Coronavirus: What questions do you have?

[cwbullet]

Yes, that patient can choose what, if any, information to make available. The patient has the right to choose who to make what information available to as well. I have the right to tell everyone that I broke my left forearm when I was 15, but that is certainly not all of my health information. I can also say that Aunt Sally cannot be told anything about me or even if I am a patient of the hospital or not.

Any information that the White House doctors have released is authorized by the patient and nobody else. So if his fever is released, it was released with consent or by breaking the law.

BINGO!

 

[rocketsaway]

My observations, 2 months in. Overall students have been complying w/ masks on the bus. Im fortunate enough to have very few onboard, grades 6 and lower.
The private schools seem to be very strict in following protocols. At one school, in the morning, a teacher stands outside and squirts hand santizier on students hands before entering the building. Same school, on a hot afternoon, kindergartners were outside, 3-4 feet apart, exercising w/ masks on.
Today, a local public high school shut down for the week due to 5 students positive. Thats about 2000 students. The county positivity rate is low-2.5%.
At the start of the school yr, the teachers union turned down a modified quarantine.

 

[cwbullet]

My observations, 2 months in. Overall students have been complying w/ masks on the bus. Im fortunate enough to have very few onboard, grades 6 and lower.
The private schools seem to be very strict in following protocols. At one school, in the morning, a teacher stands outside and squirts hand santizier on students hands before entering the building. Same school, on a hot afternoon, kindergartners were outside, 3-4 feet apart, exercising w/ masks on.
Today, a local public high school shut down for the week due to 5 students positive. Thats about 2000 students. The county positivity rate is low-2.5%.
At the start of the school yr, the teachers union turned down a modified quarantine.

Looks like you might be doing things right.

 

[Peartree]

Our local school has been on a rotating three days in person, two days remote, schedule but has just announced that next week they will return to a full five day, in person, schedule for all students. To me, that seems both premature and unwise.

 

[Marc_G]

Our local school has been on a rotating three days in person, two days remote, schedule but has just announced that next week they will return to a full five day, in person, schedule for all students. To me, that seems both premature and unwise.

School districts here in Indiana are doing the same thing despite a sharp rise in cases. Fortunately my kids' district is still hybrid/virtual (my kids are on the virtual program).

Chicago now has us on the quarantine required list.
The return to normal is a blatant political ployi n the run up to the election. I hope the officials involved are eventually convicted of gross malfeasance and public endangerment.

 

[rocketsaway]

3 days before the HS shutdown, the district approved a full 5 day in school for Nov. They have been on a hybrid 4 day since start of Oct.. The private schools, grades K-8, which I do, have been on 5 day in school, since Aug. No incidences.

 

[Sparky]

Our local school has been on a rotating three days in person, two days remote, schedule but has just announced that next week they will return to a full five day, in person, schedule for all students. To me, that seems both premature and unwise.

What good does that 3 in person and two remote do? They are still exposed to the same people in less than a 14 day period. Doesn't make sense to me.

 

[OverTheTop]

What good does that 3 in person and two remote do? They are still exposed to the same people in less than a 14 day period. Doesn't make sense to me.

I suppose that gives two days for symptoms to develop, at which point they should not go back to school. A bit short IMHO. Probably more just reducing probabilities.

 

[NateB]

What good does that 3 in person and two remote do? They are still exposed to the same people in less than a 14 day period. Doesn't make sense to me.

I think the intention is to have smaller groups in the classroom. Is the other group 2 days in the classroom and 3 at home?

 

[Bill S]

We've been doing 2 days a week and a Friday every other week, here in south-central PA. There have been very few cases (been a total of 5 students out of 4500+ students, not including staff of several hundred more people). School officials have been VERY skittish about even being doing that. It looks like they are finally going to increase attendance to 4 days a week; its about time.

 

[Peartree]

I suppose that gives two days for symptoms to develop, at which point they should not go back to school. A bit short IMHO. Probably more just reducing probabilities.

I'm not sure exactly how it works, but the two days are "remote learning" some via Zoom perhaps, but the idea is that at least a third of the class is removed from in-person instruction every day so that while, yes, they are exposed to the same people, they aren't exposed as long (two days less) and they have room to social distance in the classroom (since a third of the students aren't physically there). Since the CDC calculation for virus exposure/risk has always been the Number of People x Exposure Time, reducing either (or both) of these numbers is always a good thing. In Ohio, outside of schools and churches, the metric we often hear recommended is typically "groups of ten or less" and exposure times of 30 minutes or less.

 

[Reinhard]

(redundant, didn't properly read above postings)

 

[Sparky]

I'm not sure exactly how it works, but the two days are "remote learning" some via Zoom perhaps, but the idea is that at least a third of the class is removed from in-person instruction every day so that while, yes, they are exposed to the same people, they aren't exposed as long (two days less) and they have room to social distance in the classroom (since a third of the students aren't physically there). Since the CDC calculation for virus exposure/risk has always been the Number of People x Exposure Time, reducing either (or both) of these numbers is always a good thing. In Ohio, outside of schools and churches, the metric we often hear recommended is typically "groups of ten or less" and exposure times of 30 minutes or less.

Thanks for that, but still doesn't make much sense to me. They are there all day with rotation of all the students in the class room and sounds as if the teacher is there for all the possible exposure. I'm not trying to be difficult but it makes no logical sense to me.

 

[boatgeek]

Thanks for that, but still doesn't make much sense to me. They are there all day with rotation of all the students in the class room and sounds as if the teacher is there for all the possible exposure. I'm not trying to be difficult but it makes no logical sense to me.

To me, the big argument in favor of split shifts is about space. Assuming you have decent airflow through the room (a terrible assumption in many schools), keeping students a little further apart should reduce risk of infection when combined with mandatory masks. Really, the distance probably helps most with kids who take their masks off for a little while during the day.

 

[NateB]

-doing things-

We are seeing more severe cases again to the point of requiring ECMO. One doctor mentioned some of these cases were needing 6+ weeks before being weaned from the machines. Are we equipped to handle this type of life support for such a long time?

Edit to clarify: some of the covid cases elsewhere have been requiring 6+ weeks of ECMO. He didn't say if this was in the US or not. To my knowledge, we haven't had a pt on it quite that long.

 

[Marc_G]

The rank and file here in Indiana don't recognize that things are escalating alarmingly.

Meanwhile schools are increasing in person time, restaurant etc. restrictions are being eased, and it's "time to get back to normal." Just in time for the elections.

 

[NateB]

The rank and file here in Indiana don't recognize that things are escalating alarmingly.

Meanwhile schools are increasing in person time, restaurant etc. restrictions are being eased, and it's "time to get back to normal." Just in time for the elections.

No, they don't. I was content with the decisions made until recently. As soon as we entered "Stage 5", the cases started creeping up. I agree on the mask mandate being extended, but we need to either strengthen some of the restrictions again or else really hit the PR hard that things are getting worse again and people need to keep taking social distancing, mask wearing, and avoiding indoor gatherings seriously. Our county health commissioner recently called out weddings as a major source of cases. Unfortunately everything falls on deaf ears.

 

[Peartree]

No, they don't. I was content with the decisions made until recently. As soon as we entered "Stage 5", the cases started creeping up. I agree on the mask mandate being extended, but we need to either strengthen some of the restrictions again or else really hit the PR hard that things are getting worse again and people need to keep taking social distancing, mask wearing, and avoiding indoor gatherings seriously. Our county health commissioner recently called out weddings as a major source of cases. Unfortunately everything falls on deaf ears.

On that note... my wife and I are planning a trip, from Ohio, to South Carolina next month for a family wedding (and a little R&R time away since we've done pretty much nothing all year). Our county just went to "red" (again) and only "purple" is higher. Ohio and everything east of the Mississippi seems to be on a similar upward slope. Anyone want to give odds of whether travel restrictions will kick in again before the wedding? (sigh)

 

[NateB]

Ohio just announced they are recommending people from Indiana quarantine themselves when coming into the state. I wouldn't be too surprised if a mandate with more restrictions happens soon.

We also have plans to travel to North Carolina at the end of the month which we rescheduled from April. We will see how it goes now. I was more optimistic a month ago. Even if we don't go, I desperately need the time off.

 

[cwbullet]

We are seeing more severe cases again to the point of requiring ECMO. One doctor mentioned some of these cases were needing 6+ weeks before being weaned from the machines. Are we equipped to handle this type of life support for such a long time?

Edit to clarify: some of the covid cases elsewhere have been requiring 6+ weeks of ECMO. He didn't say if this was in the US or not. To my knowledge, we haven't had a pt on it quite that long.

We are just now starting to see a "slight" bump but nothing we can't handle. We are seeing another mild bump in routine non-covid admission. We are using ECMO, but we are using a different product out of DARPA more. We have had great success with it and will be on 60 Minutes soon because of that success.

I do think that we will hear less about COVID after the election.

 

[cwbullet]

Another week down with no true spikes. Surveillance testing is not finding any influenza either. Our lab is a large lab that supports a huge portion of county - essentially zero positives.

 

[Sandy H.]

Chuck,

I read CDC guidelines for funerals that was from July 25, 2020. I think the recommendations are solid, however I question the risk of holding/attending a funeral.

I assume your recommendations would likely match the CDC guidelines, so I will summarize what I imagine the event would look like if it is to go ahead at this time.

Outdoor service, masks mandatory, no physical contact with people from different households, no/minimal singing, up to 50 people.

Assuming those criteria and knowing that a portion of the attendees would be high risk (due to age more than health) would you consider this a low, medium or high risk.

In my mind, the safest option would be a private service with family only and a memorial service with a more traditional service once there is a vaccine, cure or some other reason for things to be more normal.

Thank you for any advice.

Sandy.

 

[Peartree]

Chuck,

I read CDC guidelines for funerals that was from July 25, 2020. I think the recommendations are solid, however I question the risk of holding/attending a funeral.

I assume your recommendations would likely match the CDC guidelines, so I will summarize what I imagine the event would look like if it is to go ahead at this time.

Outdoor service, masks mandatory, no physical contact with people from different households, no/minimal singing, up to 50 people.

Assuming those criteria and knowing that a portion of the attendees would be high risk (due to age more than health) would you consider this a low, medium or high risk.

In my mind, the safest option would be a private service with family only and a memorial service with a more traditional service once there is a vaccine, cure or some other reason for things to be more normal.

Thank you for any advice.

Sandy.

Services that I have officiated have been mostly indoors but limited to less than ten people (though one had about fifteen). Chairs were spaced six to ten feet apart and everyone wore masks. The officiant (me) wore a mask for some services, at the request of the family, but not at others (again, at the request of family, so that the eulogy would be understandable to the hard-of-hearing. There has been no singing except for one service where the family requested it outdoors, at the graveside (in a stiff wind, and wearing masks). At that service, the service was in the chapel at the cemetery, with the double doors open, with all participants, and the officiant (again, me) wearing masks. Although I have suggested to families that they might wait to have a more "complete" service at a later date, all have chosen not to pursue this option, presumably because the end of the pandemic is so indefinite and they simply want to grieve and move on. As difficult as that may seem, it is, I think, healthier in the long run. One family has reserved the option of possibly holding another memorial service with more people at a later date, but since that service was in the early months of the pandemic, I have my doubts that they will want to do so eighteen, or twenty-four, months afterward.

 

[cwbullet]

Quote for today: "It is sometimes as dangerous to be run into a microbe as by a trolley car." - Dr. James J. Walsh

 

[Blast it Tom!]

Another week down with no true spikes. Surveillance testing is not finding any influenza either. Our lab is a large lab that supports a huge portion of county - essentially zero positives.

That's another possible silver lining to this dark cloud - people generally learning to practice better hygiene, leading to an easier flu season, and with progress continuing on the virus, perhaps in the end we'll come out with public health practice positives. IF they actually learn to do it... the masks I've seen often aren't very effective, especially if worn below the nose!

 

[Bill S]

Quote for today: "It is sometimes as dangerous to be run into a microbe as by a trolley car." - Dr. James J. Walsh

Ain't that the truth. After having suffered from Lyme Disease and the lingering damage afterwards (to this very day), that trolley car might have been more merciful.

 

[afadeev]

I do think that we will hear less about COVID after the election.

I bet we will hear a lot LESS about EVERYTHING after the election cycle is truly over (whenever that may be).

On the other hand, with another upswing in infections underway, we are more likely to have another rough winter than a mild summer virus season.
That would be the case everywhere, around the northern hemisphere, not just the US. However, the US is likely to continue to lead the world in

At to how this pandemics may end?
History suggests diseases fade but are almost never truly gone:
https://theconversation.com/how-do-...s-fade-but-are-almost-never-truly-gone-146066

 

[Tech 68]

Just now from Fox News... every bit helps.
https://www.foxnews.com/health/human-coronaviruses-inactivated-mouthwash-oral-rinses-study

 

[Bill S]

Oh that's just great. Now some nitwit is going try injecting themselves with mouthwash and hurt themselves. Evolution in action I guess. Paging Mr Darwin to the white courtesy phone.

 

[cwbullet]

Oh that's just great. Now some nitwit is going try injecting themselves with mouthwash and hurt themselves. Evolution in action I guess. Paging Mr Darwin to the white courtesy phone.

Public Service Anouncement; Mouth wash is for use in your....mouth.