Kern County ER Docs C-19

Guest219794 · May 5, 2020

9 hours ago, toomuchbaloney said:
https://www.reuters.com/article/us-health-coronavirus-fdny/at-home-covid-19-deaths-may-be-significantly-undercounted-in-new-york-city-idUSKBN21P3KF
This reporting suggests that people did, indeed die, without adequate hospital care.

Accurate. This should be painfully obvious to anybody with even basic understanding of how hospitals work. When staff are overwhelmed, bad things happen to patients.

FWIW- information like that will go farther if you can find it on FOX.

https://www.foxnews.com/health/nyc-hospitals-overwhelmed-by-coronavirus-patients-resident-warns

That avoids the inevitable objection to the source, rather than the content of information based on the idea that it was presented by the lamestream media, which is clearly the enemy of the people.

toomuchbaloney · May 5, 2020

Yes. Because in 2020 most reputable media have been demonized by the POTUS who struggles to tell the truth.

Daisy4RN · May 5, 2020

1 hour ago, toomuchbaloney said:
Yes. Because in 2020 most reputable media have been demonized by the POTUS who struggles to tell the truth.

Define "reputable media".

FullGlass, BSN, MSN, NP · May 5, 2020

14 hours ago, Cowboyardee said:
1. Wait, what? I only got involved in this conversation when you claimed (entirely without evidence) that healthcare is not overwhelmed in NYC or anywhere in particular, implying that hospitals are fine and handling the crisis well. I then presented you with a first-hand account of what "not overwhelmed" and "fine" actually mean to those trying to fight this disease... You then have the nerve to tell me I have no evidence as though seeing patients suffer and/or die of inadequate care first-hand and talking friends and relatives suffering from inadequate medical resources in NYC through their ordeal couldn't possibly compete with 'facts' you pulled out of thin air, about a real life crisis and tragedy you haven't seen or taken part in, to make blustery, tone-deaf arguments on the internet.
Seriously, check yourself. This is real life, not some keyboard warrior pissing contest.
As for numbers 2-7: Completely, 100% irrelevent to anything I actually said. If the rest of your argument hinges on your fantasyland head-in-the-sand nonsense about hospitals coping perfectly well with the crisis and patients not suffering at all for the chaos, then you should definitely reconsider your entire case. But I haven't particularly taken a side on economic shutdowns and mass quarantines and I don't know why you're wasting most of your post lecturing me about it.
It's still early on. The peer reviewed meta-analyses will come later. For now, best you can do is actually listen to accounts from the front lines rather than pretending you know what's going on when you clearly don't at all.

I am sorry you are upset and kudos to you for your hard work in this crisis. I have repeatedly stated that we should not take a one-size-fits-all approach, meaning we don't treat Modoc County Calif the same way we treat NYC. Yes, hotspots like NYC need stricter controls and I have never denied that. I am not talking about NYC or other hotspots. My argument is that it is time to start lifting lockdowns and this decision needs to be made at the local level, based on local conditions. I fail to understand why you find this so objectionable. Your personal experience is not representative of the entire country.

When I talked about healthcare systems not being "overwhelmed" I was referring to the original rationale for lockdowns, which was to prevent this, and I understand why we initially had lockdowns. In that sense, overwhelmed meant that hospitals would not be able to care for everyone who required care. I was not referring to the front-line health workers IN SOME AREAS being overwhelmed by all the work they needed to do and kudos to them. And even in NYC, the number of ICU patients has been decreasing for about 3 weeks now. It is up to the state and local governments in New York state to determine how to proceed. Or do you think people in California, which has not been hit hard, should dictate to the people of New York how to move forward? No, you don't. So why do you think the people of California should have a lockdown based on the conditions in NYC?

13 hours ago, toomuchbaloney said:
https://www.reuters.com/article/us-health-coronavirus-fdny/at-home-covid-19-deaths-may-be-significantly-undercounted-in-new-york-city-idUSKBN21P3KF
This reporting suggests that people did, indeed die, without adequate hospital care.

No, that's not what the article said. It reports that some people who died at home may have died of COVID. It did not say that they could not go to the hospital to get care. If anything, many people were too scared to go to the hospital thanks to the fearmongering of the media.

16 hours ago, Wuzzie said:
Oh for god’s sake I have repeatedly expressed that having an opinion is fine. Presenting it as fact is not. And “condemn”? That’s a bit over the top. Nobody here is arguing to continue with the lockdown yet you seem to be deliberately obfuscating that fact while trying to school us on things we already know. We get your point. You just can’t seem to comprehend ours. You think your primary care patients have it rough? Try being an acute care patient right now. Or a cancer patient. And spare us the sainthood. Most of us have gone above and beyond for a patient a time or two in our careers. We just don’t feel the need to advertise it because it’s crass.
I don’t even know what you’re kvetching about anymore. The lockdowns are being lifted.

You keep arguing with me. You went from the Bakersfield docs were inaccurate to admitting the raw data was OK, but you didn't like the way they applied it. You also thought it was OK that they were condemned by some professional association and that some social media platforms are censoring COVID perspectives that differ from the current ridiculous orthodoxy. Now you say an opinion is OK, but not if it is presented as fact. Who is presenting opinions as fact? I'm not aware of the Bakersfield docs or anyone else with a dissenting opinion doing this.

And get the giant chip off your shoulder. What is your problem? You come across as very indignant that I dared to disagree with you, ask me the same question multiple times, and now you express a complete lack of concern for what non-COVID patients are suffering, as well as for the economic devastation this lockdown has caused and that continued lockdowns could result in a Great Depression. I wasn't touting my own sainthood, but trying to convey the level of suffering I am seeing due to these lockdowns.

And how DARE you put down what is happening to primary care, psych, and other non-COVID patients. You know what happens when people don't get care because they are afraid of COVID? Those primary care issues can become full-blown medical emergencies. What is wrong with you?

It now appears that many patients who may be having a stroke or MI are not calling 911 or going to the ER because of COVID. You think that's OK?

Many cancer patients have had treatments and surgeries postponed due to COVID. You think that's OK?

Opioid addiction, ODs, and alcoholism are on the rise b/c of COVID lockdown. You think that's OK?

Many people had elective surgeries postponed. We're not talking about cosmetic surgery. "As Brian Kolski, director of the structural heart disease program at St. Joseph Hospital in Orange County, California, told me, “A lot of procedures deemed ‘elective’ are not necessarily elective.” Two patients in his practice whose transthoracic aortic valvular replacements were postponed, for example, died while waiting. “These patients can’t wait 2 months,” Kolski said. “Some of them can’t wait 2 weeks.” Rather than a broad moratorium on elective procedures, Kolski believes we need a more granular approach. “What has been the actual toll on some of these patients?” he asked."

"[Dr.] Lasic, describing a precipitous decline across the New York region in patients presenting with acute coronary syndromes, worries that others won’t be so lucky. “I think the toll on non-Covid patients will be much greater than Covid deaths,” he said."

Above quotes from:

https://www.nejm.org/doi/full/10.1056/NEJMms2009984?query=featured_coronavirus

Postponing some surgeries like knee and hip replacements results in a lot of pain and suffering and that can also lead to more opioid abuse and ODs.

The toll on mental health patients is not to be shrugged off. Severely stressed mental health patients can attempt suicide or harm others.

Yes, the lockdowns are being eased in most areas, and thank goodness.

Wuzzie · May 5, 2020

9 minutes ago, FullGlass said:
Many cancer patients have had treatments and surgeries postponed due to COVID. You think that's OK?

Those patients are MY patients. So what do you think I feel about that?!

11 minutes ago, FullGlass said:
You went from the Bakersfield docs were inaccurate to admitting the raw data was OK, but you didn't like the way they applied it.

Show me where I said their raw data was inaccurate. I'll wait.

11 minutes ago, FullGlass said:
You also thought it was OK that they were condemned by some professional association and that some social media platforms are censoring COVID perspectives that differ from the current ridiculous orthodoxy.

They weren't condemned they were disagreed with by the American College of Emergency Physicians not "some professional organization". I never said I agree with censoring I pointed out that the constitution does not apply to a private entity.

13 minutes ago, FullGlass said:
And get the giant chip off your shoulder. What is your problem? You come across as very indignant that I dared to disagree with you, ask me the same question multiple times, and now you express a complete lack of concern for what non-COVID patients are suffering, as well as for the economic devastation this lockdown has caused and that continued lockdowns could result in a Great Depression.

Never said any of that don't even try to make me out to be some sort of villain. Let me try to make this clear to you once again. I don't think we should keep the lockdown ongoing. I never said we should keep the lockdown going. Again, show me where I said that. My problem is that YOU talk to people like we are morons when you repeatedly try to school us on things we already know.

19 minutes ago, FullGlass said:
I wasn't touting my own sainthood, but trying to convey the level of suffering I am seeing due to these lockdowns.

You seem to think that you are the only one seeing the suffering. I see it first hand. Every day. I see it with my patients. I see it with my friends who have themselves or their family members had COVID, I see it in my parents who are currently isolated in an unfamiliar congregate living situation that I CAN'T HELP THEM adjust to. You don't know me, you don't know my situation. How dare YOU assume to know what I feel. How dare YOU assume my intent. And how dare YOU malign my character. If you want to agree with people who believe that this is no worse than the flu, which is exactly what they said, have at it.

toomuchbaloney · May 5, 2020

2 hours ago, Daisy4RN said:
Define "reputable media".

LOL

rep·u·ta·ble - adjective: having a good reputation.

me·di·a - noun 1.the main means of mass communication (broadcasting, publishing, and the Internet)

Are there some other definitions that I should be aware of?

toomuchbaloney · May 5, 2020

1 hour ago, FullGlass said:
I am sorry you are upset and kudos to you for your hard work in this crisis. I have repeatedly stated that we should not take a one-size-fits-all approach, meaning we don't treat Modoc County Calif the same way we treat NYC. Yes, hotspots like NYC need stricter controls and I have never denied that. I am not talking about NYC or other hotspots. My argument is that it is time to start lifting lockdowns and this decision needs to be made at the local level, based on local conditions. I fail to understand why you find this so objectionable. Your personal experience is not representative of the entire country.
When I talked about healthcare systems not being "overwhelmed" I was referring to the original rationale for lockdowns, which was to prevent this, and I understand why we initially had lockdowns. In that sense, overwhelmed meant that hospitals would not be able to care for everyone who required care. I was not referring to the front-line health workers IN SOME AREAS being overwhelmed by all the work they needed to do and kudos to them. And even in NYC, the number of ICU patients has been decreasing for about 3 weeks now. It is up to the state and local governments in New York state to determine how to proceed. Or do you think people in California, which has not been hit hard, should dictate to the people of New York how to move forward? No, you don't. So why do you think the people of California should have a lockdown based on the conditions in NYC?
No, that's not what the article said. It reports that some people who died at home may have died of COVID. It did not say that they could not go to the hospital to get care. If anything, many people were too scared to go to the hospital thanks to the fearmongering of the media.
You keep arguing with me. You went from the Bakersfield docs were inaccurate to admitting the raw data was OK, but you didn't like the way they applied it. You also thought it was OK that they were condemned by some professional association and that some social media platforms are censoring COVID perspectives that differ from the current ridiculous orthodoxy. Now you say an opinion is OK, but not if it is presented as fact. Who is presenting opinions as fact? I'm not aware of the Bakersfield docs or anyone else with a dissenting opinion doing this.
And get the giant chip off your shoulder. What is your problem? You come across as very indignant that I dared to disagree with you, ask me the same question multiple times, and now you express a complete lack of concern for what non-COVID patients are suffering, as well as for the economic devastation this lockdown has caused and that continued lockdowns could result in a Great Depression. I wasn't touting my own sainthood, but trying to convey the level of suffering I am seeing due to these lockdowns.
And how DARE you put down what is happening to primary care, psych, and other non-COVID patients. You know what happens when people don't get care because they are afraid of COVID? Those primary care issues can become full-blown medical emergencies. What is wrong with you?
It now appears that many patients who may be having a stroke or MI are not calling 911 or going to the ER because of COVID. You think that's OK?
Many cancer patients have had treatments and surgeries postponed due to COVID. You think that's OK?
Opioid addiction, ODs, and alcoholism are on the rise b/c of COVID lockdown. You think that's OK?
Many people had elective surgeries postponed. We're not talking about cosmetic surgery. "As Brian Kolski, director of the structural heart disease program at St. Joseph Hospital in Orange County, California, told me, “A lot of procedures deemed ‘elective’ are not necessarily elective.” Two patients in his practice whose transthoracic aortic valvular replacements were postponed, for example, died while waiting. “These patients can’t wait 2 months,” Kolski said. “Some of them can’t wait 2 weeks.” Rather than a broad moratorium on elective procedures, Kolski believes we need a more granular approach. “What has been the actual toll on some of these patients?” he asked."
"[Dr.] Lasic, describing a precipitous decline across the New York region in patients presenting with acute coronary syndromes, worries that others won’t be so lucky. “I think the toll on non-Covid patients will be much greater than Covid deaths,” he said."
Above quotes from:
https://www.nejm.org/doi/full/10.1056/NEJMms2009984?query=featured_coronavirus
Postponing some surgeries like knee and hip replacements results in a lot of pain and suffering and that can also lead to more opioid abuse and ODs.
The toll on mental health patients is not to be shrugged off. Severely stressed mental health patients can attempt suicide or harm others.
Yes, the lockdowns are being eased in most areas, and thank goodness.

Nice try. There are known cases of people dying from covid after being sent home for self care. One was a health care worker who died alone with her preschool child as her only support in the home.

FullGlass, BSN, MSN, NP · May 5, 2020

2 hours ago, toomuchbaloney said:
Nice try. There are known cases of people dying from covid after being sent home for self care. One was a health care worker who died alone with her preschool child as her only support in the home.

? My comment was on your article, which I read. My comment in response to that stands. As for patients being sent home for self-care, without more info on the specific cases, we don't know what happened. Not every COVID patient needs to be in the hospital as many are asymptomatic or only have mild sx. So was the person in your example sent home because she presented with mild sx or was it thought that she had recovered sufficiently to go home? Did she try to see a doctor once she got seriously ill? Many patients have not called 911 or tried to see a doctor because they have been terrorized by the media into fearing to go to a clinic or hospital, even when they need to.

Wuzzie · May 5, 2020

2 minutes ago, FullGlass said:
Many patients have not called 911 or tried to see a doctor because they have been terrorized by the media into fearing to go to a clinic or hospital, even when they need to.

On this we will agree. I deal with it every. single. day.

Susie2310 · May 5, 2020

21 hours ago, FullGlass said:
2. How many times do I have to say that NYC is not the whole country? I have repeatedly said these decisions need to be made at the LOCAL level. If NYC wants to continue their lockdown, that's understandable. That doesn't mean the rest of the country does.
3. The curve has been flattened.
4. Many hospitals are now half empty or more. Doctors and nurses being furloughed. Elective surgeries are now becoming emergencies. Some patients may have died from "elective" surgeries being postponed. Rural hospitals are always financially hurting and now some of them will have to close. You think that's OK?
5. I work in primary care and psych. People are not getting needed medical care, many people are psychologically imploding, and people with mental health issues are getting worse.
6. I have had multiple patients crying over whether they can put food on the table. I have given my own food to some patients.
7. The death rate from COVID is quite low. We also now know who high risk individuals are and those individuals can take extra precautions.
So don't extrapolate your own experience to the whole country. That's very poor reasoning. COVID isn't the only health problem we have to deal with, and other patients are suffering due to the lock down. And most people don't want to go into a depression and lose all their money, possible their house and car, and so forth.
Over half the states are lifting restrictions and more and more local governments, as well as individuals and businesses, are ignoring them.

NYC is not the whole country, but, given the current situation, as I see it, ending the state lockdowns too soon, or ending them at the local level too soon, means that more states and even the whole country could experience significantly increased numbers of cases and deaths on a par with NYC. You seem not to be considering that possibility. If this happens we will be back at less than square one. How do you think that will affect access to primary care, necessary elective procedures, or treatment for chronic illness? Do you think that situation will help the economy?

If we reach the point where the whole country, or even many more states, are affected at the level of NYC, I think we will be experiencing some very severe societal problems; much more severe than even currently.

I really think you have made an incorrect statement in your point #7. It is not "just the elderly or people with chronic illnesses" who are dying from Covid-19. Young people and middle aged people not known to have prior medical conditions are contracting the virus and dying also. As I see it, stopping the lockdowns prematurely also means continually exposing the population, especially it's more vulnerable people, to a serious and frequently fatal disease which they are at significant risk of catching any time they have to be in a public situation. Most people do not have the means to avoid going out in public for essential activities, or the means of avoiding all public contact. From what I read it appears there are a high number of cases and deaths in people who are economically disadvantaged and who work in service jobs that have direct contact with the public. These people need to be protected from contracting the virus and passing it on, and the lock-downs and social distancing orders protect them as well as protecting the elderly, people with chronic illness, middle aged people, and young people.

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toomuchbaloney · May 6, 2020

2 hours ago, FullGlass said:
? My comment was on your article, which I read. My comment in response to that stands. As for patients being sent home for self-care, without more info on the specific cases, we don't know what happened. Not every COVID patient needs to be in the hospital as many are asymptomatic or only have mild sx. So was the person in your example sent home because she presented with mild sx or was it thought that she had recovered sufficiently to go home? Did she try to see a doctor once she got seriously ill? Many patients have not called 911 or tried to see a doctor because they have been terrorized by the media into fearing to go to a clinic or hospital, even when they need to.

In response to the notion that people who needed hospital care got hospital care I posted the article. People died in their homes without hospitalization from covid.