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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?

#181

Post by true_religion »

partiallypro wrote: post #164
brianwawok wrote: post #134

Earlier quoted context omitted.

What? At every one I have been to (not a lot I admit, maybe 4 in my life), I had to both provide insurance card AND pay my copay before a doctor would see me. Without payment, they send you to go to the ER.

How do you know they would send you to the ER? Did you not have insurance? Did they actually send you to the ER for not having it? Honestly, sounds like you simply had insurance, filled out a form and just assumed it was required. I've been to multiple walk-ins, and you can visit without insurance. They will ask for insurance up front, but you can simply say you don't have any. Then you will offer payment options. Th…

The OP said without payment they will send you to the ER, which is true. If you can pay, as you said, then they will see you.

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

#182

Post by umvi »

pmiller2 wrote: post #171
umvi wrote: post #157

Earlier quoted context omitted.

> And, what knowledge and/or credentials do you have to base the conclusion that "public health experts (and basically all medical experts) are in over their heads" on? Nobody alive on earth right now has ever experienced anything like this before at this scale. So by definition, there are no "veterans", there is no one with any experience whatsoever, just people who did case studies of past pandemics when air travel…

Japan? Not well: > There are just five ICU beds per 100,000 people in Japan, less than half the number in Italy, and doctors' associations have warned that hospitals are already stretched thin. [0] I notice you skipped South Korea. What stopped it there? Glad you are admitting your own ignorance. Now, if you would just listen to the people who do know a little something about viral epidemics and their containment, yo…

> I notice you skipped South Korea. What stopped it there?

South Korea is anomalous. Has literally any other country been able to replicate their success?

> Glad you are admitting your own ignorance. Now, if you would just listen to the people who do know a little something about viral epidemics and their containment, you could cure that little condition.

Containment/minimizing covid-19 deaths is a very short-sighted variable to optimize for. Leaders need to weigh the cost of containment vs. the cost of prolonged lockdown/economic collapse. I have yet to see you acknowledge containment policies as having any downsides whatsoever. I don't think you really understand how desperate the situation is from an economic standpoint. The Fed can't just print money to solve every problem; otherwise, why work? Why not just have the Fed print every citizen $1M?

> In the meantime, you should stop spewing these dangerous ideas. You sound exactly like the Texas Lt. Governor. And, let me tell you: neither I nor my family are dying for you.

If you or your family are extra vulnerable, I'm afraid you'll have to avoid contact with others until a vaccine is developed. In the meantime, I'm not content with the current solution of "halt the economy/destroy lives/print money indefinitely". I feel the best course of action is to let the disease spread normally with a few extra measures in place to slow it down (social distancing/masks). And it seems a lot of governors agree with me - many states are starting to re-open. In my opinion, covid-19 is not as bad as it seems. Our data is biased because it comes mainly from hospitals while the majority of the cases go unnoticed. Things will return to normal.

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

#183

Post by [deleted] »

recursive wrote: post #124
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…

I am a current Kaiser subscriber. (member?/customer?) Even despite the simplicity for which Kaiser is clearly striving, I had a tough time figuring out how it was supposed to work at first. I was accustomed to urgent care without a phone call. I tried to apply that experience to Kaiser. I found a Kaiser facility, via their web site, that claimed to offer urgent care during certain hours. I even double checked the def…

[deleted]

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

#184

Post by pmiller2 »

umvi wrote: post #182
pmiller2 wrote: post #171

Earlier quoted context omitted.

Japan? Not well: > There are just five ICU beds per 100,000 people in Japan, less than half the number in Italy, and doctors' associations have warned that hospitals are already stretched thin. [0] I notice you skipped South Korea. What stopped it there? Glad you are admitting your own ignorance. Now, if you would just listen to the people who do know a little something about viral epidemics and their containment, yo…

> I notice you skipped South Korea. What stopped it there? South Korea is anomalous. Has literally any other country been able to replicate their success? > Glad you are admitting your own ignorance. Now, if you would just listen to the people who do know a little something about viral epidemics and their containment, you could cure that little condition. Containment/minimizing covid-19 deaths is a very short-sighted…

South Korea contained the epidemic with massive testing and contact tracing. There is literally no reason why that could not be done here, once we get the number of cases down via lockdown measures. But, it would be foolish to start opening things up until the infrastructure to do that testing and contact tracing is in place.

If the choice is saving capitalism or saving 450,000 lives, I choose lives. I don't give a shit about the fortunes of corporate shareholders, landlords, bankers, etc., when nearly 1 in 700 lives are at stake. How about you?

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

#185

Post by umvi »

pmiller2 wrote: post #174
umvi wrote: post #162

Earlier quoted context omitted.

No, I'm suggesting those that are most vulnerable to covid-19 (old, immuno-compromised, etc) will die off in the first wave and won't be around if there is a second wave. You can't die twice. Thus the mortality rate would plummet.

And, that's exactly why we're sheltering in place. Which do you value more: those peoples' lives, or corporate profits?

Ok, that's a bit of a loaded question, and also a false dichotomy.

Obviously economic stability is more valuable than lives to a certain extent because it generates wealth for generations.

I don't think you grasp the gravity of the economic situation. It's not just "corporite profits" being lost. Tens of thousands of people are losing their jobs, businesses, livelihoods, etc, and that number is growing every day. The vast majority of Americans are not software engineers that can work remotely. A paltry $1000 stimulus check isn't going to help the millions of poor feeling the economic pressure. Many will commit suicide before this is over.

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

#186

Post by newacct583 »

roca wrote: post #180
newacct583 wrote: post #168

Earlier quoted context omitted.

California is split. The Bay Area is past peak, socal is still growing. Washington and Oregon are well past peak, around half of their peak new infection rate. New York is crossing under 1/3 now. Likewise New England and a few other smaller states are clearly over the hump. This stuff works. All these places could have easily blown right through health care capacity like Milan, but they didn't. The really frustrating…

That doesn't really answer what containment means or what the long-term strategy is. If you relax lockdowns while you still have a significant number of active cases then expect outbreaks to reoccur. So is the plan to stay locked down until active cases in the applicable area are essentially zero, i.e. eradication? If so, how long will that take? If not, what is the plan? I know there's no easy solution here but even…

This stuff has been written about ad nauseum. Every think tank has some variant they've published. Here's Ezra Klein's review of a bunch of them (he's pretty bearish on whether they'll work): https://www.vox.com/2020/4/10/21215494/coronavirus-plans-soc...

The basic idea is that you stay locked down until the outbreak size is small enough that you can test every contact of every positive case to catch them before they spread.

This takes a lot of testing. And unfortunately the one body in the USA with the financial resources to foot that bill is conspicuously silent on a plan for rolling out expanded testing. But this is how it has to work. The alternative is, as everyone here loves to scream, more expensive.

But there's no magic wand where people just decide to start working again. That won't happen, either becuase they're scared or because the outbreaks run out of control again (which is to say: people won't exit lockdown voluntarily without containment ever, either they're scared now or they'll be scared of the results they see).

So call your representatives and get testing funded and scaled. Really there is no other option.

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

#187

Post by pmiller2 »

umvi wrote: post #185
pmiller2 wrote: post #174

Earlier quoted context omitted.

And, that's exactly why we're sheltering in place. Which do you value more: those peoples' lives, or corporate profits?

Ok, that's a bit of a loaded question, and also a false dichotomy. Obviously economic stability is more valuable than lives to a certain extent because it generates wealth for generations. I don't think you grasp the gravity of the economic situation. It's not just "corporite profits" being lost. Tens of thousands of people are losing their jobs, businesses, livelihoods, etc, and that number is growing every day. The…

No, it is not a false dichotomy. You are literally saying we need to open up now. doing so will kill people: all the best available research says so. Why do you not acknowledge this? Again, I ask: which do you value more, lives or profits? I think I know which, and you simply don't want to say it.

Again, I don't give a shit about capitalism. Do you understand that?

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

#188

Post by manigandham »

pmiller2 wrote: post #87
manigandham wrote: post #44

Earlier quoted context omitted.

Why do cases matter? It should be the death rate that peaks, and that's measurable without testing. In fact it seems to be over-attributed since many deaths are now being classified to Covid even if there are many other factors.

Death rate is the proxy for cases. What matters when attempting to contain the disease is prevalence of the disease.

Is that the actual goal? Seems like we're well past containment now with infections in the millions. But if death rates are staying low and healthcare has enough capacity, then what does widespread testing accomplish?

Might as well save it for the people who actually get sick and need confirmation for treatment or cause of death.

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

#189

Post by 6nf »

scarmig wrote: post #138
Trasmatta wrote: post #18

Earlier quoted context omitted.

Anecdotally, I feel like stress has gone way up for most people, not down. Not sure it's that's true or not on the larger scale, but it definitely seems true for me and most of the people I know.

Interesting. For me, it's involved a sharp decrease in stress, though that's overlapped with quitting my job and having a substantial financial cushion.

Millions of people are out of a job and nobody is hiring. You have to recognise that your situation is much more fortunate than most.

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

#190

Post by 6nf »

pmiller2 wrote: post #173
postalrat wrote: post #153

Earlier quoted context omitted.

Are you willing at all to consider the models were flawed and shelter in place is only delaying deaths a few months?

Not until you can demonstrate that to me.

Lets wait a few months and see
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