Really makes me wonder why we're all stay at home through April, rather than just have shelter in place orders for 60+ and the immuno-compromised. Let the rest of us build up herd immunity. This could just delay all of us getting it and potentially end up with another shelter at home a few months down the road.Dr. Not Yet Dr. Ag said:
The large majority get better on their own. Even the 80+ yo on chemo I admitted is still doing well with just supportive care (his QTc was too long to initiate HCQ). Our hospital is reserving HCQ for those requiring ICU admission.
Hydroxychloroquine...........
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Last: 11 mo ago by Jabin
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This has been discussed ad nauseum. But even upwards 20% of people are requiring hospitalization, and not just the elderly. Healthy people are taking trips to the hospital.
Everyone goes back to work, and our grand prize is utterly overwhelming our healthcare system.
I really don't know why so many people still don't understand that. It isn't as simple as "well, most of us will just have a bad flu for 2 weeks, and boom.... herd immunity!" We need to play this safer until our testing ability catches up and more info on effective treatments comes out.
We all just go back to work now, it won't be pretty.
Everyone goes back to work, and our grand prize is utterly overwhelming our healthcare system.
I really don't know why so many people still don't understand that. It isn't as simple as "well, most of us will just have a bad flu for 2 weeks, and boom.... herd immunity!" We need to play this safer until our testing ability catches up and more info on effective treatments comes out.
We all just go back to work now, it won't be pretty.
I believe both you and Brewmaster make valid points. The interesting component here is that once an effective test and anti-viral treatment(s) is identified and provided to the masses similar to how we treat most other known viral infections, then this virus becomes extremely controllable.Player To Be Named Later said:
This has been discussed ad nauseum. But even upwards 20% of people are requiring hospitalization, and not just the elderly. Healthy people are taking trips to the hospital.
Everyone goes back to work, and our grand prize is utterly overwhelming our healthcare system.
I really don't know why so many people still don't understand that. It isn't as simple as "well, most of us will just have a bad flu for 2 weeks, and boom.... herd immunity!" We need to play this safer until our testing ability catches up and more info on effective treatments comes out.
We all just go back to work now, it won't be pretty.
I think the challenge most people face (including myself) is that there are no clear-cut goals/metrics to know when the virus is somewhat under control enough for society to begin the process of repair.
In my opinion, once you have rapid testing in place and treatments that are available and administered timely, then you will begin to see the reigns pulled back for society to slowly get back to normal.
"We all just go back to work now, it won't be pretty."
I don't disagree with you today, but at some point we'll have to look at a different approach or there won't be much work to go back to ...
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Hopefully we will un**** this testing cluster**** soon. It's really pretty amazing how badly the best country in the world has screwed this up.
I have a buddy who started showing symptoms on Friday, finally got tested yesterday, and telling him ~7 days for results. Hospitals won't take him just yet. Can't get prescribed any of the preliminary treatments until he has a positive test. So he's looking at a minimum of 10 days in until could receive any of the treatments. That's just unacceptable if we want to pretend we have the best system in the world.
Yeah, we have some of the best medical minds in the world, but our bureaucratic system is inspiring zero confidence. Going tp need to improve this before just going back to work won't turn everywhere into NYC and New Orleans.
Not to mention the US Surgeon General flat lying to everyone that masks are completely ineffective at reducing transmission of this virus.
I have a buddy who started showing symptoms on Friday, finally got tested yesterday, and telling him ~7 days for results. Hospitals won't take him just yet. Can't get prescribed any of the preliminary treatments until he has a positive test. So he's looking at a minimum of 10 days in until could receive any of the treatments. That's just unacceptable if we want to pretend we have the best system in the world.
Yeah, we have some of the best medical minds in the world, but our bureaucratic system is inspiring zero confidence. Going tp need to improve this before just going back to work won't turn everywhere into NYC and New Orleans.
Not to mention the US Surgeon General flat lying to everyone that masks are completely ineffective at reducing transmission of this virus.
"Not to mention the US Surgeon General flat lying to everyone that masks are completely ineffective at reducing transmission of this virus."
I've been livid about this since it happened. Tell us they are necessary for medical staff right now but don't lie.
I've been livid about this since it happened. Tell us they are necessary for medical staff right now but don't lie.
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No doubt. I mean, from day 1 we were told they weren't useful to prevent contracting the virus but are useful at stopping sick folks from spreading the virus.
So how on earth can they tell us they are useless for people to wear? Especially given the potentially lengthy asymptomatic but contagious phase.
So how on earth can they tell us they are useless for people to wear? Especially given the potentially lengthy asymptomatic but contagious phase.
absolutely
which why the current undersupply and lack of timely testing is so bad for our current state
this stuff needs to be given out in the same method as tamiflu
i've seen providers on here say they are only administering to the very ill - which makes sense if you only have a few doses available, but that doesn't seem like its role in the finalized protocols
which why the current undersupply and lack of timely testing is so bad for our current state
this stuff needs to be given out in the same method as tamiflu
i've seen providers on here say they are only administering to the very ill - which makes sense if you only have a few doses available, but that doesn't seem like its role in the finalized protocols
jagvocate said:
"Not to mention the US Surgeon General flat lying to everyone that masks are completely ineffective at reducing transmission of this virus."
I've been livid about this since it happened. Tell us they are necessary for medical staff right now but don't lie.
Not necessarily a lie. Wife worked for years as an urgent care RN and doesn't think the general public needs to be wearing masks either. There could be some benefit, but it isn't huge. People likely won't wear them correctly, change them out when they get damp, clean them or replace them as necessary, etc.
I get it as a social signal with possible marginal benefits but it's not a slam dunk easy call for everyone to be wearing them.
i don't understand why a reusable cotton mask with a vacuum bag filter insert is less good than nothing at all
everyone is obsessed with n95 supply
just level with people. even surgical masks are hard to find at this point in the crisis and likely should find their way to frontline providers. but the general populace can DIY this.
victory gardens didn't require agricultural equipment and credential experience to maintain.
everyone is obsessed with n95 supply
just level with people. even surgical masks are hard to find at this point in the crisis and likely should find their way to frontline providers. but the general populace can DIY this.
victory gardens didn't require agricultural equipment and credential experience to maintain.
cone said:
absolutely
which why the current undersupply and lack of timely testing is so bad for our current state
this stuff needs to be given out in the same method as tamiflu
i've seen providers on here say they are only administering to the very ill - which makes sense if you only have a few doses available, but that doesn't seem like its role in the finalized protocols
Yeah, you're hearing horror stories about people waiting 8 days for test results, and worsening during that time frame. Would be great if you could give them prophylactic HCQ at time of testing (ensuring they meet the fever/cough/etc protocol) so you don't miss the envelope of when the stuff would be effective
i'll take Scott Gottlieb's advice over your wife's
no offense meant
no offense meant
cone said:
i'll take Scott Gottlieb's advice over your wife's
no offense meant
No offense taken, but I'll take the career nurse over a career administrator.
outside of the hotspots, most of the tests come back negative. We aren't given the experimental drug treatment to people with a high likelihood of 1) not having it, and 2) not needing the drugs to survive anyway because we wouldn't have enough drugs if we did.Exsurge Domine said:cone said:
absolutely
which why the current undersupply and lack of timely testing is so bad for our current state
this stuff needs to be given out in the same method as tamiflu
i've seen providers on here say they are only administering to the very ill - which makes sense if you only have a few doses available, but that doesn't seem like its role in the finalized protocols
Yeah, you're hearing horror stories about people waiting 8 days for test results, and worsening during that time frame. Would be great if you could give them prophylactic HCQ at time of testing (ensuring they meet the fever/cough/etc protocol) so you don't miss the envelope of when the stuff would be effective
Makes sense to me.
Would that change if the HCQ were plentiful? Kind of how they'll throw tamiflu at anyone who says anything about a fever during flu season?
Would that change if the HCQ were plentiful? Kind of how they'll throw tamiflu at anyone who says anything about a fever during flu season?
and i'll be wearing a mask to protect myself and others
that plus if you got positive tests at point of care
you get tested in the parking lot, you wait for the results, they give you the script for HCQ and tell you to monitor symptoms
you get tested in the parking lot, you wait for the results, they give you the script for HCQ and tell you to monitor symptoms
Keegan99 said:
Do you feel the zinc supplement is important?
The theoretical whiteboard explanation is the hydroxychloroquin is simply the mechanism to get the zinc into the cell.
People with adequate diets get more than enough zinc already.
But the primary proposed mechanisms for Plaquenil are increased endosomal pH and inhibition of viral entry into the cell by augmenting the glycosylation of the ACE2 receptor and spike protein.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
cone said:
that plus if you got positive tests at point of care
you get tested in the parking lot, you wait for the results, they give you the script for HCQ and tell you to monitor symptoms
Yes that makes a big difference. Waiting 15 mins for a confirmed diagnosis is a helluva lot different than waiting for 8 days
my optimism is that by June we'll be swimming in three things:
- tests, especially point of care
- HCQ
- PPE
if we can just make it to summer without going broke
- tests, especially point of care
- HCQ
- PPE
if we can just make it to summer without going broke
jagvocate said:
"Not to mention the US Surgeon General flat lying to everyone that masks are completely ineffective at reducing transmission of this virus."
I've been livid about this since it happened. Tell us they are necessary for medical staff right now but don't lie.
It's not a lie, it's a failure of non-medical citizens to understand medical explanations.
Surgical masks help reduce transmission if EVERYONE wears them, not because it gives you much protection (most people wear them wrong, still touch their nose/mouth anyway and the virus can enter through the ocular mucosa which isn't protected) but because it protects others from you. So only if society as a whole adopts widespread use of masks will it matter. If random Dick and Jane think they are protected by wearing masks to the store and nobody else is they are wrong. Full PPE including contact and eye precautions are necessary to adequately protect you from others.
So it's accurate to say masks don't offer you much protection. The offer others protection from you, and because we will never establish widespread use here it's not a particularly useful tactic.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
In my experience, most don't prescribe tamiflu without a positive flu test.Exsurge Domine said:
Makes sense to me.
Would that change if the HCQ were plentiful? Kind of how they'll throw tamiflu at anyone who says anything about a fever during flu season?
It would be a function of how plentiful. You would need enough HCQ to give a course to basically everyone.
that's a particularly galling bit of defeatismQuote:
The offer others protection from you, and because we will never establish widespread use here it's not a particularly useful tactic.
we not try and promote usage and break the taboo and see if Americans respond first
Player To Be Named Later said:
So how on earth can they tell us they are useless for people to wear? Especially given the potentially lengthy asymptomatic but contagious phase.
Because only a small minority will ever wear them, an even smaller minority will wear them correctly, and a yet smaller minority will do the other necessary aspects (leaving it on all the time, not touching their face, washing hands, etc.) to provide the true benefit.
Essentially, unless we are all onboard and doing it to the best of our abilities, it's just a waste of masks that could best be used elsewhere.
Now if we could adopt the mindset of the Chinese/Japanese/Koreans (the needs of the many...) and 80-90% of us are wearing masks correctly all day long? Sure, sign me up. That will never happen here though.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
The 15 min test is nice if you are only seeing a handful of patients per day. The days long wait is because of testing backlog, not because the tests take a long time.Exsurge Domine said:cone said:
that plus if you got positive tests at point of care
you get tested in the parking lot, you wait for the results, they give you the script for HCQ and tell you to monitor symptoms
Yes that makes a big difference. Waiting 15 mins for a confirmed diagnosis is a helluva lot different than waiting for 8 days
cone said:that's a particularly galling bit of defeatismQuote:
The offer others protection from you, and because we will never establish widespread use here it's not a particularly useful tactic.
we not try and promote usage and break the taboo and see if Americans respond first
My job is to offer realistic solutions, not idealism. I can prescribe the ideal antibiotic at discharge but if the patient gets to the pharmacy and can't afford it I've actually done more harm than good.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
i Know there is a delay in getting results right now but there are a lot of negative test results. There isn't enough supply of HCQ to prescribe to everyone who has symptoms. The quicker tests will solve a lot of these problems.
Infection_Ag11 said:Player To Be Named Later said:
So how on earth can they tell us they are useless for people to wear? Especially given the potentially lengthy asymptomatic but contagious phase.
Because only a small minority will ever wear them, an even smaller minority will wear them correctly, and a yet smaller minority will do the other necessary aspects (leaving it on all the time, not touching their face, washing hands, etc.) to provide the true benefit.
Essentially, unless we are all onboard and doing it to the best of our abilities, it's just a waste of masks that could best be used elsewhere.
Now if we could adopt the mindset of the Chinese/Japanese/Koreans (the needs of the many...) and 80-90% of us are wearing masks correctly all day long? Sure, sign me up. That will never happen here though.
How about since many of us are not even working we just wear them to go to the grocery store. It's not hard to avoid touching your face with a mask on. I wear one nearly all day at work and never touch my face with it on.
I think it's annoying to see doctors posting the same bull crap as the government. If people are trained properly they could learn in a 10 minute video the proper way to wear a mask to a grocery store and the proper way to take it off. We don't have to use your precious masks to get some benefit so quit giving bad advice because precious medical masks are low in stock.
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Infection_Ag11 said:
Now if we could adopt the mindset of the Chinese/Japanese/Koreans (the needs of the many...) and 80-90% of us are wearing masks correctly all day long? Sure, sign me up. That will never happen here though.
Our society's "screw you, I'll do what I want because.... Murrica" is really going to screw us in these situations.
so you'd 1) let perfect be the enemy of good and 2) not encourage a DIY approach, thereby allowing the mass produced masks to go to the frontline and having a lesser but not insignificant effect be promoted amongst the herd
that either tells me you don't think this is as contagious as advertised, especially amongst very mild / asymptomatic (to where hand washing and avoiding coughing people is all that's really required from a prevention standpoint) or the only thing that can prevent spread is complete lockdown (which is long-term economically disastrous)
the entire point of promoting mask wearing is so we can get back to work, break the paranoia strangling demand, and in any way possible alleviate the burden on the healthcare infrastructure so we can avoid future lockdowns
we'll be eating beans out of a can this winter unless we get past this defeatism
that either tells me you don't think this is as contagious as advertised, especially amongst very mild / asymptomatic (to where hand washing and avoiding coughing people is all that's really required from a prevention standpoint) or the only thing that can prevent spread is complete lockdown (which is long-term economically disastrous)
the entire point of promoting mask wearing is so we can get back to work, break the paranoia strangling demand, and in any way possible alleviate the burden on the healthcare infrastructure so we can avoid future lockdowns
we'll be eating beans out of a can this winter unless we get past this defeatism
so you think american citizens responding en masse to a crisis is unrealistic?
this isn't a victory mindset
this isn't a victory mindset
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cone said:
so you think american citizens responding en masse to a crisis is unrealistic?
this isn't a victory mindset
Have you seen how a large portion of Americans have responded so far?
Jesus! How in the hell did the Hydroxychloroquine thread become the mask thread? Damn!
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