rharshberger
Well-Known Member
Didn't figure much had changed....smokers will be smokers!Still happens today.
Didn't figure much had changed....smokers will be smokers!Still happens today.
Didn't figure much had changed....smokers will be smokers!
Question for the forum: Is telemedicine's resurgence here to stay? The reason physicians have not grasped this technology is a lack of compensation for providing it. Do you think that will change?
I hope they stick with and can be compensated. It is nice as a patient to schedule a telemedicine visit for more simple issues and avoid the waiting room. My insurance covers them, but my wife's employer will not accept these visits for sick time.Question for the forum: Is telemedicine's resurgence here to stay? The reason physicians have not grasped this technology is a lack of compensation for providing it. Do you think that will change?
How do morbidity and mortality statistics of SARS-CoV-2 compare to Influenzas A & B? Or is the current data on SARS-CoV-2 insufficient to make a comparison at this time?
I think that physicians are now starting to see the benefits of telemedicine. Don't know if they'll stick with it, though.
I hope they stick with and can be compensated. It is nice as a patient to schedule a telemedicine visit for more simple issues and avoid the waiting room. My insurance covers them, but my wife's employer will not accept these visits for sick time.
On the other end, we have used telemedicine to consult with specialists before we transport patients. We have pretty wide protocols, but once in a while a quick consult and assessment from a specialist can get us different orders and save time for the patient.
Not sure, really depends on the purpose? What if your only reason for seeing a doctor is for annual physical or a prostate exam? These events require the need for "in person" exams.Question for the forum: Is telemedicine's resurgence here to stay? The reason physicians have not grasped this technology is a lack of compensation for providing it. Do you think that will change?
Not sure, really depends on the purpose? What if your only reason for seeing a doctor is for annual physical or a prostate exam? These events require the need for "in person" exams.
Funny. Many annual exams are worthless and only a way to pad a doc’s bank account. There is no evidence that universal annual exams do anything. In the military, we no longer do them. There is an annual assessment of your health needs. All exams and labs are focused based on the results of that assessment. Often, the assessment is virtual.
Good news, but not without a downside. They say that they’ll be able to produce 500 million doses/year starting in 2021, with two doses/person. That means we’re looking at seeing this in the rear view mirror about 18 months from now assuming everything goes perfectly.Modern a vaccine moving forward.
https://amp.cnn.com/cnn/2020/07/14/health/moderna-coronavirus-vaccine-phase-1-study/index.html
I think that *if* insurers will continue to pay, tele-medicine and virtual doctor visits are here to stay. Obviously, there are some things that need to be done in person, but many office visits are a waste of everyone's time. I see an endocrinologist twice a year to review and update my prescription for thyroid maintenance medication. Typically, I go to a local lab (1/2 mile from my house) two weeks prior to my visit to get labs drawn. When I show up at the doctor's office, they ask me how I feel, take my blood pressure, palpitate my neck, and I'm out of the office literally within ten minutes. With a blood pressure cuff, or if the phlebotomist could have sent in my blood pressure from two weeks prior, there is almost no reason at all for me to drive a half hour into the city to be physically seen.
My wife is a transplant recipient. In the midst of this pandemic The Cleveland Clinic docs do not want these immune-suppresed patients exposed to all the nasty bugs that live in hospitals so almost all of her visits have been virtual. As long as the (monthly) labs are good, and things are going well, why would she need to drive an hour plus to downtown Cleveland?
Similarly, while there are advantages for mental health professionals to physically see patients for counseling, certainly all visits need not be in-person visits. But again, insurers only agreed to cover tele-medicine because of the Coronavirus, and when (and if) things return to some semblance of "normal" I have my doubts that insurers will allow virtual visits to continue for all these cases, though I hope that some will.
Good news, but not without a downside. They say that they’ll be able to produce 500 million doses/year starting in 2021, with two doses/person. That means we’re looking at seeing this in the rear view mirror about 18 months from now assuming everything goes perfectly.
I hope not. I much prefer face to face with my Doc. I've had one tele-medicine appt so far. Not impressed.Question for the forum: Is telemedicine's resurgence here to stay? The reason physicians have not grasped this technology is a lack of compensation for providing it. Do you think that will change?
Good news, but not without a downside. They say that they’ll be able to produce 500 million doses/year starting in 2021, with two doses/person. That means we’re looking at seeing this in the rear view mirror about 18 months from now assuming everything goes perfectly.
+1 for this, I prefer seeing the Doc as well, also if I am paying a $100 for a doctors visit I damn well want to see a doc, the darn telemed visits are still costing me a $100 (they bill them just like a regular visit). IMO the doc actually should be seeing someone as they might spot really important signs of something else while visiting with the patient.I hope not. I much prefer face to face with my Doc. I've had one tele-medicine appt so far. Not impressed.
I wonder if visiting your Doc on a computer screen is more or less expensive than visiting a lady of ill repute on a computer screen.
+1 for this, I prefer seeing the Doc as well, also if I am paying a $100 for a doctors visit I damn well want to see a doc, the darn telemed visits are still costing me a $100 (they bill them just like a regular visit). IMO the doc actually should be seeing someone as they might spot really important signs of something else while visiting with the patient.
Are you seeing patients that are sicker because they delay their care?
Chuck, a question on the body's antibody reaction to a vaccine shot.
I've seen a news article that casts doubt on how long the antibodies remain in the system of those who have been exposed to the virus. For some it may only be weeks or months.
What are the implications for the efficacy and length of protection of any vaccine?
Thanks.
Chuck, a question on the body's antibody reaction to a vaccine shot.
I've seen a news article that casts doubt on how long the antibodies remain in the system of those who have been exposed to the virus. For some it may only be weeks or months.
What are the implications for the efficacy and length of protection of any vaccine?
Thanks.
Obviously, I'm not a doctor, but from what I'm reading, those results will almost certainly have an effect on the ongoing vaccine trials because everyone is going to want to know the answer to that. But, I have seen discussions that the immune response to typical vaccines tends to be stronger and more long lasting than the normal immune response from having, and recovering from, the same illness/disease. Some have suggested that we might have to get a vaccine booster twice annually instead of once. Of course, I look forward to Chuck's reply as well.
Yes, but I am not sure how much of a change there is today. Patients always delay care. I have had the patient dray a 90 day prescription out for a year to avoid coming back. I think that is human nature. I have seen at least one patient that I can attribute his death to a delay in care. The patient died because of a fear of COVID and did not have COVID at the time of their death. A simple surgery earlier than the presentation would have saved their life. Instead, the patient died of an infection caused by the illness.
I think I can that post avoid all privacy issues.
The Moderna trial specifies repeated blood draws running out through 2 years to specifically test for antibody levels. This is the only way to know for sure how durable the vaccine induced antibody response will be.
Yes, but with the EUA, we will not have to wait that long to administer the vaccine. That will determine if we need a second or third dose.
Great stuffAbsolutely, there will certainly be an unblinded safety monitoring group that looks at the trial data in real time. I would guess there will also be a 3rd party unblinded group that will be monitoring for efficacy also. As time sensitive as this trial is, the data will be unblinded the moment it hits statistical efficacy (if it does hit that point that is).
We will almost certainly need a 2nd dose of the Moderna vax at 1 mo as the only two arms in the trial are 2 dose Vax and 2 dose placebo. Single dose is not even being evaluated. Also, the primary efficacy endpoint (what they have agreed with the FDA they will be measuring for approval) is:
There is a secondary endpoint (“extra stuff we will look at and tell you about, but not really the primary point of the trial“ in FDA speak) that looks at COVID infection 14 day post 1st dose, but it is unlikely that would reach statistical significance as that is only a 14 day window for infection to arise.
- Number of Participants with a First Occurrence of COVID-19 Starting 14 Days after Second Dose of mRNA-1273 [ Time Frame: Day 29 (second dose) up to Day 759 (2 years after second dose) ]
This trial is setup for maximum chance of success, not for optimized dosing. Each arm has 15k patients, and every dose or dose regimen evaluated would need an additional 15k participants.
Word is the start was delayed a few weeks from start of a July until the 21st because they had to hire a bunch of clinical research staff to oversee such a large trial. This is a place where Pfizer and AZ have big advantages over Moderna, ie been there, done that on gigantic trials.
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