Coronavirus Discussion Thread

Summit

Critical Crazy
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It could be that the administration doesn't trust that they're getting good data from the CDC. Thus they're requiring the data be sent to another agency within the DHHS. I'd be surprised if CDC doesn't receive the info as well but it would have to be forwarded to them. If the CDC is filtering their "output" through a political lens, that's a problem as that's not supposed to be what they do.

You have the power balances absolutely backwards. CDC's director serves at the pleasure of the president and can be replaced at any moment without senate confirmation.

DHHS, the VP, and the President can have access to the raw NHSN data collected by CDC if they think there is anything biased, hinky, or whatever in their interpretation thereof.

Instead a new collection infrastructure and interface was created and all the hospitals had little notice to prepare to shift their reporting. Why?

It is so bizarre that nefarious assumptions come easily. The only reason to move the data collection on infection out of CDC is to filter what CDC has access to, or to simply be capricious in response to not giving the president''s preferred political spin by suppressing data (and seemingly to make life harder for all the hospitals that already have gargantuan data reporting burdens to many levels of government by making us all switch, again).

Last, your implication that COVID-19 death stats are skewed by counting dead people with the virus is pretty silly. Many or most states track COVID vs COVID-related deaths, but it is a distinction with little meaning. It is like saying that CDC skews smoking related death statistics because they count lung cancer in smokers as smoking related deaths when it was really the cancer or complications of cancer that killed them. What upset the apple cart?
 

VFlutter

Flight Nurse
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Last, your implication that COVID-19 death stats are skewed by counting dead people with the virus is pretty silly. Many or most states track COVID vs COVID-related deaths, but it is a distinction with little meaning. It is like saying that CDC skews smoking related death statistics because they count lung cancer in smokers as smoking related deaths when it was really the cancer or complications of cancer that killed them. What upset the apple cart?

I am not sure that implication is silly at all. There are likely many COVID positive patients who die due to other factors that are counted as COVID deaths. Many hospitals have treated it as guilty until proven innocent. There is a distinction that needs to be made there.
 

Summit

Critical Crazy
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I am not sure that implication is silly at all. There are likely many COVID positive patients who die due to other factors that are counted as COVID deaths. Many hospitals have treated it as guilty until proven innocent. There is a distinction that needs to be made there.
That is not borne out by the data in any significant manner unless you believe the hysterical crap being posted by "COVID is a hoax" types saying that hospitals are swabbing skydiving fatalities, car accident victims, and gunshot fatalities (they aren't), that those are then positive, and that this why the numbers are so high (it isn't).

If there was a swab, there was a reason. The only universal screening recommendation is obstetrics. Some systems also swab scheduled electives (who must quarantine and be asymptomatic) but these are <<1% positive and <<1% mortality!

Apart from screening those specific populations above, people get swabbed at hospital for a reason: either they have COVID symptoms or they are critically ill without explanation.

On a death certificate (have you seen one?) there is typically a leading cause of death, the immediate antecedents (secondary to and tertiary to,) and then major comorbidities. So if someone dies of lung adenocarcinoma secondary to smoking with comorbidities of COPD, hypertension and atherosclerosis... do you find it unreasonable to say that is a smoking related death? If you don't think so, then the logical extension is that smoking doesn't really kill very many people and neither does COVID.

Otherwise, you see what I mean by a distinction without difference.

Nobody is reporting a death as COVID related without a positive PCR. Think critically: who is dying, and why did they get swabbed?
 
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RedBlanketRunner

Opheophagus Hannah Cuddler
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@Summit That summed it up admirably.

And here we go. The major debate is on:
And

And of course, the Russians....


By the way, can anyone point me towards a simplified explanation of the RNA rule of six? I'm having a beast of a time simplifying this to explain to non nerds.
 
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ffemt8978

Forum Vice-Principal
Community Leader
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This is the last warning for everyone to keep your political opinions out of this thread. Next time somebody gets a forum quarantine.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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Also, and this goes for everyone, the political commentary has no place in this thread unless it specifically pertains to COVID-19 and treatments.
My apologies extended if I'm the culprit mentioned. Please consider excusing me if I ask that this be better defined: "unless it specifically pertains to COVID-19 and treatments." Does this specifically pertain to treatment and not general info on the larger stage relevant to C-19? That is, directly as opposed to obliquely. Ex: hacking virus vaccine trials being obliquely but not quite directly related to treatment.
 

ffemt8978

Forum Vice-Principal
Community Leader
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My apologies extended if I'm the culprit mentioned. Please consider excusing me if I ask that this be better defined: "unless it specifically pertains to COVID-19 and treatments." Does this specifically pertain to treatment and not general info on the larger stage relevant to C-19? That is, directly as opposed to obliquely. Ex: hacking virus vaccine trials being obliquely but not quite directly related to treatment.
PM sent. Newsworthy links are allowed....political commentary on those links is not.

Edit to clarify for everyone: objective political information is part of dealing with COVID-19. Subjective opinions of the political aspects is what will get you in trouble.
 
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Carlos Danger

Forum Deputy Chief
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That is not borne out by the data in any significant manner unless you believe the hysterical crap being posted by "COVID is a hoax" types saying that hospitals are swabbing skydiving fatalities, car accident victims, and gunshot fatalities (they aren't), that those are then positive, and that this why the numbers are so high (it isn't).

So the director of the Illinois department of public health is lying?


There were lots of stories coming out of NYC at the height the crisis there about COVID being listed as the cause of death if there was even a possibility that it could have been true. Certainly you aren't suggesting that all of the people saying that were tin-foil hat wearing science deniers? Some are respected physicians.

If there was a swab, there was a reason.
That may have been true early on, but now that tests are much more widely available and so many authorities have been claiming that an important part of getting a handle on this and learning about it is testing, there are an awful lot of people getting tested who don't have a clinical "reason" at all.

Apart from screening those specific populations above, people get swabbed at hospital for a reason: either they have COVID symptoms or they are critically ill without explanation.
"COVID symptoms" is pretty broad. We are testing anyone who presents anywhere in the system (ER, urgent care, doctor's office) with any type of respiratory complaint or fever, and some physicians are testing much more liberally than that based on non-classic but known symptoms such as GI complaints and factors such as age and the patient's risk of exposing others. And considering that there are free COVID tests offered all over the area several times a week that see hundreds of people who don't necessarily have any complaints at all, it isn't difficult to imagine that a person could be tested and have a diagnosis without having classic COVID symptoms or even any symptoms at all.
 
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SandpitMedic

Crowd pleaser
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I swabbed someone today who was simply seeing me for a med refill for some chronic neuropathic pain. She had an SpO2 of 90% for no known reason (historically >95%) and no history of or symptoms of cardiovascular illness.

It’s provider discretion. I can swab anyone I want if they are willing (and due to hysteria everyone is willing).
 

silver

Forum Asst. Chief
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I am not sure that implication is silly at all. There are likely many COVID positive patients who die due to other factors that are counted as COVID deaths. Many hospitals have treated it as guilty until proven innocent. There is a distinction that needs to be made there.

Why should one disease get different treatment in how we report deaths?
 

Summit

Critical Crazy
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There were lots of stories
Dude... I totally go on stories... internet is full of many truths right? And things never get blown out of proportion and those with an agenda never magnify a few anecdotes and piece of hearsay as a proven dominant trend, right?

Quality confirmation bias...

there are an awful lot of people getting tested who don't have a clinical "reason" at all.
Dead people?

And considering that there are free COVID tests offered all over the area several times a week that see hundreds of people who don't necessarily have any complaints at all, it isn't difficult to imagine that a person could be tested and have a diagnosis without having classic COVID symptoms or even any symptoms at all.
Dead people?

I thought we were talking about deaths. You are talking about sub-acute walky talkies going to a testing tent.

Yawn.

Commercial lab TAT are easily approaching 10 days because of the surge in cases. Just 2-3 weeks ago it was 3 days. Must be all those dead people they are testing.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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there are an awful lot of people getting tested who don't have a clinical "reason" at all.
During a pandemic the only reason that I can think of to not get tested is if you are an alien life form. Even a hermit troglodyte has a chance of exposure on the way to getting tested.

I still don't understand why people are so willing to get a qtip shoved into their brain to diagnose something that has no treatment.
Check the hundreds of thousands of stupid moves videos on youtube. Qtip to the brain is small change. Now 40 Qtips with the test performed by a drunk chimpanzee with zilch fine motor skills... naw, there would still be some people giving that a try.
 

CCCSD

Forum Asst. Chief
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There is no reason to get tested unless you are feeling sick. The minimal amount of supplies should be saved for those in need. Getting tested, for something that won’t show positive unless you are sick is a huge waste of resources.

The only thing testing tells you is if you are already infected, you are infected. If you aren’t, its a negative, AT THAT TIME ONLY, creating a false sense of security.

Perhaps if you were working in this arena, you might understand it.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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Excuse me. Confused. Since people can be asymptomatic, presymptomatic or paucisymptomatic and still be contagious, test->positive->isolation->1 less vector in the wild. Where's the flaw here?
I can see the logic with say, dengue, > 'Yups. you have dengue. Want to feel like death warmed over here or at home? All the same unless you show signs of hemmorhage. Your call rolling those dice. One in four chance. '
 
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FiremanMike

EMS Coordinator
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So the director of the Illinois department of public health is lying?


There were lots of stories coming out of NYC at the height the crisis there about COVID being listed as the cause of death if there was even a possibility that it could have been true. Certainly you aren't suggesting that all of the people saying that were tin-foil hat wearing science deniers? Some are respected physicians.


That may have been true early on, but now that tests are much more widely available and so many authorities have been claiming that an important part of getting a handle on this and learning about it is testing, there are an awful lot of people getting tested who don't have a clinical "reason" at all.


"COVID symptoms" is pretty broad. We are testing anyone who presents anywhere in the system (ER, urgent care, doctor's office) with any type of respiratory complaint or fever, and some physicians are testing much more liberally than that based on non-classic but known symptoms such as GI complaints and factors such as age and the patient's risk of exposing others. And considering that there are free COVID tests offered all over the area several times a week that see hundreds of people who don't necessarily have any complaints at all, it isn't difficult to imagine that a person could be tested and have a diagnosis without having classic COVID symptoms or even any symptoms at all.
In this area, anyone going in for an elective procedure MUST have a negative Covid test within 72 hours of procedure, so there’s another chunk of folks getting asymptomatic testing..

Didn‘t the CDC come out within the last few weeks and say that viral spread from an asymptomatic patient was actually pretty rare?
 

GMCmedic

Forum Deputy Chief
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In this area, anyone going in for an elective procedure MUST have a negative Covid test within 72 hours of procedure, so there’s another chunk of folks getting asymptomatic testing..

Didn‘t the CDC come out within the last few weeks and say that viral spread from an asymptomatic patient was actually pretty rare?
They did, then they came back the next day and said what they actually meant was "we dont know enough about covid yet"
 

Carlos Danger

Forum Deputy Chief
Premium Member
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Dude... I totally go on stories... internet is full of many truths right? And things never get blown out of proportion and those with an agenda never magnify a few anecdotes and piece of hearsay as a proven dominant trend, right?

Quality confirmation bias...
Again, if you are intent on dismissing everyone who disagrees with you as a tin-foil hat wearing idiot - even the well regarded physician in charge of the Illinois Dept of Health - then I can't help you. What was that about confirmation bias?

To refuse to acknowledge that this thing has been politicized and capitalized upon to a large degree is pretty remarkable.

I thought we were talking about deaths. You are talking about sub-acute walky talkies going to a testing tent.
I was specifically presenting examples to counter your assertion that only people likely sick with COVID were being tested for it. Now you know that isn't true.
 

Peak

ED/Prehospital Registered Nurse
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Didn‘t the CDC come out within the last few weeks and say that viral spread from an asymptomatic patient was actually pretty rare?

While there is a lot that we don’t fully understand, I don’t quite get why asymptomatic spread is such a mystery to people.

If patient A is symptomatic and is coughing and sneezing and patient B has no symptom to act as a vector to spread disease, then even if they had the same viral load (which is unlikely) then it isn’t difficult to reason that the asymptomatic patient is going to be less contagious.
 

FiremanMike

EMS Coordinator
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While there is a lot that we don’t fully understand, I don’t quite get why asymptomatic spread is such a mystery to people.

If patient A is symptomatic and is coughing and sneezing and patient B has no symptom to act as a vector to spread disease, then even if they had the same viral load (which is unlikely) then it isn’t difficult to reason that the asymptomatic patient is going to be less contagious.
Makes perfect sense to me, but it certainly wasn’t the case early on when they were shutting down entire firehouses for 14 days because one person tested positive..
 

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