COVID-19 updates

[JoeKitchen]

Your claim is false. Cuomo did not promote Chloroquine as a treatment, he announced that New York was beginning clinical trials to see if it was effective. Two totally different things.

It's the same thing Peter.  Trump touted the trials just as Cuomo did.  The difference is how the press covered it. 

With Cuomo it was real hope whereas when Trump talked about it, it was false hope.  If Trump is responsible for those death, so is Cuomo. 

As an aside, I dont hold either responsible. 

Here is a pretty non-biased article on what Trump was touting, Trump touts New York coronavirus trials as progress against pandemic  See, he is not hap hassardly suggesting we start using Chloroquine as a treatment, but was referencing the trials just as Cuomo did. 

[Craig Lamson]

I agree it's a dilemma.  There are no easy answers.  I'm presenting the argument from the other side. I believe we should try to follow the rules. I do.   But government has to make decisions pretty soon to modify those rules because the current plan won't work.  People have to work to feed themselves and their families.

Hopefully the government can get off thier partisan asses and pass a cleanbill to help those that need it. Without a doubt this will be harder on soem that others and lets hope we can help them.  The government wil do what it thinks is best. and right now I agree its for people to stay home. Period.  If its two weeks, or a month or whatever if we don't do it we hurt people.  How much is a human life worth in dollars and cnets?

[William Walker]

But that's the whole point.  If the casualties wind up not being that bad, maybe a lot less than from regular seasonal flu, then why are we shutting down the world?

Alan, when last did you hear of ~2000 Italians dying in three days of flu? In my 64 years on this earth I personally know of no-one who died from the flu... I'm not saying it doesn't happen - I believe the scientists when they quote those figures in the same way I believe them when they say this is much worse than flu.

Why do you believe the flu numbers (which you accurately quote) but not the numbers the same folks are telling you about this virus? This is worse and, sad to say, we have not seen the worst of it in either your country or mine.

Do your best to stay out of harms way by listening to the experts - which does not include your president!

[armand]

Chloroquine and hydroxychloroquine are both anti-malarial drugs and can be taken for both treatment and prophylaxis of malaria.  Both of them have side effects, some particularly severe.  We absolutely DON'T know if they work for treating or even prophylaxis of SARS-CoV-2.  Other than the one very small French trial which was highly flawed, there is no report of clinical results.  Based on that French paper there will be a very large open label study in NYC on the use of the two malaria drugs with and without added azithromycin (Zithromax, a commonly use antibiotic for bacterial respiratory infections).  There is no guarantee that we will get good data from this.  There are ongoing clinical trials of these drugs in a number of different countries.  We don't even know what the right dose is!!!

One thing that has happened, is that community physicians have been prescribing the two malaria drugs such that patients who are on these for treatment of lupus and rheumatoid arthritis are now SOL if their Rx needs to be refilled.  This is totally irresponsible.

Imagine if it turns out to have some in-vivo effectiveness. Then those patients who were taking it before will be really screwed up.

Clinical trials usually take quite some time and the statistics involved are quite tricky. I’m afraid we will see a rush of poor quality studies in the desire to do good only to realize later their conclusions are not valid.

PS. On a side note, worse comes worse, the SLE and RA patients do have alternatives

[Rob C]

And how often do I need to repeat myself that this is reasonable to expect in the beginning, but sooner or later it wont be. 

I have yet to see any plans on how to go forward when it is no longer practical for people to remain in doors. 

I might add, if people start seeing such "essential services" as landscaping being attended to, how long before they say screw it, and get back to work themselves?

Has your country actually described what an essential job consists of, or is it left open to personal interpretation based upon a few vague suggestions?

FWIW, you should call your local guy in true blue and ask him to send a squad car over to the neighbour. But hey, maybe the neighbour owns a couple of guns...

What a bloody civil mess you guys have created for yourselves with your laws and ambitions optimised for an age long past.

As for that famous national notion of the freedom to do what you like, regardless of the rest of society, because it's somehow your imaginary right, I believe you only have that delusion and grand arrogance because you never spent years of nightly bombing raids where you live, of sleeping in underground railway stations, under the stairs or under tin roofs of garden bomb shelters, just waiting for the real decisive moment when the motor of the doodlebug above you stopped, and you knew it had only one way to go.

You have collectively had it too good on the home turf; you haven't had to face the external challenges to life in the domestic zone as others have.

[Rob C]

I think you're deliberately trying to not understand. They isolated and the numbers came down. The virus can still come back like it did in Hong Kong when they let their guard and released restrictions too early. There is no magic involved.

Again, how often do we have to keep repeating the same conversation.

You don't; you can do as I did and opt some people out of your life.

[JoeKitchen]

Has your country actually described what an essential job consists of, or is it left open to personal interpretation based upon a few vague suggestions?

FWIW, you should call your local guy in true blue and ask him to send a squad car over to the neighbour. But hey, maybe the neighbour owns a couple of guns...

What a bloody civil mess you guys have created for yourselves with your laws and ambitions optimised for an age long past.

As for that famous national notion of the freedom to do what you like, regardless of the rest of society, because it's somehow your imaginary right, I believe you only have that delusion and grand arrogance because you never spent years of nightly bombing raids where you live, of sleeping in underground railway stations, under the stairs or under tin roofs of garden bomb shelters, just waiting for the real decisive moment when the motor of the doodlebug above you stopped, and you knew it had only one way to go.

You have collectively had it too good on the home turf; you haven't had to face the external challenges to life in the domestic zone as others have.

Yes, the governor sent out a fairly large list of what is and is not essential.  It was about 4 pages long listing nearly all possible sectors and whether or not they needed to stop business.  I'll pass on calling the police since I honestly see nothing wrong with three guys doing some yard work outside.  Considering no police came either, it does not look like anyone else on my street felt otherwise. 

I'll agree with you that we have had it too good for too long when it comes to war.  But I certainly dont think the solution would be nightly bombings to teach us a lesson. 

[Robert Roaldi]

You don't; you can do as I did and opt some people out of your life.

Too true. Thank you, apparently I needed the reminder.

As an antidote, here's some sensible advice from someone who spends his life studying these things, http://www.trackingzebra.com.

[William Walker]

It's the same thing Peter.  Trump touted the trials just as Cuomo did.  The difference is how the press covered it. 

With Cuomo it was real hope whereas when Trump talked about it, it was false hope.  If Trump is responsible for those death, so is Cuomo. 

As an aside, I dont hold either responsible. 

Here is a pretty non-biased article on what Trump was touting, Trump touts New York coronavirus trials as progress against pandemic  See, he is not hap hassardly suggesting we start using Chloroquine as a treatment, but was referencing the trials just as Cuomo did.

Joe, of all the scary things that Trump has ever said, this would scare the hell out of me if I was an American: “At my direction, the federal government is working to help obtain large quantities of chloroquine,” Trump said.

Now he's directing the medical effort? God help you guys!

[James Clark]

Texas Lt. Gov. Dan Patrick: 'I'm all in' on risking my health to lift social distancing guidelines for economic boost

I really hope there is a plan to protect the vulnerable, even though no one wants to talk about it.  Something's goin give; I'd rather it be controlled then not.

I live in Austin, I'm currently busy managing crisis communications for some of my clients (one of whom is a developer/manager of over-55 communities), and I have direct ties to the TX political system.  If there are any plans, they are being held closely enough that the people that would logically need to know about them don't.

This would be par for the course for this generation of Texas politics, though.  They think this virus thing is no big deal, but these jackasses activated the National Guard to "protect" us from a conspiracy involving the US Army, Bluebell ice cream, and WalMart a few years back.

By the way, one of my best friends, 49 in otherwise good health, is on life support in Wisconsin and odds are he is going to die from this. Dan Patricks can go f*** himself.

[faberryman]

Joe, of all the scary things that Trump has ever said, this would scare the hell out of me if I was an American: “At my direction, the federal government is working to help obtain large quantities of chloroquine,” Trump said. Now he's directing the medical effort? God help you guys!

Dr. Fauci was not at Trump's press briefing yesterday. Maybe Trump is going to abandon expert advice and just go with his gut. He said he was a very smart person, a stable genius.

[Alan Klein]

I would bet your dentist is considered an essential service, at least for emergencies and I'm sure they were not ordered to shut down...but they did anyways. Maybe that tells you something about intelligent people making decisions not to get ill and spread the virus to their customers.

Maybe he's only following guidelines and just doesn;t want to get sick himself.  If they change the guidelines and say "yes" serve your clients, then dentists will dress in PPE equipment, keep their office sterized, and help their patients one at a time.  It doesn;t have to be an either or situation.  I just got a message from a New Jersey lab that I've used re-opening their laboratories.

Here's what they're going to do.  Why can't procedures like these apply to doctor offices and other type businesses?

March 24, 2020

We welcome patients in the following offices — 


•   Bridgewater
•   East Brunswick
•   Edison
•   Elizabeth
•   Freehold
•   Hillsborough (Raider Blvd)
•   Hillsborough (Rte. 206)
•   Lacey
•   Metuchen
   •   Monroe
•   Neptune
•   New Brunswick
•   Nutley
•   Point Pleasant
•   Somerset
•   Tinton Falls
•   Warren


University Radiology is committed to ensuring the safety and health of our employees, patients and visitors.

Updated office hours, screenings, and scheduling are available on our website.

All offices will be closing by 6pm and closed on weekends. Any temporarily closed locations will be reopened as soon as the situation improves.

We follow the Center for Disease Control infection control guidelines to ensure we are providing the highest quality of care while protecting against the disease.

We are taking extra precautions at each of our facilities to safeguard patients and employees against COVID-19.
•   Radiologists and staff wipe down their work areas at the beginning, as needed throughout the day and at the end of their work days including their phones, computers, equipment, and surfaces.
 
•   Alcohol-based hand sanitizer dispensers are installed in all Imaging offices at the doorway of each modality room.
 
•   We have an adequate supply of germicidal wipes (such as Sani-Cloths).
•   We will provide personal protective equipment and other infection prevention and control supplies (e.g., hand hygiene supplies) to be used for both healthcare personnel protection and source control for any infected patients (e.g., facemask on the patient).
 
•   We have ensured our cleaning companies are following guidelines and using cleaning products recommended by the CDC.
 
•   We have specific persons designated within each of our locations that are responsible for communication with public health officials and dissemination of information to other healthcare personnel at the facility.

Patient Information for Appointments:
•   University Radiology will not perform procedures on patients known or suspected to have COVID-19 Coronavirus.
 
•   All patients coming to our offices should self-screen at home prior to arriving.
 
•   Any patient with the following symptoms will not be seen in our outpatient offices:
o   New cough
o   New shortness of breath
o   Fever over 100.0
o   Sore throat
 
•   All patients will also be verbally screened upon arrival to our offices. If considered high risk, the patient will not be imaged in our office.
 
•   We are working with our referring clinicians to direct the imaging of high risk individuals to facilities that are appropriately equipped to handle such patients, such as hospitals.
 
•   Patients are only allowed one visitor with them, and if possible, should arrive alone.
 
•   All employees and visitors to our offices will undergo a COVID-19 screening via questionnaire.
 
•   Patients who do not pass the verbal screening will not be seen in our office that day – your primary heath care provider can provide you with information regarding the appropriate facility for your needs.
For more information:   
https://www.universityradiology.com/coronavirus_update
https://www.cdc.gov/coronavirus/index.html
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
https://www.nj.gov/health/cd/topics/ncov.shtml
 


LOCATIONS & DIRECTIONS


SCHEDULE APPOINTMENT

[Robert Roaldi]

Dr. Fauci was not at Trump's press briefing yesterday. Maybe Trump is going to abandon expert advice and just go with his gut. He said he was a very smart person, a stable genius.

Trump has a track record of getting rid of people who don't tell him what he wants to hear. Let's hope that Dr. Fauci was off doing something important and couldn't be there today.

[Slobodan Blagojevic]

...

March 24, 2020

We welcome patients in the following offices — 
..

Is Corona causing people to type in bold? Or is Corona causing me to see bold?

[MattBurt]

I understand that Bart, but it is a flaw that a lot of people have right now.  So much so that in every country there are news stories about people not following the rules, lots of people. 

So it is not something I think can be fixed even with constant messaging.  It's just a flaw of people in general. 

You know in Philly the mandatory shut down of business has been on for a week and social distancing measures a little longer.  I live a block from one of the trail heads to the Wissahickon Park and Trail and need to drive along both roads that follow the ravine on either side of it.  People usually park on these roads who go to the park, and both roads were completely filled with cars, which means the park was packed.  The trail is only two cars wide, so with that many people, I just cant imagine effective social distancing was taking place. 

These measures can last for a couple of weeks, but until death comes to the door, I dont see it being practical expecting most to follow them much longer.  It's not in our nature and I would rather work with our nature then against it.

This has been a problem in Colorado too. Not right here so much but places closer to large population centers have been overrun with backcountry skiers, rock climbers, hikers, and people wanting to find space. But the problem is if everyone does it at once then it becomes counter productive.
There is also the problem of people who decided now is the time to learn a new outdoor pursuit. Instructors and guides have closed their businesses and inexperienced people are going to wind up needing rescues and medical services which is also counter productive.

But death is coming. I predict those disregarding the guidelines are going to get a wakeup call in another week or two.

[Alan Klein]

Alan, don't you get it. If we let everyone get sick all at once...our medical systems will collapse and the vast majority of patients that need hospitalization will just be dying at home. We'd also see people with heart conditions, diabetes, respiratory issues, cancer...you name it that would require hospital care would also be dropping dead.

By increasing the timeframe for that 80% getting sick to range over months rather than all at once, the medical system would fare better and less would die.

Don't know if you just don't understand this or have some other motive behind your continual questioning why we just don't all get sick today so we can get over this really fast.

Well, I'm not an undertaker if that's what you mean. 

In any case, they're getting more hospitals to the affected areas.  Medical ships to NY and California.  FEMA sending 1000 bed hospital to NY and 2000 bed to Cal.  1000 bed unit to Oregon.  Why can't we train nurses to provide ventilators to patients at home?  Why can't doctors start making home visits again?  We have to start thinking out of the box.  You're just giving up.

[MattBurt]

Well, I'm not an undertaker if that's what you mean. 

In any case, they're getting more hospitals to the affected areas.  Medical ships to NY and California.  FEMA sending 1000 bed hospital to NY and 2000 bed to Cal.  1000 bed unit to Oregon.  Why can't we train nurses to provide ventilators to patients at home?  Why can't doctors start making home visits again?  We have to start thinking out of the box.  You're just giving up.

Taking action to prevent more death is not giving up. I think what you are promoting is giving up.

[Paulo Bizarro]

For those like joe who want an estimate of how many weeks their lives might be disrupted for - this appeared on the BBC website today.  A few options, but none of them particularly rosy......

https://www.bbc.co.uk/news/health-51963486

Jim

Here in Portugal, the facts:~

- first case reported march 2
- state of emergency declared march 16: everything closed down except essencial services (supermarkets, pharmacies, take away restaurants, etc). Social distancing, i.e 4 people per 100sqm in supermarkets, etc.
- specific measures to protect the eldery. 30 dead today, 26 of which above 70 years old.
-specific economic measures in place to support small and medium sized companies, which represent the large part of our economy. People stay at home still working by remote means, receive 70% of their salary. Dealy tax payments, etc.
- Plan is to peak the epidemics mid-April, tail end into May, start to recover in June.
- Before march 16, daily growth rate in number of cases was ~40%, today is around 20%. There is a lag period until the results are seen, given the nature of the bug.
- Closing down schools was essential, as many cases came from kids with no symptoms.
- It was a pity that the EU did not enforce planned airport shutdowns, each country took ad hoc measures, which was not efficient.

[hogloff]

Well, I'm not an undertaker if that's what you mean. 

In any case, they're getting more hospitals to the affected areas.  Medical ships to NY and California.  FEMA sending 1000 bed hospital to NY and 2000 bed to Cal.  1000 bed unit to Oregon.  Why can't we train nurses to provide ventilators to patients at home?  Why can't doctors start making home visits again?  We have to start thinking out of the box.  You're just giving up.

Home care is your solution. How much time will the nurse(s) and Doctor spend in transit rather than treating patients. Will each patient need their own nurse(s) by their beds rather than being able to treat multiple patients at one time. What about someone wiping your butt because you are hooked up and not able to get up...will you sit in soiled diapers until the nurse comes calling the next day.

I think you should send your leader an e-mail laying out your ideas...he needs some new ideas.

[Paulo Bizarro]

Check the highlighted part.

Indeed SARS-COV-1 even startedin the same Wuhan market.

SARS-COV-2 is about 80% similar to previous by about 80% in its genome signature. It's just more deadly, and got out of containment, unfortunately. SARS-COV-1 killed about 900 people in China at the time. It is also the reason why Asian countries were so efficient in containing this one now, they knew what to do, and more importantly, WHEN todo it. The sooner the better.

Yes, China was too slow and hid the epidemics for about a month, and it spread to the rest of the world, which does not have experience on how to tackle such things. Compound that with a bureaucratic response coming from mostly incompetent "leaders", and here we are today.