COVID-19
- Thread starter Wild Bill
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Circa
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Everyone over a certain age that gets admitted doesn't always get the care the young ones do. If you've ever lost a grandparent in the past and wondered If they could have done more... That's a yes usually. (Pre existing conditions are the way out 99% of the time)... DUHHHH But the cost/Benefit ratio turns hospitals into something the people on Earth are acting as If they just learned. Nobody cared a month ago, and they won't care in a few years.
Our medical system is built on Dolla, dolla.. bills.... Old Peeps. If the government medicaid doesn't wanna pay and the family can't afford? It's End Game. It's pretty easy to see If the family has trust funds...
I'm happy everyone Is seeing the disgusting crap that Is never talked about... FINALLY!
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If we are being honest what has put the US in this position is the race to the bottom in search of ever increasing share holder profits that started in the late 70’s and early 80’s and has been accelerating ever since. Blame for that bullshit can and should be laid squarely at the feet of “Conservative” economic theory and those that have supported it these past couple of decades.
Also, if memory serves me the Donald and his spawn have been up Chinas ass chasing a buck for quite some time now. Not sure how someone with so many conflicts of interests who also has a solid record as a lying and unscrupulous scumbag can be entrusted to do the right thing but hey...
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Irish YJ
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LOL... More conservative and Orange Man Bad... Obama and Biden did so much to change things. Biden's son took a billion plus from China. Trump is the only president in the past several decades to attempt to do anything. The dems went ape shit when added tariffs to China goods. The dems went ape shit when he cut travel in the early covid days...
but.. hey
"China is no competition to us. China can't even figure out....."
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"The US has no interest in containing China" and "The growth of China is overwhelmingly in our interest"
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Trump's covid China travel ban is hysteria and xenophobia.....
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I imagine they are working double shifts - 70-80 hours a week - and watching multiple patients die. An airborne virus that stays in the air. No negative pressure rooms. No gowns. A mask for a few days. Moving from room to room. COVID-19 has eight different strains. Are you carrying one to a patient with another? That's physically and emotionally exhausting even if you can put your family into the back of your mind. The more exhausted you are, the worse your immune system is.
I can certainly understand rationing ventilators if you have none or few to those who have the best chance of surviving. With this virus, if someone is intubated and does not have any underlying conditions, they may still be on a ventilator for up to ten days. Longer if they do. You are now aware of the survival rates for each age group.
You have to make rational - but unthinkable until now - decisions. One vent - the 45 year old or the 80 yr old? The father of three or the mother from a nursing home? I believe Illinois is also examining the need to make those decisions. I'm sure many governors and hospital systems are facing the same situation and having those same discussions.
Four in the ER are now on vents and awaiting rooms. The ER waiting room is packed. Ambulances are on the way. A rural hospital wants to transfer a patient but you have no rooms. No skilled nursing facility will take a patient ready for transfer out because they don't have insurance - or lower-reimbursing federal insurance.
Each room needs a terminal clean after a COVID-19 patient leaves it. The convention center (TCF Center, formerly Cobo) is being turned into a 900 bed hospital in 24-48 hours. Gov Whitmer today announced that she signed two supplemental budget appropriations that provide another $150 million in state funding to respond to COVID-19. To date, Michigan has already secured contracts for more than 20 million masks, more than 2,000 ventilators, nearly 9 million ounces of hand sanitizer, more than 255,000 boxes of gloves, 2.4 million gowns, more than 2,000 additional hospital beds, among other testing equipment. Michigan is now tracking a total of 6,498 confirmed cases of COVID-19 statewide. Michigan could reach a total 10,000 confirmed coronavirus cases by Wednesday, and surpass 25,000 cases by Sunday, reports the Detroit Free Press. Michigan’s top infectious disease expert, Dr. Joneigh Khaldun, today said the state is still “several weeks” away from its peak level of COVID-19 cases.
A ten percent hospitalization rate if it peaks at 25,000 and the curve is flattened, would result in 2,500 hospitalizations. But we are several weeks away from the peak according to Dr Khaldun.
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Ndaccountant
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I would say this has had much more of an impact, specifically the trend since the dot com crash. If we would have allowed "pain" at that point, rather then sending interest rates to historic lows (and have remained there since), we would be in a much different world IMO. MMT has created an overwhelming incentive to finance corporate cash flow with little or no regard to the downside. After all, the playbook has already been shared. The answer to stock market and economic declines is to flood the market with money, which "inflates" asset prices. There is no need for a corporate backstop. MMT IS the backstop.
This is a complete lie and stop acting like you have any idea what you are talking about. It is our job to first do no harm and then to respect the goals of our patients. On rare occasions we withhold care from someone who wanted it (for example, we will not do open heart surgery for someone who is so sick they will not survive the surgery). However, in the vast majority of cases we provide the care (within reason) that aligns with the patient's/family's goals and wishes.
I can guarantee you that every healthcare provider in the World (myself included) is going to bed sick to their stomach every night at the thought of withholding potentially life saving care to a patient due to rationing. I have not had to do that yet, but I assume the day is coming. And I am dreading that day.
So please, do not belittle what we are going through
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Indiana Governor Holcomb justy declared abortions an elective surgery like Ohio and a couple of other states. Those that tilt left are all worked up. Courts have overturned the EO in Ohio. I suspect Holcomb's will get overturned as well. So much for saving two lives at the same time.
Heard the "Pillow Guy" talk about prayer/religion and immediately thought about the uproar he just started. Tired of everyone trying to make a mountain out of a molehill. He said it, so what? Outraged the guy would say something like that? Fine, just don't share your outrage with me. We have free speech and it's free for everybody. Laughed when Trump said, "I didn't know he was going to say that".
Heard the "Pillow Guy" talk about prayer/religion and immediately thought about the uproar he just started. Tired of everyone trying to make a mountain out of a molehill. He said it, so what? Outraged the guy would say something like that? Fine, just don't share your outrage with me. We have free speech and it's free for everybody. Laughed when Trump said, "I didn't know he was going to say that".
dublinirish
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<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Nurses, doctors, medical scientists - you can stand down, crisis over.<br>The power of the Holy Finger saves us.<br>Kenny Copeland, one of those American multi-millionaire Evangelical preachers, has got this . . . <a href="https://t.co/EI6LnY8ULT">pic.twitter.com/EI6LnY8ULT</a></p>— Gene Kerrigan (@GeneKerrigan) <a href="https://twitter.com/GeneKerrigan/status/1244989285067116551?ref_src=twsrc%5Etfw">March 31, 2020</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
Irishize
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In times like these folks lead w/ emotions (which is natural), the truth is usually somewhere in the middle. YJ is correct IMO when he states....”read more, watch less”.
There’s zero convincing by one side that the other side is wrong yet folks still engage in tribal back & forth. Go on Twitter and it doesn’t take long to decide what side of the aisle a person resides.
Whether you agree w/ Trump or not, you’re stuck with him for at least the rest of this calendar year. Both sides can point to things that Trump did or didn’t do that may have helped or hindered the pandemic. The buck stops w/ the POTUS...but...Congress & the Media play a huge part as well. IMO, the confluence of Trump as POTUS, MSM being more blatantly biased than ever & Congress being at an all-time high w/ pettiness & partisanship has given us the perfect storm.
America is at a crossroads. As bad as this pandemic is, maybe it will be what brings us back together moving forward. If not, you can expect another POTUS who falls short of the character our parents & grandparents came to expect (and that list started long before Trump) and you can expect the MSM to be even more blatant about editorializing vs reporting the news “the way it is”.
IMO, Trump & the current iteration of the MSM are both caricatures of their original roles yet the public has accepted both as the new standard vs looking in the mirror and realizing we Americans are responsible for all of this. It’s just built up over time and this is the logical result but Americans can’t see past their rhetoric to realize it.
I’m not saying we can go back to the halcyon days of Eisenhower or Truman as a modern role model for future POTUS b/c the media wasn’t as intrusive back then so who knows what imperfections a POTUS pre-JFK brought to the table? Same w/ the media. Looking back, there’s little debate that Cronkite, Brinkley, Brokaw, Rather, etc were left leaning but they never got to the point where they were so blatantly in the tank for one side over the other. (Except Rather who paid for it w/ his job and has made no bones about what side of the aisle he resides today). And that just makes Fox News ratchet up the noise to offset the other side...moving them even more to the right.
I’m confident that there’s the ability for good, fair reporting at all the major networks but it’s being smothered or overridden by what leads to more clicks & ad revenue which goes to show you that when we settle for Crony Capitalism, the fix is in regardless of what side of the political aisle someone sits.
This thread is pretty much a reflection of the tribal war of words we see in the MSM as well as social media. Each side can post myriad data to support their beliefs/claims. Yet each side insists that their data is more reliable/statistically significant/etc. Sometimes we need to just “agree to disagree” and move on to work on a solution to the problems at hand. I don’t see that occurring anytime soon but I can hope.
There’s zero convincing by one side that the other side is wrong yet folks still engage in tribal back & forth. Go on Twitter and it doesn’t take long to decide what side of the aisle a person resides.
Whether you agree w/ Trump or not, you’re stuck with him for at least the rest of this calendar year. Both sides can point to things that Trump did or didn’t do that may have helped or hindered the pandemic. The buck stops w/ the POTUS...but...Congress & the Media play a huge part as well. IMO, the confluence of Trump as POTUS, MSM being more blatantly biased than ever & Congress being at an all-time high w/ pettiness & partisanship has given us the perfect storm.
America is at a crossroads. As bad as this pandemic is, maybe it will be what brings us back together moving forward. If not, you can expect another POTUS who falls short of the character our parents & grandparents came to expect (and that list started long before Trump) and you can expect the MSM to be even more blatant about editorializing vs reporting the news “the way it is”.
IMO, Trump & the current iteration of the MSM are both caricatures of their original roles yet the public has accepted both as the new standard vs looking in the mirror and realizing we Americans are responsible for all of this. It’s just built up over time and this is the logical result but Americans can’t see past their rhetoric to realize it.
I’m not saying we can go back to the halcyon days of Eisenhower or Truman as a modern role model for future POTUS b/c the media wasn’t as intrusive back then so who knows what imperfections a POTUS pre-JFK brought to the table? Same w/ the media. Looking back, there’s little debate that Cronkite, Brinkley, Brokaw, Rather, etc were left leaning but they never got to the point where they were so blatantly in the tank for one side over the other. (Except Rather who paid for it w/ his job and has made no bones about what side of the aisle he resides today). And that just makes Fox News ratchet up the noise to offset the other side...moving them even more to the right.
I’m confident that there’s the ability for good, fair reporting at all the major networks but it’s being smothered or overridden by what leads to more clicks & ad revenue which goes to show you that when we settle for Crony Capitalism, the fix is in regardless of what side of the political aisle someone sits.
This thread is pretty much a reflection of the tribal war of words we see in the MSM as well as social media. Each side can post myriad data to support their beliefs/claims. Yet each side insists that their data is more reliable/statistically significant/etc. Sometimes we need to just “agree to disagree” and move on to work on a solution to the problems at hand. I don’t see that occurring anytime soon but I can hope.
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Where was this guy when it started? lol
NDRock
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Flying around on his $20 million jet?
irishnd31
Biggest Idiot On This Site
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Well that settles it, pack the flip flops and sun screen.
Love how he cured the US and no one else gets any. 'Merica!
As far as Flattening the curve, the images can be deceptive, IMO, but possibly understandable to convey the concept. What is most important is where on the upswing of the upslope you start with mitigation measures. That requires early indentification with cooperation of all entities involved.
Secondly, in addition to medical ethics that permeates the HC system operations, hospital ERs cannot turn away anyone coming into the ER whether walk-in or by ambulance regardless of source or ability to pay based on a law called EMTALA. That prevents "dumping". As an example, a veteran with VA insurance cannot be turned away, especially if the VA is full and they seek care at your hospital.
Thirdly, hospitals cannot discharge a patient to any unsafe condition. If someone or the family does not have the skill to care for them at home, they are not discharged except to a facility that can meet the clinical needs that can be met by that facility and only if they have met discharge criteria as determined by CMS medical standards. This sometimes results in the hospital eating the cost of care until they are able to obtain a bed for the patient at a lower level of care. The homeless requiring a lower level of care cannot be dumped on the street.
Fourth, in the case of a health disaster like this pandemic with all the beds in the hospital and in skilled nursing facilities in the area full, transfer out of the ICU becomes problematic. The system is overwhelmed. Rural or hospitals in areas that usually transfer to a hospital that can provide a higher level of care are unable to do so.
Fifth, no HC staff or physician can give less care than their medical and ethical standards required.
Sixth, elderly patients with normal aging have changes that affect their care - decreased cardiac output, coronary artery disease, decreased renal function, etc which makes care complicated and may prolong a hospitalization. After a few days, nutrition needs to be instituted for recovery. After anyone has long-term intubation, a tracheostomy must be done.
In this country, we currently have over 27 million uninsured people, which also means they may have no provider to diagnosis and treat and prescribe meds for chronic conditions. Nobody is turned away. Nobody is discharged early who still need care.
So, you may understand what Michigan and other states and cities are experiencing - and the sacrifices front-line providers are faced. To then not have personal protective equipment and be told it cannot be obtained and that they must work as if they are probably all infected with COVID-19 anyway is unacceptable in our country and endangers them and their families.
I have gone on too long, but this is important.
Interesting attempt to deflect then redirect.
I was in fact and rightfully so in my opinion pointing the finger at the Ayn Rand acolytes of the world and the Chicago School of Economics. You know the whole “pull yourself up by your bootstraps” and “magic market” crowd. That is the thinking that drove the polices that drove the proverbial stake through the heart of manufacturing as well as organized labor in this country as we knew it and drove manufacturing to places with the cheapest/slave labor (ie Mexico and China) It was a concerted and organized effort from the right. I will say that a few on the right such as Pat Buchanan were at times critical of some of these ideas although they were often coming from a white/Christian nationalist perspective (sound familiar?).
Now, the democrats decided to move to the right during the Clinton years (James Carville and triangulation and all that) and in the course of doing so embraced much of the same neoliberal thinking (hello NAFTA). Interestingly enough Clinton’s moves towards financial deregulation set the table for the 2008 crash.
I then asked the obvious and quite fair question of how trust worthy is a person who’s children and personal businesses are knee deep in the Chinese shit and who is demonstrably unscrupulous and a compulsive liar. That’s a legitimate concern. With that in mind I agree Biden should be taken to task over his own families issues with nepotism.
As to China specifically, for all the bluster not much has been accomplished over the last three years as it relates to “reigning in China” and the reformed NAFTA ie USMCA was little more than a rebranding exercise. Rebranding, now that is something Donald excels at. Lol.
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Irish YJ
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While I agree in principal with the above, my personal experience says otherwise. I had a cancer scare (ended up being a harmless lipoma between peck muscles, but didn't know till removed) that required surgery, and have overseen my mother's breast and lung cancer bouts. I went to one of top breast cancer docs and surgeons in the nation, while my mother went to one of the better cancer centers in IN. Both of us have A1 insurance. The way I was treated vs how she was treated, were completely different. I was handled first class and communicated to like an adult. My mother's treatment has been completely shitty at times, borderline deceptive, and she is communicated to like a child and pushed around.
During the initial diagnosis and treatments, either my aunt (a retired GP), or myself, or both of us accompanied her, or on the phone with her for all communications. It was so bad and confusing (differing stories, or purely incorrect) we started recording all the communication. I had to have private come to Jesus conversations with two of her docs.
The doc and his mini-me overseeing her chemo told her on multiple occasions she was taking low dose chemo (and several other simply incorrect crap), when in actuality she was on very high dose. They acted like she was overreacting to the side effects. Through my own research, I found she was getting a very high dose regiment. When I called out the doctor and his assistant out (which included playing recordings), they both looked like deers in the headlights. That was one of many issues I pointed out that day.
And when they found out my aunt was a GP, they both about crapped their pants. All in all, their behavior completely changed. I had a similar encounter with her radiation doctor. Thank god that all happened early in the process, and their demeanors and level of support changed. My aunt and I still have to pay close attention as they absolutely still treat her differently because she's 75. But honestly, what about all the old folks that don't have a nosy type A son, or a retired GP sister to help them.
notredomer23
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Italy is well on the decline it seems. Back to back days around 4K new cases.
Irish YJ
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responded in Trump thread
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sharksamardzija8345
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Yikes.
ACamp1900
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Do you disagree with the bolded??? I feel that’s been the case for at least a few administrations now to varying degrees.
notredomer23
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I've watched every press conference and I think this is the best one yet. Sobering tone but first time they're painting a full picture.
Irish YJ
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If you're expectation of the press is to be journalists and temper their political narrative, then you should be very disappointed with the press. If you enjoy the constant outrage peddling and party narratives, then I'm sure you're just fine with the current press. There's a reason why public confidence in the media is at an all time low. And while confidence in the media varies between political affiliation, both sides have dropped confidence.
While "enemy" is a strong term, any group that paints themselves as fair and unbiased, or for the people, yet totally sells out for $$ and party narrative isn't really a true friend to the "people"... no?
Irish YJ
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I'd say sobering, but the doctors were also painting a somewhat optimistic pictures going through the charts.
sharksamardzija8345
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Of course I disagree. That’s an extremely powerful and unfortunate statement that has been normalized by the president.
notredomer23
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No doubt. I am optimistic we will outpace the models too considering Birx mentioned it’s based off New York and New Jersey which I think are unique to rest of the country. Fauci mentioning that deaths lag behind by couple weeks to a month compared to new cases would mean new cases are all but wrapped up by mid-late May.
Irish YJ
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I think it's reality. Unless you think their jobs are to get clicks, carry water for either party, and create narrative.
Who holds the press accountable?
Irish YJ
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I definitely think NY and NJ are unique. I think it's quite possible that reality is closer to other states/cities that were hit early and haven't seen anywhere near the rate increase. At least that's my hope. We should start to see results of different trials/treatments come in as well. Praying those are effective, and that would be a game changer too.
phork
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Circa
Conspire to keep It real
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I didn't intend to belittle you or the men and women undergoing very troubling times. I was stating something I dealt with and that might not be a whole medicinal system. I apologize If I offended the troopers that are puttin in the work.