Kern County ER Docs C-19

Jduney · May 1, 2020

This video is really eye-opening....there's so much differing information out there.

Daisy4RN · May 1, 2020

"Full lockdown policies in Western Europe countries have no evident impacts on the COVID-19 epidemic"

"Our results show a general decay trend in the growth rates and reproduction numbers two to three weeks before the full lockdown policies would be expected to have visible eﬀects. Comparison of pre and post lockdown observations reveals a counter-intuitive slowdown in the decay of the epidemic after lockdown. Estimates of daily and total deaths numbers using pre-lockdown trends suggest that no lives were saved by this strategy, in comparison with pre-lockdown, less restrictive, social distancing policies. Comparison of the epidemic’s evolution between the fully locked down countries and neighboring countries applying social distancing measures only, conﬁrms the absence of any eﬀects of home containment. Evolution of the epidemic in Sweden however indicates that, in the absence of any social distancing measures, the epidemic’s decay may be subject to larger ﬂuctuations. This work thus suggests that social distancing measures, such as those applied in the Netherlands and Germany, or in Italy, France, Spain, and United Kingdom before the full lockdown strategies, have approximately the same eﬀects as police-enforced home containment policies."

https://www.medrxiv.org/content/10.1101/2020.04.24.20078717v1.full.pdf

FullGlass, BSN, MSN, NP · May 3, 2020

On 5/1/2020 at 3:37 AM, Wuzzie said:
How do we quarantine the sick when we have asymptomatic sick people? I mean, what an asinine statement those two made.

Please watch and listen again. Their point is that we should quarantine those are have COVID and in addition, individuals who are in a high risk group should self-isolate and so forth. There is no need to put a mass lockdown on everyone and in every location.

On 5/1/2020 at 2:45 AM, hherrn said:
But, when guys like the Bakersfield docs put out something like they did, and it is used to support the argument, that argument loses ground. Of course it was "condemned by professional associations". It did not meet the level expected in that profession.

No, they did not deserve to be condemned. They presented their perspective based on what they are seeing in their area. They were very clear on where they got their data and when they made extrapolations. There is nothing wrong with that. True science cannot flourish or really exist without free and open discussions and constant re-examination based on new information. While one can disagree with the Bakersfield docs, there is no reason to condemn them.

What I find chilling is how rapidly an orthodoxy has been established with regard to COVID. We have about 3 months worth of knowledge, which means we don't really know very much. There are no controlled, double-blind studies. We don't even have really good random sampling at this point. So we don't really know the true prevalence, or how many people are asymptomatic carriers, how many people just got a very mild case and didn't even know they had COVID, all the possible symptoms, and so forth. So it just boggles the mind that new opinions and information that don't conform the current orthodoxy is rejected, condemned, and censored.

On 5/1/2020 at 2:45 AM, hherrn said:
Using terms like "cowering in fear" is a good way to offend people, but not a great way to open their minds. What a lot of folks are doing is hard for them, and many are doing it more for the benefit of others. I expect to get this, but observe strict precautions to protect others. Calling me a coward could get my hackles up. It didn't- I know you are upset and probably didn't mean it personally.

I don't care.

On 5/1/2020 at 2:45 AM, hherrn said:
And, pulling that stuff off Youtube is unrelated to the First Amendment. The First Amendment has to do with government restriction. The government has to allow me to have a cross burning ceremony complete with white robes and pointy hats. That does not mean facebook has to allow me to post it. These are private entities.

On 5/1/2020 at 3:37 AM, Wuzzie said:
And as Heron pointed out since when did the First Amendment apply to private parties or enterprises? If Youtube wanted to take the video down that was fully within their right to do so and given the backlash these guys are getting from people who specialize in the things they pretended to ("we took classes") I think it was the right thing to do.

Actually, censorship by private companies running social media platforms that are de facto monopolies is indeed a hot legal topic. Specifically, Youtube, Twitter, and facebook have no real competition. Therefore, many legal experts have argued that these platforms should be viewed as utilities for communication and that they should not have the right of censorship. Also, on what basis are they making these decisions? They aren't being run by a bunch of COVID experts. And I see no reason to ban content just because some experts object to it.

https://www.abajournal.com/magazine/article/social-clashes-digital-free-speech

On 5/1/2020 at 9:43 AM, emtb2rn said:
Very well written. A clear & concise repudiation of the kern docs faulty logic. Plus he has 2 simpsons references which is always a bonus.

Sorry, I disagree.

FullGlass, BSN, MSN, NP · May 3, 2020

On 5/1/2020 at 2:45 AM, hherrn said:
We regularly make cost benefit analysts on safety vs quality of life and economics. Individual choice vs government regulation, etc. This is why we allow 16 year olds to drive, don't ban cigarettes, etc.
. . . along with the infringement of liberties, of an extended lockdown will outweigh the benefits. I believe we have reached this point, at least in California, where I live"
That is the strong argument. I encourage all to make a better case by sticking to sound science (even though this is new), and non-inflammatory claims.

We agree on cost benefit analysis.

We don't really have any truly sound science on COVID at this point.

As for "inflammatory claims," it appears that some on this forum think an inflammatory claim is one that differs from their own opinion or an unfounded orthodoxy. That is not reflective of true science or logic.

And more and more doctors are coming forward in basic agreement with the Bakersfield doctors. Some have been saying this all along. I provided materials from Dr. David Katz, a doctor with impeccable credentials. I suggest you review the information.

And as of yesterday, WHO lauded Sweden and stated they should be the model. This is a fascinating article and interview:

"The world has watched in amazement as Sweden eschewed draconian lockdowns and instead trusted its citizens to manage this virus for themselves. Now the head of the Health Emergencies Programme of the World Health Organization, epidemiologist Michael J. Ryan, M.D., has praised the approach: Sweden “relied on the relationship with the citizens, and on the citizens’ ability and willingness to implement physical distancing and self-regulation… I believe that if we are to reach a new normal situation, Sweden can in many ways represent a model for the future.”

https://www.aier.org/article/lockdown-free-sweden-had-it-right-says-world-health-organization-interview-with-prof-johan-giesecke/

Wuzzie · May 3, 2020

2 hours ago, FullGlass said:
Please watch and listen again. Their point is that we should quarantine those are have COVID and in addition, individuals who are in a high risk group should self-isolate and so forth. There is no need to put a mass lockdown on everyone and in every location.

Never said that a mass lockdown was the way to go but again we can’t quarantine the people who have Covid because a large portion of them are asymptomatic and untested. What do you propose we should do about that?

FullGlass, BSN, MSN, NP · May 3, 2020

3 hours ago, Wuzzie said:
Never said that a mass lockdown was the way to go but again we can’t quarantine the people who have Covid because a large portion of them are asymptomatic and untested. What do you propose we should do about that?

I am very concerned that the "flatten the curve" has morphed into prolonged lockdowns. The purpose of flattening the curve was to prevent the healthcare system from being overwhelmed. It was NOT to prevent sickness and death, but bluntly to alter the date when those occurred. When lockdowns were announced, they were not intended to go on until we have a cure, treatment, or vaccine.

Realistically, if the healthcare systems are not overwhelmed, then they can treat everyone who needs it, and that likely saves lives. This has been accomplished. We also know more about COVID and know who the high risk groups are, so these individuals should definitely protect themselves.

1. People who have tested positive for COVID should be quarantined. Due to the shortage of tests, some people with a high probability of COVID, and have been diagnosed by their providers as likely having COVID, should also be quarantined. This is already being done.

2. We know which individuals are at high risk: older people, especially over 70 y.o, HTN, obese, diabetic, heart issues are at the highest risk, along with individuals with compromised immune systems. These people should self-isolate. If these people self-isolate, then it doesn't matter what the rest of us do! High risk individuals living with other people will need to make arrangements to protect themselves in their homes. As nurses, you all know this is possible through PPE (which can be home-made), and strict hand-washing, disinfection, etc. We already teach family members of sick individiuals and high-risk individuals how to minimize risk of infection spread at home. It might make sense for some family members living with high-risk individuals to also self-isolate.

For everyone else, we begin lifting lockdowns, based on local conditions. We don't treat Alturas, CA like NYC. We can continue with social distancing. Restaurants could open, with reduced seating capacity for social distancing, etc. There is no reason for beaches, parks, and hiking trails to be closed.

The vast majority of people who are infected with COVID are asymptomatic or have mild symptoms. We need to start building herd immunity.

I don't know why this is so hard for people to understand.

At any rate, this discussion is becoming a moot point. People have had it after 7 weeks. 31 states have begun lifting lockdowns. In states like California, where the Governor is on a facist power trip, residents are beginning to ignore the lockdown anyway. Local governments are beginning to take legal action against the lockdowns, and local law enforcement have in many cases just refused to continue to enforce the lockdown. Planes that were almost empty at the start of the lockdowns are now 80 to 90% full.

WHO just announced that Sweden is the model. In other words, not a strict lockdown.

https://nypost.com/2020/04/29/who-lauds-sweden-as-model-for-resisting-coronavirus-lockdown/

And in Wisconsin, no COVID spike after in-person voting:

https://www.nationalreview.com/2020/04/coronavirus-wisconsin-election-no-spike-cases-after-in-person-voting/?utm_source=recirc-desktop&utm_medium=blog-post&utm_campaign=river&utm_content=more-in&utm_term=third

The natives are getting restless and starting to disregard lockdowns anyway (focus on California)

https://apnews.com/55f97b2efde8b788d1e726b04ac3393c

https://www.forbes.com/sites/johnkoetsier/2020/05/01/apple-data-shows-shelter-in-place-is-ending-whether-governments-want-it-to-or-not/#2864b80f6fb5

https://apnews.com/32d5564a7774aae7c2b45b850d1000f5

https://www.dailymail.co.uk/news/article-8277407/Californian-governor-Newsom-blasted-allowing-citizens-watch-sunrise-amid-lockdown.html

Wuzzie · May 3, 2020

What part of “never said that a mass lockdown was the way to go” did you have difficulty understanding? Also, I’m perfectly aware of the purpose of “flattening the curve” as are most people on this site so we really don’t need it explained to us like we are morons nor do we need an explanation of which people who are at higher risk if dying from this. We get it. What I was speaking of was the Bakersfield Duo’s statement that you “don’t quarantine healthy people” (which BTW historically is inaccurate) it’s corollary being “only quarantine sick people” but in light of the fact that people are sick, and infectious, with Covid prior to having symptoms how can we quarantine stick people if they/we don’t know they’re sick?

FTR, I am in a state that is opening up. I’m glad this is happening for many reasons but I fully expect people to lose their minds and our numbers are going to spike. Our hospitals have prepared as best as they can but given we have absolutely zero idea what we are facing it would be a lie to say we are “ready”.

FullGlass, BSN, MSN, NP · May 3, 2020

6 hours ago, Wuzzie said:
What part of “never said that a mass lockdown was the way to go” did you have difficulty understanding? Also, I’m perfectly aware of the purpose of “flattening the curve” as are most people on this site so we really don’t need it explained to us like we are morons nor do we need an explanation of which people who are at higher risk if dying from this. We get it. What I was speaking of was the Bakersfield Duo’s statement that you “don’t quarantine healthy people” (which BTW historically is inaccurate) it’s corollary being “only quarantine sick people” but in light of the fact that people are sick, and infectious, with Covid prior to having symptoms how can we quarantine stick people if they/we don’t know they’re sick?

FTR, I am in a state that is opening up. I’m glad this is happening for many reasons but I fully expect people to lose their minds and our numbers are going to spike. Our hospitals have prepared as best as they can but given we have absolutely zero idea what we are facing it would be a lie to say we are “ready”.

Why do you keep asking me the same question over and over? I have repeatedly answered your question:

1. People who have tested positive for COVID should be quarantined. Due to the shortage of tests, some people with a high probability of COVID, and have been diagnosed by their providers as likely having COVID, should also be quarantined. This is already being done.

2. We know which individuals are at high risk: older people, especially over 70 y.o, HTN, obese, diabetic, heart issues are at the highest risk, along with individuals with compromised immune systems. These people should self-isolate. If these people self-isolate, then it doesn't matter what the rest of us do! High risk individuals living with other people will need to make arrangements to protect themselves in their homes. As nurses, you all know this is possible through PPE (which can be home-made), and strict hand-washing, disinfection, etc. We already teach family members of sick individiuals and high-risk individuals how to minimize risk of infection spread at home. It might make sense for some family members living with high-risk individuals to also self-isolate.

3. We have NEVER in this country had a widespread lockdown like this. It is unprecedented in our history and in world history. More and more "experts" are now stating it may have been a mistake.

4. We need to make lockdown and/or social isolation decisions at the LOCAL level. This is not one-size-fits-all. And like it or not, more and more local governments have come to this realization and are lifting lockdowns.

5. I am not privy to the thoughts of the Bakersfield doctors. I am giving my opinion based on what I've learned and my reaction to listening to them.

6. Why do you keep asking me what to do? I've given you my opinion, repeatedly. I've also given you the reality, which is that lockdowns are being lifted and more and more people are ignoring lockdown orders. I personally do not make these policy decisions. Why don't you share what you think we should do?

Here are the official definitions of quarantine and isolation:

Isolation and quarantine help protect the public by preventing exposure to people who have or may have a contagious disease.

Isolation separates sick people with a contagious disease from people who are not sick.

Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick.

https://www.CDC.gov/quarantine/index.html

So, no, we don't quarantine or isolate EVERYONE out of fear some are sick or have been exposed.

And like it or not, the lockdowns are being lifted. Except for a few areas, like NYC, the healthcare system was not overwhelmed and there is no reason to think it will be now. And even in NYC, everyone that needed treatment got it. The tent hospitals and the US Navy ship for overflow were hardly even used. That's because the initial estimates were "2 million Americans will die" and those estimates have been revised drastically down.

Most hospitals have been quite empty during this period. Doctors and nurses are being furloughed and laid off. This has been especially hard on already struggling small town and rural hospitals and some of them may now have to close FOREVER. Do you think this is good?

Many "elective" surgeries have been postponed, and this may have caused needless deaths and certainly caused a lot of suffering:

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

The Untold Toll — The Pandemic’s Effects on Patients without Covid-19

allnurses Guide · May 3, 2020

Quote
Polls: Californians broadly trust state government on coronavirus
https://www.MSN.com/en-us/news/politics/californians-broadly-trust-state-government-on-coronavirus-mistrust-trump-poll-finds/ar-BB13tZRd

* My Non-fascist California city is mostly still in Stage 1. Two days ago Governor Newsom said, "We are days, not weeks away before we eliminate more restrictions." https://www.wral.com/california-governor-says-hes-days-away-from-lifting-some-stay-at-home-restrictions/19080848/

* There are now discussions on how and when to safely reopen schools. Some districts will probably open sooner than others. https://www.wral.com/questions-surround-governors-proposal-to-open-schools-early/19077644/

* Golf courses are opening again. https://www.golfadvisor.com/articles/california-counties-permit-reopening-golf-courses

Gov. Newsom said doctors can begin performing non-emergency surgeries effective immediately. https://townhall.com/tipsheet/bronsonstocking/2020/04/23/california-resumes-elective-surgeries-governor-warns-of-slow-reopening-n2567474

Quote
4-part plan to reopen California from coronavirus shutdown
Stage 1: Safety and preparedness
The state will build up testing, tracing, PPE and hospital capacity
Prioritize safety for workers and customers in essential workplaces
Prepare safety guidelines for expanded workforce, broken down by industries
Stage 2: Lower-risk workplaces
Gradually open some lower-risk businesses and workplaces, adapted for social distancing
Curbside pickup for retail businesses
Reopen manufacturing businesses
Office workers may return if telework is not possible
Increase access to public space.
Stage 3: Higher-risk workplaces
Use restrictions on gathering sizes and other limits to reopen higher-risk workplaces
Salons and gyms reopen with restrictions
Sports (without live audiences) and movie theaters
Religious services return to in-person settings
Stage 4: End of stay-at-home order
The highest-risk environments will be reopened once appropriate treatments are developed
Live sporting events with fans
Concerts and festivals
Conventions
https://www.MSN.com/en-us/health/medical/here-is-gov-newsom-e2-80-99s-4-part-plan-to-reopen-california-from-coronavirus-shutdown/ar-BB13kOJ9

Wuzzie · May 3, 2020

2 hours ago, FullGlass said:
Why do you keep asking me the same question over and over? I have repeatedly answered your question:

Because you keep ignoring the fact that I have repeatedly told you I do not agree that at this point a widespread lockdown is needed and and that I am happy my state is opening up yet you continue to insist on “educating” me on things I and almost everyone on this forum already know. It’s super annoying.

Wuzzie · May 4, 2020

Also wanted to add that my issue with the Bakersfield Duo isn’t that they think their area should reopen, it’s their lack of professional integrity in providing evidence to support their viewpoint. Either they pretended to be experts in an area in which they absolutely have no experience or they out right lied. Their calculations were most certainly misrepresented to the public, as discussed in the previously linked article and proven by an actual epidemiological expert, which I find morally and ethically repugnant. It’s fine to have an opinion but to present an error-riddled one as fact to a confused and scared public is utterly inexcusable. Every area of the country needs to move forward in a manner relative to how COVID has affected them and the resources they have available. Nobody has a definitive answer in how to handle an unknown entity but we certainly do not need inaccurate information driving the decision making. There is no “one size fits all” solution. It’s as simple as that.

FullGlass, BSN, MSN, NP · May 4, 2020

12 minutes ago, Wuzzie said:
Also wanted to add that my issue with the Bakersfield Duo isn’t that they think their area should reopen, it’s their lack of professional integrity in providing evidence to support their viewpoint. Either they pretended to be experts in an area in which they absolutely have no experience or they out right lied. Their calculations were most certainly misrepresented to the public, as discussed in the previously linked article and proven by an actual epidemiological expert, which I find morally and ethically repugnant. It’s fine to have an opinion but to present an error-riddled one as fact to a confused and scared public is utterly inexcusable. Every area of the country needs to move forward in a manner relative to how COVID has affected them and the resources they have available. Nobody has a definitive answer in how to handle an unknown entity but we certainly do not need inaccurate information driving the decision making. There is no “one size fits all” solution. It’s as simple as that.

They provided raw data from their practice. How is that inaccurate? That is not unethical. They provided their opinions. That is not unethical. They extrapolated, yes, but they were clear when they did that. Their big point is that COVID has caused a relatively small number of fatalities and that the lockdown is overkill. They also feel that the response should be different in different areas, which is also what you believe.

You are free to disagree with them, but that does not make them unethical or inaccurate.

Nobody really knows much about COVID. In my opinion, people who claim to be "experts" who know all about COVID are the ones who are being unethical. Didn't "experts" project 2 million Americans would die? That isn't going to happen. They were wrong. Why are you okay with them making those types of statements which caused widespread fear and panic, but you are so upset with the Bakersfield docs?

"The coronavirus has touched almost every country on earth, but its impact has seemed capricious. Global metropolises like New York, Paris and London have been devastated, while teeming cities like Bangkok, Baghdad, New Delhi and Lagos have, so far, largely been spared. The question of why the virus has overwhelmed some places and left others relatively untouched is a puzzle that has spawned numerous theories and speculations but no definitive answers. That knowledge could have profound implications for how countries respond to the virus, for determining who is at risk and for knowing when it’s safe to go out again."

"Draconian social-distancing and early lockdown measures have clearly been effective, but Myanmar and Cambodia did neither and have reported few cases."

https://www.nytimes.com/2020/05/03/world/asia/coronavirus-spread-where-why.html