking it isn’t wide-spread or isn’t any worse than the flu really should volunteer. Ugh. Earlier when Michigan was blowing up, I knew hospitals that were holding crash courses for dermatologists and ophthalmologists to be incubating people. So crazy. Operating above 80% capacity for ICUs means people are going to die unnecessarily.

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specialsauce
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Re: Coronavirus: When should we be concerned?

Post by specialsauce » Mon Jun 15, 2020 9:29 pm

Indy wrote:
Mon Jun 15, 2020 9:12 pm
Thank you for that sauce. I love the request that people thinking it isn’t wide-spread or isn’t any worse than the flu really should volunteer. Ugh. Earlier when Michigan was blowing up, I knew hospitals that were holding crash courses for dermatologists and ophthalmologists to be incubating people. So crazy. Operating above 80% capacity for ICUs means people are going to die unnecessarily.
Sure. The writer of the above post was a few years behind me in training, good kid, I know he’s being overworked and under appreciated.

Yes, we have contingencies in place at our hospital for when the intensivists and ER docs inevitably are overwhelmed. Includes Possibly bringing retired physicians and physicians trained in other specialties to the units.

https://www.azfamily.com/news/continuin ... 31379.html

Interview of a mentor of mine

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Superbone
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Re: Coronavirus: When should we be concerned?

Post by Superbone » Mon Jun 15, 2020 11:49 pm

Man, Saucy. I can’t imagine dealing with that all day, every day and with a newborn at home. Hang in there.
Wormwood/Superbone 2019/2020 season bet: Suns win < 30 games, Wormwood wins, else 'Bone wins. 1 month avatar shame starting July 1st of winner's choosing. (Note: Requires full 82 game season.)

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In2ition
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Re: Coronavirus: When should we be concerned?

Post by In2ition » Tue Jun 16, 2020 7:37 am

Superbone wrote:
Mon Jun 15, 2020 6:29 pm
In2ition wrote:
Mon Jun 15, 2020 9:14 am
There is talk that we may not have fans for the entire '20-'21 season and that may be for the NFL too. If that's the case, will sporting events and concerts ever come back?
Why wouldn't they?
If it's always going to be a threat and not die down, why would they come back?
"30 wins would be an extremely disappointing season" yeah, I said it and I mean it.

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Nodack
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Re: Coronavirus: When should we be concerned?

Post by Nodack » Tue Jun 16, 2020 10:12 am

Always is a long time. My glass is half full.

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Cap
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Re: Coronavirus: When should we be concerned?

Post by Cap » Tue Jun 16, 2020 10:37 am

Nodack wrote:
Tue Jun 16, 2020 10:12 am
Always is a long time. My glass is half full.
Every f-ing day feels like a long time.
JJ will be better than KP when all is said and done [in 2020]. Mark it. — AIG, with Indy betting against

My [2019-20] prediction is better than mid 30s... mark it down! — Superbone

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