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NinjaDoc

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Everything posted by NinjaDoc

  1. Hope every ones doing okay, Sorry was not active here much, but the one place I didn’t want to talk “work” was here and the discussion were more intense here than at work lol Either ways I suspect me wife and kid had the infection about 2-3 weeks ago. All symptoms fit at that time the rapid tests were not available. The first week was real bad to the point I almost felt like going to the hospital, but gradually improved. I got swabbed and quarantined but test came back negative . I continued quarantine for few more days until symptoms got better 99% but had to go back to work Eventually since lack of staff to cover. I still maintained “social distancing” as much as possible. Fortunately being kidney doc, 95% decisions can be made based on labs and tests. And I was able to avoid direct patient contact for couple more weeks. I probably will get antibody tested just to reassure myself. But at this point all bets are off with this disease with people reporting tons of stuff based on half baked research which drowns out proper research. Now a days there are two kinds of healthcare workers, ones who takes care of covid patients and ones who give interviews. I see lot of docs online and in tv dishing out advises and information. Literally only 10% of the them actually took care of patients. Most of them have no business shelling out advises. Been talking to colleagues from various places. Depending on where you work the attitude and reality is different. I have over heard ophthalmologist in physician lounge complain to the ENT guy that this is all a media hoax, Ian the same hospital where we just lost a 50 ish healthy guy to covid that morning. If I was more of an in your face guy I would have shoved him to the wards and asked to take a walk around rather sit in his cocoon passing judgement and conspiracy theories . Any ways over the weeks things have slowed down. As of now ground reality for me at least, as expected from numbers cases from general public in the two hospitals i cover slowed down. The ones coming in are not aggressive and sick etc. I believe this is because of social distancing. I say this because the third hospital covers for prison population and nearly more than half the ICU beds are filled up with prisoners with covid. The one place where they cannot social distance effectively. This makes me wonder what will happen Come May if they lift social distancing completely. Step by step reopening might be okay. Opening up restaurant, malls and other “socializing and mass gathering areas” to be delayed perhaps. the disease is less understood, the progression and variability and questionable strains all make this one of the most challenging times to deal with. I completely understand the tough situation some folks are in due to lack of work minimal savings and difficult survival. Where to strike a balance is difficult. Hopeful gradual ease back of non essentials will be the key. hope everyone and family is staying safe.
  2. Just trying to give some optimistic outlook based on some numbers. Just keep this as a positive thought and don’t expect it to be true course. source : Institute of Health Metrics and Evaluation at the University of Washington. Just an estimate. as of now it’s just a guesstimate even since non of the pattern followed any common sense so far. The growth of new cases in Ohio has slowed until last Saturday 3/28 cases in Ohio were growing by 20%+ every day. after that Sunday 3/29 - 17.57% Monday 3/30 - 16.94% Tuesday 3/31 - 13.76% Wednesday 4/1 - 15.83% Thursday 4/2 - 13.94% Friday 4/3 - 14.13% Saturday 4/4 - 12.89% Sunday 4/5 - 8.13% Based on this these guys revised and saying Ohio is now projected to peak in hospitalizations in 2 days, on April 8. By Sunday, April 26, Ohio is projected to need less than 200 hospital beds across the entire state. Ohio is projected to have 0 shortages in terms of regular beds or ICU beds. Ohio is projected to need 223 ventilators, down from the previous projection of 615. All seems positive, on ground lvl I can tell you at one point they were making arrangement to convert all the closed of cafeteria sections into make shift wards to cover demands and of course to make lot of money etc, but we never saw the extreme brunt, we never had the tough job to choose who gets to go on the ventilator. Whtr the grandma with sniffles or the young dad with sniffles and large goober. They all got put on ventilator of course for more billing and money is money. there is an old saying, it’s easier to wake people up when they are sleeping. But when they pretend to be sleeping it’s difficult.
  3. To clarify, By decline I meant % growth of new cases, overall numbers still slow climb. But the onslaught seems to have slowed down
  4. Ohio is on the way of decline phase, if we are able to keep the current scenario Tight and intact we likely will be on the way to stable state by end of April. Of course anything can change. But At least light at the end of the tunnel. dewine did a lot of things right at the right time despite a lot of people denouncing him and sentencing him to the stake Glad to see majority of people followed the right step. sad to see still lot of people peddling out fking conspiracy theory when people Are loosing life. We lost more life’s than 9/11 slowly painfully and worst part; all alone during their final days and hours. All these conspiracy peddlers should walk through the hospital / ICU floor to see ground reality. We probably escaped the major brunt because of timely action taken and followed. here is to hoping that may 2020 is back to normal for us.
  5. Medicine is always risk vs benefit, even just taking a Tylenol has risk vs benefit. You doing the right thing, no need to worry. You have to take care of responsibility which there is no other solution. What is shunned upon is Gang of people just hanging out and spreading stuff for non life essential things like may be spring break. Protect your self as much as you can, wear mask and gloves during house visits etc. despite this , if you start to have symptom rest up heal up and don’t go out anymore for calls. but Sometimes I don’t know the right answer, I might be biased as well. As in I am critical of people are traveling via planes and mass transit for non essential trip etc, but what’s essential is an undefined entity. If you ask me I will say for sure motorcycling is a safe hobby to pursue now( as I said I am biased) ( the classic OR rides) since minimal human contact, minimal socialization, minimal gas stop, high quality all the PPE all the time, but some others might point fingers at that and say don’t do it.
  6. Don’t worry As of now we have enough gloves and stuff no worries there, just the masks and proper PPE. Plenty of rubber nobody uses it that’s all whtr it’s gloves tires or life itself.
  7. Don’t take this as a critic against the country, but high time our priority is reorganized. it’s amazing that we are spending 2 trillion on military equipment and fighting a war Against an Imaginary enemy some where that nobody wants and nobody wins. Throwing all the young men and women of the future on to that shit show only for them to return older and broken both in mind and body. Then the audacity to ignore them and then use them for votes and image building. mean while the next generation of enemy is not imaginary but invisible like a virus that’s going to eat away our very existence both in our real life and virtual world. Funding should be throw into research science both medical and other higher end socio techno financial end goals. It’s appalling to see the wealthiest and what used to be front running nation among all of humanity reduced to a state that we are asked to reuse PPE for front line healthcare workers and having to ration our tests and wait years for results on who ever we were able to test. We can be , should be better than this, hopefully this episode is a reset on everything. again this should also be an eye opener on health care delivery. Healthcare is something where we should strike a balance between. Capitalism and socialism. Because unlike wealth which we can accumulate based on our personal hard work, we are sometimes only as healthy as our fellow human beings are. This episode should open our eye, if majority of the population are unhealthy and cannot afford healthcare it doesn’t matter how much gold mark mega insurance we carry, we will also suffer. Let’s discuss that in another topic
  8. I feel like we might be off to a decent start so far compared to China.italy might have been unique, Italy roughly 60 million in 120k sq meter space with major chunk smoking elderly. USA it’s 320 million in roughly 4 million sq meter with elderly in nursing homes and old age places too debilitated to be functional smoking and mingling. Don’t know if that makes any difference but at least here in Midwest it seems to be, coasts were more dense population and more active older folks in society is present it’s hitting harder. @snot regarding going back to old life I am hoping these peak in about 3 weeks and starts to plateau and wean off in 8. Just arbitrarily plucking these numbers based on what I am seeing just in my area. Started as 1 First then 2-3-4 came. Then now about 7-8 suspicious cases pending confirmation , it still in its up swing.( test results takes forever)
  9. As of now information is less and ever evolving. without sticking to current statistics and ratio I will give an imaginary scenario island with 100 people Let’s say covid can Infect about 60 of them easy- we can never say who it’s going to infect of the 60 infected 30 will be okay can walk around spreading more 20 sick stay home 5 will need hospital and 5 icu. and in this island there is only one ventilator all that we are trying to do is to slow Down the rate of transmission to a point that the 5 that will show up for the vent shows up over a period of 5 to 10 weeks instead of all coming together in 1-5 days which means almost all dead. And the only way to achieve this is by slowing down the initial infection, and the subsequent spread from the infected. Even if a person with virus inside is not actively coughing and sneezing his oral nasal mucosa and saliva mucus secretions etc still can shed virus which at present seems to be pretty contagious. many young people who have the virus and can continue functioning will continue to have fun roam around touch everything and once a little old Lady is at the right place and the right time Will end up with a wrong fate
  10. Problem with the disease is healthy people are still functional and most asymptotic to just mild flu like symptoms which could just be mistaken as allergies that are common these times. So just assume all non essential interaction are not worth it, as in you are either receiving it or transmitting it without even knowing.
  11. China was widely blamed for doing this hush hush job resulting in world spread. We should have learned from them. then we proceeded to do the same by not believing it and other crap. I think mr trump was taking more information and input from political and economic pundits rather than actual Cdc and health care experts. It was sort of gamble to save the economy vs acting on an unseen threat. It was quite evident from the difference in opinion about this disease right from the podium by mr trump and dr faucci On hind sight he should have trusted the scientific world and information that was gathered from around the world. Instead of encouraging and reassuring investors and market should have focused on common people. Er on the side of caution and approached this aggressively from the start and led the fight. Would have had a better outlook when compassion clarity and strength coming from the top. better approach would have been mobilizing more fund like what happening right now, keep economy in life line and stop and curb this way earlier. Mike DeWine is doing exactly The right thing. Need extreme approach to start with, as they say any measures we take before pandemic appears extreme and afterwards it seems inadequate.
  12. Many patient who were vulnerable and even more family and bystanders in the elderly age group kept coming to hospital last week with no concern for the disease. When we would advise them to be safe avoid contacts and stuff they would tell me it’s all a hoax and i was wondering where is such a View point developing. All I see was panic and more panic in social media. I don’t have tv hence don’t know what actual media says. Then One of the Doc in forefront of the fight bought this clip up in discussion and I couldn’t believe it. Worst part is just a random search shows avg age of Fox News audience is 64-65 / a major chunk above 80 that’s even worse. 😑 I do understand these days it’s all opinion channel and there are no news channel. That’s why I don’t even have tv and waste time on it. People just want to watch what they want to see and hear. There is no gathering info and analysis by individual, just spoon fed vitriol and hate 24x7 from either side. All over the world same deal. it’s propaganda spreading and political mind altering from left or right happening on a daily basis. But when it comes to actual science there should be no excuse for this kind of approach and attitude. a hard truth based on science and facts which affects all of humanity shouldn’t be altered like this. Media shouldn’t be the judge of what’s right and wrong about science as it evolves. This right here was a massive disservice to the US.
  13. Me too, this year flu incapacitated me like never before. Almost wanted to get admitted myself.
  14. All information I say take it with grain of salt as I am purely a kidney guy. (But we are the most common sense / numbers driven field in medicine/ so all my opinion are too rational to be true in medicine. ) First off if you had a dx of dvt in past/ or active risk of dvt/ the use of or lack of aspirin doesnt play a big role. Aspirin can take an edge off risk if you never had dxed dvt issues or risks but not in a significant way. Only presence or absence of blood thinners matters/ plus if it was dvt / PE most likely you would have been typing this message from hospital bed during recovery. - we can rule out PE ( I should never say never in medicine I guess) then the symptoms, this year flu was bad, common theme seen was despite vaccination people getting hit bad. Even young healthy people. And significant cases of double impact as in one episode recovered some time end of fall winter and another during dec Jan period. Most have been dxed with test proven Inflz para inflz etc but Recently after corona news started I was also thinking same whtr those rare tests that came back negative was corona which when ever knew. But currently based on the info available, corona is highly contagious and if it was here that early we would have seen a massive influx of cases already and not such spotty rare presentation. in short that was most likely one of the common viruses running around which was really debilitating this year. Also the sub Acute symptoms like runny nose continue to run for sometime. having said that if you have one leg swelling and pain etc make sure you get ultrasound.
  15. Now the saying goes instead of 14 it might actually be 24 days where you can shed and spread As healthcare worker with symptoms she should be tested, Ohio health I believe will fast track such cases, turn around might be 48hrs. Should get it tested since both the other test is negative
  16. This is the toughest part of the disease, the symptoms are so broad and common it could be anything. Hopefully she can get tested and it comes out negative. Or may be I should say say comes back positive and you guys are recovering. That’s would be a much better scenario.
  17. one of the things i missed out in Ohio, if all the logistics matched up i would have given this a try for sure. cheaper, safer, skill developing and more fun. Cant get any better than this
  18. just wanted to highlight this from earlier post just in case it was missed in wall of text. Avoid any nsaids for the time being until more info starts coming in. When flu like symptoms and body ache starts this will be the first line meds we all grab, but as of now hold off. So far tylenol seems to be clear to use.
  19. So far total 4 patient of which 3 have been confirmed. One pending confirmation. young healthy confirmed guy just 51yrs is in ICU on vent since last two days. treatment has been difficult with no consensus now and people trying different stuff. even those meds are in short supply. worst part is lack of protective gear for the healthcare staff. Significant shortage of masks even as of now. Shortage of tests and duration to Get result is going to be a bigger problem. As of now high clinical suspicion before approval for test, this means chasing and isolating contacts by test etc going to be difficult. In short/ as of now patient volume not crazy yet/ But shortage of protective gear/ tests and medicines can be felt already. No way shape or form we will be able to handle the worst case scenario. as of today we are still not seeing a massive influx etc, this may be promising but also reflects some what isolated area our hospitals are covering. Roughly based on the multiplication time line may be need a week or two before our area is hit hard. Will know soon how real this disease is, how effective the measures taken has been, as in comparing cases keep trickling in vs mass influx vs not much at all seen. hang tight, continue to follow the recommendations. Hopefully this blows over in few weeks.
  20. As of today 2 confirmed cases in our facility and one Highly suspected one. This is based on minimal testing of subjects based on clinical suspicion and lack of resources. First case didn’t have travel history no high risk contacts nothing, the suspicious case is younger guy not much risk factors and significant resp distress. cuyahoga has the largest reported from Ohio, but probably tested way more esp CCF doing drive by. if your sick stay home, could be corona could be just flu, no need to panic. If it gets worse to the point of significant resp distress go to hospital, don’t go to a clinic or urgent care or anything since they will just send you to the hospital anyways. As of now avoid ibuprofen and using left over steroid pack etc confounding information coming out on these so far. starting to see the cases trickling in, have a bad feeling of impending trouble at the hospital. Hope you guys are taking this serious. Avoid Social contacts as much as possible. Happy to see people taking this seriously so far, most social networking and media doing its part. see young people planning to enjoy the down time, holidays price much lower on stays and travel etc, but some reports coming in shows even-some younger people getting hit hard even if it’s rare.
  21. The spread will level of, no question about it. Just like any infectious process. Again it’s not the spread we should be worried about. Timing and peak. The spread over months is so much easier to manage than spread over days. That’s why social isolation and hand washing and stuff will help. These are not to defeat the virus but to slow it’s onslaught.
  22. Not sure how it works, South Korea seemed like their isolation and co tact tracing was top notch. I know the state in India where I am from the health sector is poor in resource but great in aptitude and skills. News from back home is super fluent work flow and tracing and isolating each and every contact and Building up working Charts. Where I am from I know that scheme work easy due to close relationships/ lot of family friend close support system / knowledge of whereabouts minute to minute. For eg, you can ask a neighbor and he will have most times accurate info where person A is. it’s kind of hard to explain. So these countries with such a social network they probably ahead of the game. We probably will follow the Italian model of spread. for eg about a week ago Korea had done tracing and testing of nearly 140,000 With a superior kit while we were at test 1500 or so.
  23. Guys, stay far away from people as much as possible. Follow the social isolation. The reports seems to be right most part, My intuition was wrong, this thing seems as bad as what it’s feared to be. Personal experience from colleagues in some hot spots seems like this is much virulent form. And we just started seeing the tip of the iceberg. In our practice area we started seeing some positive cases. Not yet horrible scenario of icu filling up etc yet. Hopefully the curve flattens enough for us to deal with it in a timely manner. If the reports turns out to be true , Just a rough guesstimate on worst case scenario is 200 million being affected / 20 million needing hospital/ less than 2 million death/ and less than 1 million hospital beds in USA. If we follow stringent measures advised, we might be able to cut the numbers by a lot , and at least to a point where the 20 million needing hospital can be bought down to 10-15 and spread over time so we can tackle with the 1 million beds we have.
  24. My brain had to give you guys the alarmist view point the healthcare is adopting to curb this infection. I agree with them just based on the current view point. And continue to follow the hyper precautions . But to be quite honest my heart and personal experience is telling me the virus was here even before the alarms and notoriety. Was seeing cases in hospital which was coming back negative for flu but fit all the bills for bad viral - lung picture. Some cases even young people getting infected and presenting with caked out lungs. This was even December January period way before alarms went off. If infact that’s the case probably thousands of Ohioans already have it and it still hasn’t resulted in pandemonium. Now that we started testing for it we started finding it. If not we would have charted it as bad case of atypical flu or something. But this is just pure anecdotal personal view point of mine.
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