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Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

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Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#111

Post by mrfusion »

calibas wrote: post #92
guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Where's the source of "excess mortality is way up"? I didn't see it in the article, though it does suggest there may be fewer heart attacks and strokes because of "a decrease in air pollution and fewer high-fat restaurant meals".

They get counted as corona virus deaths as I have heard if.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#112

Post by mrfusion »

abalone wrote: post #75
makomk wrote: post #26

Earlier quoted context omitted.

There's one obvious possibility... there's some evidence that flu triggers heart attacks in people already at risk for one, Covid-19 also seems to do the same, lockdowns have cut short the flu season but are less effective against Covid-19, and I've seen suggestions elsewhere that doctors are refusing to even consider doing this kind of procedure on people who test positive for Covid-19. It's possible the heart attac…

Except stroke admissions are way down too. No obvious link between the flu and strokes.

I saw an artical that corona causes strokes in young people.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#113

Post by TallGuyShort »

newacct583 wrote: post #62
TallGuyShort wrote: post #53

Earlier quoted context omitted.

>> People are staying home because they're scared of getting sick, that's not something that can be fixed by public policy. Staying home IS the public policy in many places right now. Mere weeks ago, my social media feed was full of information about hospitals cancelling all non-emergency procedures, being overrun, doctors flying to New York, PPE shortages, etc. I wouldn't be at all surprised if a lot of people who w…

> Staying home IS the public policy in many places right now. Staying home from the hospital is absolutely not policy anywhere, nor has it been, ever. You missed the context.

No, because I don't care and I'm just going about my life mostly as normal. Many people have missed the context, and that's either a massive failure of education or a massive failure in communication, and the mere fact we're having this discussion is evidence of that. Isn't it?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#114

Post by zenexer »

mirimir wrote: post #109
guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Right, they're likely dying at home, and being counted as COVID-19 deaths. That's the safest guess, in the absence of epidemiologic data. Even so, medical systems and coroners ought to be archiving samples for testing. Eventually there'll be adequate RNA and antibody testing capabilities. Without that data, we won't know what happened.

They’re not being counted as COVID-19 deaths; they’re not being counted at all. A lot of people are living in isolation right now, often with no regular contact with the outside world. The sad truth is that there are probably a lot of people lying dead in their homes right now, and they could go unnoticed for months.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#115

Post by BLKNSLVR »

mirimir wrote: post #109
guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Right, they're likely dying at home, and being counted as COVID-19 deaths. That's the safest guess, in the absence of epidemiologic data. Even so, medical systems and coroners ought to be archiving samples for testing. Eventually there'll be adequate RNA and antibody testing capabilities. Without that data, we won't know what happened.

My assumption is that cause of death wouldn't be blindly written off as COVID-19 though.

How thoroughly do deaths of the elderly and infirm get looked into as per the cause?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#116

Post by maxerickson »

wahern wrote: post #102
maxerickson wrote: post #48

Earlier quoted context omitted.

Not really. It's often "convenient" relative to all the places that aren't open, and they won't turn you away until they've assessed your situation. What's wild is that we structure payment and regulatory models where a walk in at the ER costs more than a walk in at the urgent care located literally next door. Gotta self assess how serious the situation is if you don't wanna contribute to the high risk revenue pool.

The urgent care clinic can assess you. In fact, they could probably assess you over the phone before you even arrive. Kaiser heavily pushes their nurse hotline to help minimize costs. I can hardly fathom going to either the Kaiser emergency or injury departments[1] without calling the nurse hotline. The nurse, in consultation with a staff physician in the call center, does an assessment, tells you what to do next, if…

Right, my point is, why isn't the nurse line also standing at the door to the single walk in access point for the hospital? Because we are wild fools, that's why.

The hospital is liable for the costs in the ER, so fuck no are they going to tell you go home and get some rest if they can charge you $2000 to do that after taking your insurance.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#117

Post by fzeroracer »

umvi wrote: post #106
pmiller2 wrote: post #34

Earlier quoted context omitted.

No, it doesn't mean "stop sheltering in place," unless cases of COVID-19 have peaked. In order to tell whether they've peaked, you need testing in place, as well. Even if they have peaked, it could mean "relax some of the restrictions, but not fully end SIP, while monitoring cases." Opening things back up prematurely, without sufficient testing, is just going to get people killed.

> Opening things back up prematurely, without sufficient testing, is just going to get people killed. Yep, some people will die. That's unavoidable. Tens of millions die every year. Hundreds of millions will die per year in a few decades. That's life. If you are at-risk, you should continue to avoid contact with others. But there's currently no cure for covid-19 other than your own immune system. The sooner the disea…

Bold of you to assume that a disease can just run its course and then end. Would you say the same thing about the Chickenpox or some of the earlier flu pandemics we've seen? Are you willing to bet on a far deadlier second wave not occurring?

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#118

Post by mirimir »

zenexer wrote: post #114
mirimir wrote: post #109

Earlier quoted context omitted.

Right, they're likely dying at home, and being counted as COVID-19 deaths. That's the safest guess, in the absence of epidemiologic data. Even so, medical systems and coroners ought to be archiving samples for testing. Eventually there'll be adequate RNA and antibody testing capabilities. Without that data, we won't know what happened.

They’re not being counted as COVID-19 deaths; they’re not being counted at all . A lot of people are living in isolation right now, often with no regular contact with the outside world. The sad truth is that there are probably a lot of people lying dead in their homes right now, and they could go unnoticed for months.

Woah, I didn't think of that. I know that it happens, for those without close friends and family. But for many, the first clue has been failure to report for work. Which doesn't happen so much now. And it's eerie to think that it's become far more common.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#119

Post by guscost »

mrfusion wrote: post #108
guscost wrote: post #5

Dying at home, many of them. Excess mortality is way up, and it’s not all COVID-19: https://www.washingtonpost.com/health/patients-with-heart-at... > The possibility that patients may be suffering — and even dying — at home rather than going to a hospital led the American College of Cardiology to launch a “Cardiosmart” campaign last week, attempting to reassure a wary population and encourage those with symptoms to c…

Should the media have some of the blame for these deaths by scaring people? Cherry picking young corona deaths, up playing tenuous studies saying corona causes diabetes and strokes, replaying stock footage of overloaded hospitals. If they gave people accurate statistics they could make an informed decision whether they want to go to a hospital.

Yes.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#120

Post by remote_phone »

maxerickson wrote: post #116
wahern wrote: post #102

Earlier quoted context omitted.

The urgent care clinic can assess you. In fact, they could probably assess you over the phone before you even arrive. Kaiser heavily pushes their nurse hotline to help minimize costs. I can hardly fathom going to either the Kaiser emergency or injury departments[1] without calling the nurse hotline. The nurse, in consultation with a staff physician in the call center, does an assessment, tells you what to do next, if…

Right, my point is, why isn't the nurse line also standing at the door to the single walk in access point for the hospital? Because we are wild fools, that's why. The hospital is liable for the costs in the ER, so fuck no are they going to tell you go home and get some rest if they can charge you $2000 to do that after taking your insurance.

Except with something like Kaiser, they are the insurance provider and the hospital system. You only pay a copay for the ER, and that’s it. There’s no incentive to push unnecessary medical services.
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