Kansas closed all schools for the rest of the year, so I'm DEFINITELY not working from home!
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Kansas closed all schools for the rest of the year, so I'm DEFINITELY not working from home!
Coward!Quote:
Originally Posted by GoMuskies
Sent from my iPhone using Tapatalk
It's actually worked out fabulously well at my office. I'm on a floor roughly the size of two football fields, and they kicked out half the floor for remodeling a few months ago. Now all but I think 5 people (including me) are working remotely. So I bring my lunch, do all my meetings online and generally "work from home" from the office. It's a fantastic, wonderfully social-distanced setup.
Your rent should be adjusted to a per head present ratio.Quote:
Originally Posted by GoMuskies
This is me. I'm one of 7 people who is coming to the office (65 working from home) in an open floor plan. My wife got furloughed for 3 weeks and I've got 3 kids at home, so there is zero chance of being remotely productive there.Quote:
Originally Posted by GoMuskies
I was in a similar position until today when they moved us all to WFH. If you saw the disinfecting routine I went through the past 2 days you would think I was coming back from Chernobyl.
Philadelphia police announced that people should start shooting criminals who are robbing them. Well, not exactly, but they may as well have.
https://www.fox29.com/news/philadelp...violent-crimes
Philadelphia is a hellhole. And no one can tell me differentlyQuote:
Originally Posted by GoMuskies
Please help me understand how making this information public is helpful.....Quote:
Originally Posted by GoMuskies
Philadelphia asked for this. They elected a super progressive prosecutor who was long declining to prosecute "victimless" like theft under $1000. He's taken away cash bonds and enacted other insane policies in the criminal justice system. This sucks for Philly citizens who will be victims of crime but many of them asked for this.Quote:
Originally Posted by GoMuskies
Kind of like how this country asked for this horrible response at the federal level from this idiot in charge.
For the life of me I am still astounded how people continue to make this a left-wing vs. Right-wing or Progressive vs. Liberal situation in the country. Finally Governors and politicians are stopping this crap and working together across both sides of the aisle. People need to start realizing this is a deadly virus and will likely kill hundreds of thousands if not millions of people across the planet before this is over. Right now in Italy they have already decided that anyone over 80 years of age will no longer receive Medical Care even if in critical condition. Right now this may not seem like it is a deadly thing in our country but if our hospital system gets overloaded past capacity, then people will be left to die in the hallways in the streets like it is happening in Italy and other European countries. People need to wake up. That is not a single country on this planet has handled it is perfectly. The ones that have handled it the most quickly are communist and authoritarian type responses which we couldn't just doing this country. Also, Trump is not making the decisions at this point. He has a leadership team which he is allowing to make the decisions of what is happening. He is just a face piece at this point if that's not clearly obvious to everyone. Clearly, he is always the least prepared person on stage at each of these briefings which is why he is deferring to everyone. Obviously he could be handling this better and staying away from things like the Chinese virus or comments that he can not make come true, but he's not the only one overwhelmed and I don't think anyone could be doing a much better job in this horrible situationQuote:
Originally Posted by SemajParlor
Very nice post and most importantly, as you stated states and fed is working like it was designed to have the best chance to succeed.Quote:
Originally Posted by kmcrawfo
Hey Doc, just had my first Telehealth session on the internet in lieu of actual doctor's office visit. Do you see this happening with your practice? Beats sitting in a waiting room with 10 other people.Quote:
Originally Posted by kmcrawfo
Ohio suspending drive thru testing for lack of tests. Where the hell are the tests? Haven’t we been promised for weeks that they were coming?
It likely easier with derm than other specialties but there is a limit to the level of visit one can code with a telemedicine visit, so I imagine specialists would shy away from this. Especially procedure-driven specialists such as derm and ortho. But it’s better than no visit at all... which will be the norm for most specialists the next few months.Quote:
Originally Posted by bobbiemcgee
My 2¢ regarding politics: it is impossible to separate this and politics as we rely on our government for protection. Why are people buying more guns and ammo? Is it because they fear they will run out and can’t buy any like toilet paper? Or do they fear over government foul play and want to ensure “well-armed militia?”
Regardless it is plain as say that Trump has done a shitty job in many facets: leadership, confidence in the CDC, ensuring proper testing, etc.. It has been and epic fail on the federal response. That has nothing to do with me leaning left. Conversely the state response has been an epic success. DeWine has shown decisiveness, leadership, and confidence in a plan of action. If you have the thought that the President doesn’t have much influence in this, close your eyes and picture DeWine in place of Trump and tell me the results would be the same. This is not about right wing vs left wing, this is about right vs wrong.
And finally.... WHERE ARE THE MF TESTS? People will die because there is not appropriate testing.
Turning the pandemic into a political discussion is the most tone deaf thing I have ever seen.Quote:
Originally Posted by Lloyd Braun
One good thing that I was hoping for out of this global health crisis was that people would come together, help each other and possibly stop blaming anyone and everyone who are on the opposite end of the aisle. I have seen quite a bit of that in different ways over the last couple of weeks. Then, I read posts like this.
The blame has nothing to do with the aisle and more to do with the shitty job that person has done while people do not get the adequate health care they need. To quote... well... you... “spare me your self-righteousness” and read what I actually wrote.Quote:
Originally Posted by Xville
I am trying to quickly wrap up urgent surgeries on my melanoma and other more aggressive cancer patients. Then, I will be transitioning to 100% teledermatology.Quote:
Originally Posted by bobbiemcgee
I am not a germaphobe or someone who tends to panic, but this virus scares the sh@#t out of me. Not only from a virulence factor, but its potential ability to completely shut down our society and healthcare system. This virus can kill you even if you don't contract it like is happening in Italy and starting to occur in NYC
A few thoughtsQuote:
Originally Posted by Lloyd Braun
1. The government has relaxed telederm regs and are now allowing docs to use office visit coding which will hopefully help provide some access to care and help some docs keep the lights on so to speak and not go out of business.
2. No one is dying because they are not getting tested. Just an inaccurate statement. If u are sick and in respiratory distress u r going to get treated regardless of your underlying diagnosis. People will die because the vast majority of this country is not taking this seriously and is continuing to congregate. The result may be an end up overwhelming our Healthcare System. At that point once again people will not be dying because they've not been tested they will be dying because our Healthcare System was overwhelmed.
3. Most of the management of this has been appropriately delegated to the states to manage. That is how this country was designed. Our federal government can provide guidance and assistance, but management decisions should be done at a state / local level. It is true some states have done an excellent job at this such as Ohio. Other states such as Florida baffle and how they do this date still have all the public beaches open for people are shoulder to shoulder. When I look out of my house in Florida and I see down the street right now 20 to 30 people shoulder to shoulder waiting in line at the ice cream, Donut and coffee shop even at this hour it just makes me shake my head wondering what on Earth are these people thinking
3. I do not know that the governor of Ohio would have done any better job at this. There are limitations Far too difficult to discuss as to why we have not had as many tests as we would like. The Food and Drug Administration has certain guidelines and restrictions which must be followed before any tests can be utilized or approved. The testing infrastructure in this come country was set up based on the H1 N1 flu epidemic which was extremely virulent. The Assumption was that infrastructure could support the amount of test we needed. We also had to verify virus strain and accuracy of the testing for what we had here. We have now done that and you are going to see that the testing ramps app astronomically in the next few days.
4. Everyone truly needs to stop pointing fingers at each other. For the most part politicians have stopped doing this unless there's complete idiot's such as AOC. Even She has finally stopped to some degree. There is no room for political leveraging at this point. This is real and I think hopefully the public will soon realize that. I am sickened by the comments I read on the foxnews.com website which seemed to talk about Trump re-election and conservative gibberish just as much as I am a liberal and Democrat gibberish that I see still lingering out there. It is not true or acceptable to say that it is impossible to not mingle politics and this virus. That is a blatantly false comment just as if we were in another world Wide war or similar conflict. There are times when our Country Must Stand United and this is one of them.
5. Things I do think Trump could do better and I wish he would do better. I wish he would stop calling this the Chinese virus. I do think calling it The Wuhan virus is fine as it did originate in Wuhan, but the designation of Chinese or China I think only adds inflammation to an already touchy topic. I also think he has a problem of not simply saying this is difficult this is hard and it will change and bad things will happen but we will be here to support you. I truly think our country would accept some humility in admittance that no everything has not been perfect, but it was unreasonable to expect everything to be perfect. We are learning from the situation we are adapting and we will do our best to develop and build a system to be ready the next time something like this happens. He needs to take his boxing gloves off and quit blaming past administrations as well. This is not the time for that. This is the time to unify all the assets and resources we have and focus like a laser beam on defeating this virus.
One last thing. See below what previous harsh Trump critic Gov Cuomo said today. This is exactly the truth and what our entire country needs to think right now
Cuomo spoke of renewed cooperation with Trump, putting aside what's been, at times, a rocky relationship.
He said he and the president agreed that “we’re fighting the same war, and this is a war, and we’re in the same trench, and I have your back and you have my back, and we’re going to do everything we can for the people of the State of New York.”
More testing flattens the curve significantly faster, which in turn saves lives. Look at South Korea and pretty much every country’s curve and the impact testing has. There are multiple factors in flattening that curve and testing has a large impact. People are not taking it seriously, largely because they believe to be unaffected. That changes the second they are told they or someone they know (not Tom Hanks) is positive for this virus, which nobody really knows because nobody can be tested unless you know someone who tested positive or are very ill. That is a ridiculously slow process. To say no one is dying because they aren’t tested is true on the surface to that individual, but not to the population as a whole.Quote:
Originally Posted by kmcrawfo
The state departments of health are following direct orders and guidelines from the CDC. I imagine if enough funds were allocated for more rapid advancement of tests, or even outsourcing from other countries that do not have the same demand of tests that we would flatten our curve significantly faster. As it stands we are weeks behind and currently following Italy.
Social Distancing is what flattens the curve. One of all of my partners in my practice is from South Korea and most of his extended family still lives there. I can tell you with the reason South Korea was able to stop this from exploding as much as other countries is because they implemented basically marshall law type authoritarian control for social distancing, self quarantine, and isolation regardless if you had had a test or not. Even doing that there is still illness and death abound in that country and the results being reported as positive cases are nowhere close to the actual amount of disease and sickness currently in that country.Quote:
Originally Posted by Lloyd Braun
The fact that the vast majority of people in this country still are not taking this seriously and are not practicing social distancing is what is going to kill people. Every person should be acting as if they are positive as up to 60% of people will show no symptoms yet still be able to spread the virus.
It is attitudes like this kid is doing is what killed people in Italy and has the risk of doing so here.
https://twitter.com/DrDenaGrayson/st...552738826?s=20
Dr. Dena Grayson
✔
@DrDenaGrayson
��#Florida spring-breakers:
“If I get #corona, I get corona....I’m not going to let it stop me from parting.”#Coronavirus “is really messing up my spring break.”
“This virus ain’t that serious.”
We’re “trying to get drunk before everything closes.”
So you hold the opinion that increasing testing will not affect the curve? There’s no doubt social distancing flattens it. There is also no doubt that widespread testing helps with social distancing. Talk to any ID expert and they will reiterate that increased testing will positively help contain this. Let me present a common patient that will increase in numbers over the next few weeks: a young adult without known COVID-19 contact develops fever and headache, slight cough and goes to the ED or UC. Tests negative for flu, sent home and told to self quarantine and return if symptoms considerable worsen. They do not qualify for testing because they are not high risk. A week goes by and their condition worsens, now has worsening cough and shortness of breath, ongoing low grade fevers. Their chest X-ray, vitals, labs are all stable. This person likely has the illness but continues to not qualify for testing as supply is not ample. Available testing at onset (after fever, symptoms, negative flu test) would isolate that individual assuming it were a positive test. Instead, that individual likely exposed this to at least one other individual and probably more. Was it their fault for not staying home until all symptoms resolved? What if they developed pneumonia with mild symptoms? You cannot put every case in a vacuum as the course is not predictable and varying on a case by case basis.Quote:
Originally Posted by kmcrawfo
Half of those in the ICU in the US are under the age of 60. This is not strictly a bad disease for the elderly as previously thought. More data will continue to come out that supports your fears that this is very serious. To say widespread testing doesn’t impact the curve is contradictory.
It is also attitudes like thisQuote:
Originally Posted by kmcrawfo
https://twitter.com/DevinNunes/statu...s-trump-clarke March 15, 2020
and this:
https://twitter.com/davidfrum/status...22174238846978 March 14, 2020
While I know there has been pleas to ignore politics in this matter, the issue is that how politicians have reacted to this story as it developed matters. Had it been taken more serious from the start, maybe the curve could have been flattened earlier. But we were repeatedly assured from the Federal Government that it was under control, it was going to zero, and there was no reason to be concerned. All the while it spread throughout the country essentially unchecked.
This poll from Pew shows that 56% of Fox news viewer believe that the media has greatly exaggerated the threat (and another 23% believes they have slightly exaggerated it). Making up this ground is going to take time, and the ground needs to be made up because the messaging was fumbled from the start.
I disagree..........I think that the vast majority of people are taking this seriously. I think that our youth and the youth of the world think they are largely invincible. Add to that, the virus hasn't impacted enough people in this country in enough areas. It is tough to take this seriously when you don't know a single person that has the virus or has been impacted by it. I think that's about to change very soon......the more we test, the more the numbers are going to grow. The next two weeks are going to be VERY telling and we should know significantly more by the end of March.Quote:
Originally Posted by kmcrawfo
The problem with kids these days (I hate how that sounds) is not so much they think THEY are indestructible, as far as this virus is concerned, they likely are to some extent. It is the selfishness that it is "all about them!" It is how their behavior affects everyone else, especially all the old people who live in Florida, and there are quite a few.Quote:
Originally Posted by bleedXblue
I know, kids have always had this invulnerable streak, and short-sighted selfishness, but the degree of self-centerdness seems to be especially glaring in these kinds of responses.
Why should this be different than EVERYTHING else? Sadly our generation raised them and enabled this pathetic behavior.Quote:
Originally Posted by UCGRAD4X
It seems the only two groups NOT taking this seriously are stupid kids (I do feel old) and partisan Trump supporters who cling to his initial comments. Their arrogance will cause people to die unnecessarily.
So these partisan supporters are clinging to his initial comments because they are blind faith followers...right? But these same supporters are now ignoring his changed tune and heightened awareness over the last week? So they went from blind faith supporters to skeptics in the course of a week? That literally makes no sense.Quote:
Originally Posted by Muskie in dayton
I am absolutely buried and swamped trying to manage this crisis at my clinics, so this will likely be my last post for a while. I am deeply saddened and disappointed by the continued political banter not only on this website but across the board. Seriously, wake up people. It is sad to see that much of our country truly has lost the strength and unity that we had that enabled us to survive and Conquer World War I, World War II and other disasters of our past.
I hope we are all able to learn from our mistakes (which I have in abundance) and the mistakes of others (which are most glaring in hind-sight) and try to limit discussion and criticisms to information that helps us move forward.
"Woulda-shoulds-coulda" might help in the next pandemic (but probably not since it will probably unlike any we have seen before - such as this one in many ways) but not-so-much at this time when unity is most critical. Let's stick to good wishes, prayers and an attitude of - where do we go from here.
ALL-FOR-ONE!
please
Quote:
Originally Posted by Muskie in dayton
What? How do you derive a theory like this? Seriously. Just stop it.
I think it is the unparalleled blind hatred of Donald Trump by the left that is driving some of the lack of co-operation. No president, even Nixon, has had to put up with the amount of crap that the big 3, ABC, CBS, and NBC have blamed Trump for. Was he a bit slow to respond? maybe. He has since tried to get everyone on board and pulling in the same direction. If Gov. Cuomo and he can get along, the rest of us can all pull together, and stop this in it's tracks as quick as possible.Quote:
Originally Posted by kmcrawfo
Spot on. Stop the hate and get behind OUR president and his team.Quote:
Originally Posted by JTG
Italy had more confirmed cases today than on any singular day. They also now have more fatalities than China. That’s despite the measures that have been taken.
There is a very real chance that all of us, no matter who we voted for, will know someone that dies from this. I hope I’m wrong about that. Unfortunately I was wrong when I initially said this was not a big deal. So, yeah, it would be nice to put the political bullshit aside. It’s a respiratory virus, and trying to keep it from spreading is a little like trying to keep the dust out of your house with a screen door. It helps to a point, but only to a point. This is a crisis literally everywhere in the world regardless of what the politics are.
I am all for getting behind him and coming together as one to fight this thing. But at the same time I think every move should be analyzed, criticized, and questioned by the media and experts. We need as much input as we possibly can from as many sides as possible. I am nervous by the number of yes-men that seem to be around him, I need to know there is someone in that room that is willing to speak truth to power.Quote:
Originally Posted by bleedXblue
In other words, we need more Dr. Faucis.
I saw just today 2 additional doctors speak about the CV with the Presidents Team in attendance. The Surgeon General and another Dr. I don't sense anyone is hiding anything. The message has been pretty consistent and clear the last two weeks or so.Quote:
Originally Posted by STL_XUfan
I read that 50% of our cases are in 10 counties right now. I'm sorry for the people in those counties, of course, but I'm still hopeful that being in the great wide open middle of the country turns out to be an effective way of avoiding the virus.Quote:
Originally Posted by xubrew
Because I know a bunch. Does this actually seem far fetched to you? That someone recalcitrant in their opinions is recalcitrant to changing their belief based on facts and data?Quote:
Originally Posted by bleedXblue
That's a classic response. Well done. Recalcitrant. Hilarious. You even had to edit it. LMAOQuote:
Originally Posted by Muskie in dayton