Coronavirus

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caryking
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Civilized said:

caryking said:

Civilized said:

packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
Of the 3M, how many do you think will refuse?

No idea.

My guess is, far fewer will refuse in that demographic than others because of that demographic's significantly higher mortality from the virus. Kind of a vaccine corollary to "there are no atheists in foxholes."

Why?
No particular reason, just curious. My mother (not in a nursing home) has said, she will not take it right now. She wants to see some affect before she does. In the meantime, she will continue to live a more cautious life.
On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
ciscopack
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Came to NMB to do 1/2 day of work and 20 miles out; I found out I left my cell. Screw it, I'm not turning around. 3 of 4 TVs were supposed to have problems....2 were operator errors and 1 needs a new box & TV. Spectrum has moved and I thought it said South but it said N and after some fun driving, I find the new store in the new shopping mall but it's been closed for over a week due to everyone having Covid. I ride to Surfside and came back with the new box. I'm in for 3/4 day in and have at least that much more to do.....half day my butt. Finding something these days without a cell is tough. I was even pre-map and pre-phonebook. Rode by Revels and turned around....hey man....here's my problem and I bought 2 lawn mowers from your Fuquay store...can you help me.
IseWolf22
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Pacfanweb said:

Civilized said:

caryking said:

Civilized said:

packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
Of the 3M, how many do you think will refuse?

No idea.

My guess is, far fewer will refuse in that demographic than others because of that demographic's significantly higher mortality from the virus. Kind of a vaccine corollary to "there are no atheists in foxholes."

Why?
Pretty good analogy there. Few older folks are going to refuse the vaccine. They don't want the virus.
My 90 year old grandmother is nervous about the vaccine. But she's getting it as soon as possible because who knows how many good years she has left and she wants to enjoy them.
statefan91
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We went to Brevard where my parents have a small house because my grandparents moved down from NY ~25 years ago. We were down in the parking lot and they were up on their balcony. Both are 90+ and haven't been able to be around the grandkids at all. They're ready for a vaccine.
Mormad
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Daviewolf83 said:

Mormad said:

Daviewolf83 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.


Typically, it's peeps who need supplemental O2 and meds like antivirals and decadron. This can stop the downward spiral to the need for icu care in those felt to be at risk. Luckily, most infected don't require such care, and it's a judgement call for the ED docs whether some can be discharged from the ED to home or need consultation for admission for higher level care.

As you know, a small percentage of those admitted are actually being admitted for other issues and found to have covid on routine testing. But they're still listed as covid admissions because their infection, whether clinically significant or not, changes everything in order to limit exposure to staff and other patients.



The goal is to keep covid OUT of the hospital. It stresses the system and inhibits the ability to care for the non-infected community. It costs the system so much more than the relatively tiny uptick in payment they get for covid status. One NC hospital has shut down its OR because of 55 infected OR staff. They can't even staff their rooms adequately, and when emergencies are done they have to use cross coverage staff. Not all OR staff are proficient at craniotomies or open hearts, so it puts those patients at some increased risk, for example. Physicians are being asked to manage patients usually managed by hospitalists or critical care docs because those teams are being maxed out by covid. If we have experience running ventilators we're being asked to cross cover and potentially manage the critically ill. My pain management physician, who is originally trained as an anesthesiologist, is cross covering in the icu on the weekend. Every week brings a new challenge.
PackPA2015 and Mormad - Thank you for the information on the types of treatments being provided to those who are hospitalized. I had assumed the percentage was small for those hospitalized for other reasons, but testing positive for Covid-19. With 75-80% of hospitalized Covid patients not being placed in ICU, I wondered about the level of severity for these other cases and the types of treatments being provided. Your information is very helpful in filling in the blanks on this area.

Do either of you have an idea as to the average length of stay for Covid patients not placed in ICU? I have seen some news reports recently, indicating the average length of stay had been declining, but I have not seen any solid numbers. I was curious if this is accurate.

Thanks again for taking the time to respond. I am still traveling back home from my son's football game at Louisville, so I may not respond further until later tonight.


Talked to a pulmonologist and a critical care doc just now. No hard and fast numbers, but they think it's about a week for non-intubated patients.
RunsWithWolves26
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My dad is ready for it. His mom is in the nursing home and we haven't been able to see her outside of talking through a glass window since March. Dad said "I don't care the vaccine risk, I wanna hug my momma because who knows how long any of us have left on this earth." When your hero says something like that to you, it really gets your attention. Hope these vaccines are the answer!
statefan91
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With Moderna potentially getting EUA this week, and Johnson & Johnson hopefully having Phase 3 readouts in the next month, hope is that production can really ramp up. I believe J&J is a one shot vaccine which would obviously be significant.



griff17matt
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ciscopack said:

Came to NMB to do 1/2 day of work and 20 miles out; I found out I left my cell. Screw it, I'm not turning around. 3 of 4 TVs were supposed to have problems....2 were operator errors and 1 needs a new box & TV. Spectrum has moved and I thought it said South but it said N and after some fun driving, I find the new store in the new shopping mall but it's been closed for over a week due to everyone having Covid. I ride to Surfside and came back with the new box. I'm in for 3/4 day in and have at least that much more to do.....half day my butt. Finding something these days without a cell is tough. I was even pre-map and pre-phonebook. Rode by Revels and turned around....hey man....here's my problem and I bought 2 lawn mowers from your Fuquay store...can you help me.


On God, I think you have a stroke on half your posts. Are you okay?
packgrad
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griff17matt said:

ciscopack said:

Came to NMB to do 1/2 day of work and 20 miles out; I found out I left my cell. Screw it, I'm not turning around. 3 of 4 TVs were supposed to have problems....2 were operator errors and 1 needs a new box & TV. Spectrum has moved and I thought it said South but it said N and after some fun driving, I find the new store in the new shopping mall but it's been closed for over a week due to everyone having Covid. I ride to Surfside and came back with the new box. I'm in for 3/4 day in and have at least that much more to do.....half day my butt. Finding something these days without a cell is tough. I was even pre-map and pre-phonebook. Rode by Revels and turned around....hey man....here's my problem and I bought 2 lawn mowers from your Fuquay store...can you help me.


On God, I think you have a stroke on half your posts. Are you okay?


Seriously. What does any of that have to do with this thread?
Pacfanweb
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Cisco channeling his inner Roboheel
Steve Williams
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Staff
Reading this from CNN/WRAL and I think my brain exploded.

Here's what the studies don't yet show. They haven't looked at whether the vaccine prevents someone from carrying Covid-19 and spreading it to others. It's possible that someone could get the vaccine but could still be an asymptomatic carrier. They may not show symptoms, but they have the virus in their nasal passageway so that if they're speaking, breathing, sneezing and so on, they can still transmit it to others.

https://www.wral.com/coronavirus/why-a-covid-19-vaccine-doesnt-mean-that-you-can-stop-wearing-a-mask/19429201/

I guess I thought the point of getting the vaccine was to prevent you from contracting a virus that you already have immunity to. Foolish me.
wilmwolf
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The weird thing is that he posts fairly normally on the sports boards. He only goes full bot here.
statefan91
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They just don't have the data at this point, but assumption is that it will protect against both infection and transmission.
Mormad
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That is correct. The only thing they can say right now is that the vaccine doesn't necessarily stop you from getting infected, but seems to greatly reduce your odds of getting sick. Therefore, they can't say that it will stop the spread.
TheStorm
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Pacfanweb said:

Cisco channeling his inner Roboheel
bornheel.
SupplyChainPack
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Dippin' Dots.

Is there anything they can't do?


https://www.popsci.com/story/health/covid-vaccine-cold-chain-dippin-dots-ice-cream/?utm_medium=syndication&utm_source=flipboard
AlleyPack
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Mormad said:

That is correct. The only thing they can say right now is that the vaccine doesn't necessarily stop you from getting infected, but seems to greatly reduce your odds of getting sick. Therefore, they can't say that it will stop the spread.

My (serious) question is... once people start getting the vaccine, will they STOP wearing masks (b/c they think they can't get the virus) -- yet they still might become carriers, and thus the spread could actually increase? (to those who haven't been able to get the vaccine yet)

It will all be interesting to see.
packgrad
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AlleyPack said:

Mormad said:

That is correct. The only thing they can say right now is that the vaccine doesn't necessarily stop you from getting infected, but seems to greatly reduce your odds of getting sick. Therefore, they can't say that it will stop the spread.

My (serious) question is... once people start getting the vaccine, will they STOP wearing masks (b/c they think they can't get the virus) -- yet they still might become carriers, and thus the spread could actually increase? (to those who haven't been able to get the vaccine yet)

It will all be interesting to see.
I think if we get the demographic of people that the virus is killing vaccinated, we can worry less about the rest of us. Statistically, it is highly unlikely to affect the vast, vast majority of people. Spreading the virus amongst those who will most likely never even know they ever had it is not a concern of mine.
Steve Williams
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Staff
Just playing devil's advocate here- wasn't the narrative we've heard for the last 10 months that we had to have a vaccine to stop the spread? Now we have one, and it sounds like the main thing it does is help protect you from getting a bad case of Covid and really does nothing to prevent spread. Am I missing something?
gtman49
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Steve Williams said:

Just playing devil's advocate here- wasn't the narrative we've heard for the last 10 months that we had to have a vaccine to stop the spread? Now we have one, and it sounds like the main thing it does is help protect you from getting a bad case of Covid and really does nothing to prevent spread. Am I missing something?
Yes, it was always an inaccurate narrative. Any vaccine - flu, COVID, whatever doesn't stop the virus from spreading from host to host, it just keeps the host from getting sick.
statefan91
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Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65

Wayland
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statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.
TheStorm
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Wayland said:

statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.
Lockdown seems to be working wonders, huh?
Mormad
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Wayland said:

statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.


Seems like that is a good thing
Mormad
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We're cutting elective surgeries 50%.

199 in house, 19 in ED, 30 in the unit, 14 tubed

Avg length of stay 1 wk for non-icu, those tubed avg 3wks smoking the ET tube.

170390 tests performed, 13336 positive

Highest # of admissions in one day 42

Age 0-17, 1957 pos out of 21k tests, 37 hospital encounters, no deaths

Age 18-24, 1698 of 19k, 78 hosp, 1 death

Age 25-49,4707 of 56k, 545 hosp, 9 deaths

Age 50-64 2857 of 41k, 739 hospital, 42 deaths

Age >65, 2505 of 46k tested, 1449 hosp encounters, 241 deaths

Docs are definitely wanting the vaccine based on activity/ conversations in the lounges. Even those that had covid are hoping for second round vacs.
Pacfanweb
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Steve Williams said:

Just playing devil's advocate here- wasn't the narrative we've heard for the last 10 months that we had to have a vaccine to stop the spread? Now we have one, and it sounds like the main thing it does is help protect you from getting a bad case of Covid and really does nothing to prevent spread. Am I missing something?
Couple of thoughts:

One, if the vaccine stops you from getting sick from Covid, that's a good thing.

Two, they are still studying whether you can spread it after the vaccine, so we just don't know. It's not a fact that you can or cannot spread it after the vaccine...so once you're vaccinated, you still mask up just in case, I guess.

Three, since the most vulnerable are going to get it first, hopefully that'll drastically drop the death rate since they are overwhelmingly the ones dying from it.
So whether it's still spreading or not, if the deaths plummet, hopefully that'll let the rest of us get back to normal more quickly.
If it can't kill the old and the weak, who's it gonna kill?

Four, maybe they WILL find out it stops you from spreading it, that would be a nice development.
PackMom
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Wayland said:

statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.
One thing that likely impacts this is the CNAs who work in multiple facilities.
Pacfanweb
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Mormad said:

Wayland said:

statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.


Seems like that is a good thing
Sounds awful, but yeah, it is. I guess that's why those folks will get the vaccine first.
FlossyDFlynt
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Mormad said:

We're cutting elective surgeries 50%.

199 in house, 19 in ED, 30 in the unit, 14 tubed

Avg length of stay 1 wk for non-icu, those tubed avg 3wks smoking the ET tube.

170390 tests performed, 13336 positive

Highest # of admissions in one day 42

Age 0-17, 1957 pos out of 21k tests, 37 hospital encounters, no deaths

Age 18-24, 1698 of 19k, 78 hosp, 1 death

Age 25-49,4707 of 56k, 545 hosp, 9 deaths

Age 50-64 2857 of 41k, 739 hospital, 42 deaths

Age >65, 2505 of 46k tested, 1449 hosp encounters, 241 deaths

Docs are definitely wanting the vaccine based on activity/ conversations in the lounges. Even those that had covid are hoping for second round vacs.
I can only speak to surgeries, but none of my sites have done any cut down on elective procedures yet (none are in NC, for reference). It is a holiday slow down period though, so numbers are lower anyway. I would be very surprised if they cut back on elective surgeries, unless things take a turn for the worse
Mormad
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This is our busiest time because those with private insurance wanna get fixed before their out-of-pocket costs reset Jan 1, and it's built in time off to recover. That said, we're fairly slow right now because of covid. My hospital doesn't want to limit elective surgery because that's how they make money, but we're starting to bulge at the seams and staffing will soon become the insurmountable issue. Nobody's told me i can't schedule a case yet, but i suspect it's coming.
Daviewolf83
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AlleyPack said:

Mormad said:

That is correct. The only thing they can say right now is that the vaccine doesn't necessarily stop you from getting infected, but seems to greatly reduce your odds of getting sick. Therefore, they can't say that it will stop the spread.

My (serious) question is... once people start getting the vaccine, will they STOP wearing masks (b/c they think they can't get the virus) -- yet they still might become carriers, and thus the spread could actually increase? (to those who haven't been able to get the vaccine yet)

It will all be interesting to see.
According to Dr. Fauci, even with the vaccine, we should plan to continue wearing masks into next Winter. Quite frankly, he is crazy if he thinks people, once vaccinated, are going to continue to wear a mask.

Mask use and social distancing will likely have to continue until next winter
Daviewolf83
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Mormad said:

We're cutting elective surgeries 50%.

199 in house, 19 in ED, 30 in the unit, 14 tubed

Avg length of stay 1 wk for non-icu, those tubed avg 3wks smoking the ET tube.

170390 tests performed, 13336 positive

Highest # of admissions in one day 42

Age 0-17, 1957 pos out of 21k tests, 37 hospital encounters, no deaths

Age 18-24, 1698 of 19k, 78 hosp, 1 death

Age 25-49,4707 of 56k, 545 hosp, 9 deaths

Age 50-64 2857 of 41k, 739 hospital, 42 deaths

Age >65, 2505 of 46k tested, 1449 hosp encounters, 241 deaths

Docs are definitely wanting the vaccine based on activity/ conversations in the lounges. Even those that had covid are hoping for second round vacs.
Mormad - Thanks for posting this information and your other post on the average length of stay for non-ICU Covid patients. I am not surprised the elective surgeries are being cut, due to the increases we continue to see in hospitalizations.
Daviewolf83
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TheStorm said:

Wayland said:

statefan91 said:

Agreed - get HCWs, nursing homes, 65+, essential workers/teachers vaccinated and then things start looking a lot better. If you look at the NCDHHS dashboard, majority of cases are < 65 but majority of deaths are > 65


And still 10 months in, a majority of the deaths in NC are congregate.
Lockdown seems to be working wonders, huh?
We actually are not that locked down, based on my travel experience from this past weekend. Last Friday, my wife and I drove to Louisville, Kentucky for my son's football game on Saturday. I saw a huge amount of traffic on the road traveling to and from Louisville. As we passed several large outlet malls, you would never know we are in the middle of a pandemic and there is most definitely no lockdown. The shopping malls were packed. Hotels were a different story. I am not sure if their are restrictions on occupancy, but there were not many people staying in the two hotels we stayed in on our trip.

We actually stayed across the river from Louisville in Indiana on Friday night and it was interesting that restaurants there were open to limited in-person dining. There was actually a wait to be seated at a restaurant we visited. In Kentucky, all restaurants are take-out only. There is zero in-person dining allowed in Kentucky. The good news is that everywhere we went on the trip, I would estimate 99% of the people I saw were wearing masks. We drove up through Virginia, West Virginia, and Kentucky and at every stop, people had on masks. Coming back, we drove through Kentucky and Tennessee and we observed the same. People at all rest stops (with one exception on the trip back) had masks on when they got out of their cars.
TheStorm
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I was trying to be sarcastic about the Assisted Living Facilities...
TheStorm
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Mormad said:

This is our busiest time because those with private insurance wanna get fixed before their out-of-pocket costs reset Jan 1, and it's built in time off to recover. That said, we're fairly slow right now because of covid. My hospital doesn't want to limit elective surgery because that's how they make money, but we're starting to bulge at the seams and staffing will soon become the insurmountable issue. Nobody's told me i can't schedule a case yet, but i suspect it's coming.
Mormad, Thanks for all the detailed information from my question from Saturday morning... still had one unanswered, are they bringing people in from the assisted living facilities to the hospital - or are they just keeping them where they are, like they did with my mother?

Just curious what is "normal" when someone already near the end of their life gets covid? Thanks in advance.
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