None of these central PA counties that have said that they are "moving to yellow" have based their decisions upon medical information.  All of them have based it upon the fact that hospitals "appear to be doing just fine" and can "handle the capacity."  

13 Lancaster republicans officials signed a letter to Wolf basically saying if you don't take us to Yellow we are going to do it on on our own on May 15 because "90% of our deaths have been in nursing homes".  The Lebanon County DA said she wouldn't enforce any closures and threw in a statement about wolf being a dictator.  Cumberland County commissioners doing the same thing along with Franklin County, etc.  

You can see the political stunt a mile away.  This is all designed to make this a political issue for the fall and to throw some red meat out for the base.  If any of these decisions had to do with medical evidence, they would have gotten medical health officials and/or medical professionals to co-sign the letters saying that the danger is less.  But NONE of them have any medical support.  

This is what happens when we allow our elected officials to act without any experience or expert advice.  While the Wolf administration has a-lot to answer for when it comes to transparency and their response to nursing home infections, the GOP is turning this into a purely political issue.  It's truly an embarrassing display.  

No one wants to be this way forever; but now the local officials are getting into a pissing competition with the state and giving more confusion to the general public about who to follow and what instructions are best to keep them safe.  

i haven't missed one haircut during the stay at home order...not one.      

42 minutes ago, Mlodj said:

Interesting observation.

It's really terrifying how much of the management we're making it up as we go. Two of our best friends out here are working in ICUs right now and the treatments even in highly academic centers are very much reactive instead of proactive.  Lack of data and trials is definitely an issue but the crazy range of symptoms also might be an issue too. More and more organ systems are now known to be effected and they keep describing patients with similar demographics/disease progression/prognosis etc  requiring wildly different ventilator strategies. Completely anecdotal but still it's interesting/terrifying. 

A doctor spoke on abc news this morning and was asked what he has learned so far with treatment of covid patients and the one thing he mentioned is not rushing to put them on ventilators. 
 

i thought that was interesting considering how getting more of these super expensive ventilators was  such a top priority early on.  

11 hours ago, lynched1 said:

Blame Trump for rushing to open. Blame trump for dragging it out. 

I say let people pay for their decisions. You want to hide indoors fine. Figure out how to pay for it.
They rest of us with jobs and insurance that aren't willing to cower in fear will carry on with less traffic and shorter lines.

The Freedom of choice!

BTW F Wolf right in the *****!

Do what you want. I work from home and intend to keep doing so. I’m thinking a lot of trumpbots might be too sick to vote this fall. That would be a shame.

@donwinslow

 

Quote

I think the Trump presidential library should just be a cemetery.

 

5 minutes ago, SNOORDA said:

A doctor spoke on abc news this morning and was asked what he has learned so far with treatment of covid patients and the one thing he mentioned is not rushing to put them on ventilators. 
 

i thought that was interesting considering how getting more of these super expensive ventilators was  such a top priority early on.  

Part of the issue is once they're on ventilators it's 1) very hard to get them off and 2) the mortality rate increases dramatically if you reach that stage. There are some diseases where you can intubate a patient prophylactically because you know they're going to get worse or you know they're going to get better in a short period. With COVID it's really important to make sure you HAVE to intubate before you do because you're committing to ventilating that patient potentially for weeks (taking up critical care space, staff and a vent) even with relatively poor outcomes. Vents are still the only way to manage/save those most severe cases though. Without them thousands now would be dead now. 

With this being a new virus I can only imagine what the medical professionals are dealing with.  Especially with the patients with other conditions.  What interventions work for one may not be successful for another.  I get it.  Scary still indeed amid all the folks wanting to get back to normal.  Seems that the sooner we can accept that things are not going to be anywhere close to normal for quite some time, the better off they will be.  Having this perspective has helped my own mental health.  It's going to take time, probably a long time to collect and share the data from studies.  Do Dr.'s share treatments/diagnosis with one another outside of clinical studies?  With all the Hippa regulations and such?

Anyone gotten a Jehovah's Witness phone call? Just got one. Answered an unknown number from my area code expecting a telemarketer robocall, but it was actually a very nice lady who asked me how my family was doing and then shared a bible passage with me about isolation/strength and perseverance. Something in Psalms. Then told me I could go to JW.org for more inspirational quotes. I kept waiting for her to solicit a donation or something, but she never did. Those people aren't nearly as bad on the phone as when they randomly ring your doorbell.

She did say she'll call back another day with another quote, but I'll know not to answer next time. 

How in the world did this dude become some sort of political superstar?

Forcing Covid patients back into the most vulnerable communities? Downright insidious. 

3 hours ago, DrPhilly said:

Not sure how you can assert this when the fact is we don't know.  Plus beds isn't the only resource that is relevant.  You need beds, personnel, equipment, etc.

Maybe all is cool and I agree that things should go back toward normal life in a controlled manner.  All good there.

I can assert that by reading article after article about hospitals and the information and numbers provided by the people running them that show the facts are that most hospitals are well equipped and have plenty of beds, staff and gear to resume normal operation.  Many have begun to perform elective surgeries. It was UPMC that said of the 5600 beds they have, only 112 of them are being used by covid patients.  The stats are out there for you to find and it shows a much different picture that what you’re being told to believe by the media. 

2 minutes ago, DiPros said:

With this being a new virus I can only imagine what the medical professionals are dealing with.  Especially with the patients with other conditions.  What interventions work for one may not be successful for another.  I get it.  Scary still indeed amid all the folks wanting to get back to normal.  Seems that the sooner we can accept that things are not going to be anywhere close to normal for quite some time, the better off they will be.  Having this perspective has helped my own mental health.  It's going to take time, probably a long time to collect and share the data from studies.  Do Dr.'s share treatments/diagnosis with one another outside of clinical studies?  With all the Hippa regulations and such?

They do.  It's a bit more complicated but basically can remove identifying patient information (name, birthday, photo etc) and share as  much data as they want.  All generic information is shared back to governing bodies like the CDC who compile raw data but as far as treatment management it's a bit more difficult.  Tons of case studies are being published right now but that's a little bit of information overload/questionably useful since often it's just a paper on the management of 1 or a small group of patient in different scenarios.  Typically the best and most useful data sharing is within major hospital groups themselves.  Conglomerates of hospitals and doctors under the same management/in the same region will share data and experiences at conferences and meetings which eventually (hopefully in this case) lead to standardized practices within those groups.  If those guidelines are seen successful they get disseminated to smaller hospitals around the area (for example Penn/Pitt and to a lesser extent Jefferson largely indirectly impact the management protocols and practices throughout much of PA). Eventually those protocols and outcome protocols will be published and compared to eachother.  That's a relatively slow process usually, although I'm sure with the urgency that will be fast-tracked (for better or worse) in this case.

1 hour ago, Smokesdawg said:

None of these central PA counties that have said that they are "moving to yellow" have based their decisions upon medical information.  All of them have based it upon the fact that hospitals "appear to be doing just fine" and can "handle the capacity."  

13 Lancaster republicans officials signed a letter to Wolf basically saying if you don't take us to Yellow we are going to do it on on our own on May 15 because "90% of our deaths have been in nursing homes".  The Lebanon County DA said she wouldn't enforce any closures and threw in a statement about wolf being a dictator.  Cumberland County commissioners doing the same thing along with Franklin County, etc.  

You can see the political stunt a mile away.  This is all designed to make this a political issue for the fall and to throw some red meat out for the base.  If any of these decisions had to do with medical evidence, they would have gotten medical health officials and/or medical professionals to co-sign the letters saying that the danger is less.  But NONE of them have any medical support.  

This is what happens when we allow our elected officials to act without any experience or expert advice.  While the Wolf administration has a-lot to answer for when it comes to transparency and their response to nursing home infections, the GOP is turning this into a purely political issue.  It's truly an embarrassing display.  

No one wants to be this way forever; but now the local officials are getting into a pissing competition with the state and giving more confusion to the general public about who to follow and what instructions are best to keep them safe.  

I see people on the local facebook group making this assertion about nursing home deaths as well.

I really don't understand it. Do deaths in a nursing home somehow not count? Can we just throw away facts we find inconvenient because we don't like the current state of things?

I don't disagree that I think we could be a bit more aggressive about opening up than Wolf is being. I think there are a lot of localities within counties where the number of cases is incredibly low, and the one-size-fits-all approach lumps these areas in with the larger hotspots.

However I also appreciate that pushing these decisions down to *local officials* is going to result in a LOT of bad decisions at the local level, where listening to expert advise and making data-driven decisions is even LESS popular than it with with the national republican party.

To be sure, many local officials - most probably - would make very prudent, good decisions for their constituency. But it would only take a few of them making incredibly rash decisions that could see this thing get out of control quickly. 

** all due respect to Pete

47 minutes ago, DBW said:

I can assert that by reading article after article about hospitals and the information and numbers provided by the people running them that show the facts are that most hospitals are well equipped and have plenty of beds, staff and gear to resume normal operation.  Many have begun to perform elective surgeries. It was UPMC that said of the 5600 beds they have, only 112 of them are being used by covid patients.  The stats are out there for you to find and it shows a much different picture that what you’re being told to believe by the media. 

Yeah right, I can also assert that they've been able to handle it based on the situation with the lockdown in place.  What neither you or I can logically do is assert that they would've been able to handle it without the lockdown.  You have no data to backup that claim.

48 minutes ago, Kz! said:

How in the world did this dude become some sort of political superstar?

Forcing Covid patients back into the most vulnerable communities? Downright insidious. 

Nursing homes are part of the healthcare system. They are expected to have the expertise and equipment to manage segregation of patient populations - they should be doing so every day for existing patients with compromised immune systems, and COVID-19 cases are not the only sick people discharged from hospitals heading to nursing homes.

If a nursing home is unable to accommodate particular types of patients, they do have the ability to indicate this and not admit someone on this basis - as is my understanding anyway.

The goal of the above is to ensure that nursing homes that are equipped and able to safely handle COVID-19 cases are not "opting out" of their role in dealing with this pandemic simply by stating "no we're not going to take them". 

They should be able to handle these things. If they did not, that's on local operators.

Unfortunately, and I know all too well, many of these local operators of nursing homes have no idea what they're doing. Because we do not properly fund areas of our healthcare system that are less profitable. 

10 minutes ago, DrPhilly said:

Yeah right, I can also assert that they've been able to handle it based on the situation with the lockdown in place.  What neither you or I can logically do is assert that they would've been able to handle it without the lockdown.  You have no data to backup that claim.

That’s not what I’m saying at all.  What I’m saying is that we are 2 months in and For the most part, the hospitals are doing just fine, we know that.   So let’s open things back up.  We can’t stay locked down forever until there’s zero cases anywhere.  That’s never going to happen.  We have reached a point where things are well under control and we should start going back to work and life.  Staying home for another month isn’t going to wipe the virus off the planet.  It’s always going to be a threat now.  We locked down to avoid a disaster movie coming to life, but now that we’ve accomplished that, it’s time to slowly and safely open things back up and let people go back to work and provide for their families.  

1 hour ago, TomatoPie said:

@donwinslow

 

 

It'll look something like this...

25 minutes ago, JohnSnowsHair said:

I see people on the local facebook group making this assertion about nursing home deaths as well.

I really don't understand it. Do deaths in a nursing home somehow not count? Can we just throw away facts we find inconvenient because we don't like the current state of things?

I don't disagree that I think we could be a bit more aggressive about opening up than Wolf is being. I think there are a lot of localities within counties where the number of cases is incredibly low, and the one-size-fits-all approach lumps these areas in with the larger hotspots.

However I also appreciate that pushing these decisions down to *local officials* is going to result in a LOT of bad decisions at the local level, where listening to expert advise and making data-driven decisions is even LESS popular than it with with the national republican party.

To be sure, many local officials - most probably - would make very prudent, good decisions for their constituency. But it would only take a few of them making incredibly rash decisions that could see this thing get out of control quickly. 

** all due respect to Pete

People love that nursing home percentage thing. "70 percent of the deaths are in nursing homes!!!!!" Says the people who's parents or relatives aren't sick at a nursing home. 

2 hours ago, DrPhilly said:

Seems like it won't be worth that much then.

It's worth about as much as the Governments messaging during this pandemic.

I cared for my mother when Pop died suddenly.  Having had that experience, I think what happened with the long term care facilities was the lack of testing and the workers and possibly residents being asymptomatic.  Also, perhaps lack of PPE.  Even if they had proper supply it was not mandated quickly enough?  I don't know.  I just know that while my Mom albeit in different times was quarantined while residing in an assisted living facility.  If I wanted to see her, I was granted access to her, but geared up.  Even when she was in the hospital, if there was flu on that floor, once again, I could visit, but with gown, gloves, and mask on.

How can locals, or even federal authorities make good decisions when this is a novel virus?  Decisions are based on reaction until they figure out the interaction to help aid in the spread.

Shooting at a 600 person party in Texas.  600 people.  Don't they know that the virus is disproportionately targeting minorities?

12 minutes ago, BirdsFanBill said:

People love that nursing home percentage thing. "70 percent of the deaths are in nursing homes!!!!!" Says the people who's parents or relatives aren't sick at a nursing home. 

The question is, how do we go back to normal life and protect those high risk communities at the same time?   Whether we open today or two months from now, are those communities at any less risk?  What have we really done with the 2 months of lockdown that has protected any of them?  They’re still getting sick and still firing at an alarming rate compared to the younger, healthier people obviously.  We haven’t and won’t eradicate the virus by locking down for 2 more or even 6 more months.  You could argue that by staying locked down we don’t run the risk of asymptomatically carrying the virus to our elders in those homes and you’d be right but I would argue that in another 6 months, you run the same risk of that versus today.  that’s why We need to be more conscious of our actions and our decisions to go into those places and protocols should be in place to prevent this or any other disease from entering those facilities.  But the fact is, those places have never been great in terms of keeping illness out.  Look at any given flu season (not comparing covid to flu) and you see how easily that gets in and runs wild, killing many.  So yeah this is worse if it gets in but again, another 6 months of isolation isn’t going to eradicate covid.  It’s here to stay.  

33 minutes ago, DBW said:

That’s not what I’m saying at all.  What I’m saying is that we are 2 months in and For the most part, the hospitals are doing just fine, we know that.   So let’s open things back up.  We can’t stay locked down forever until there’s zero cases anywhere.  That’s never going to happen.  We have reached a point where things are well under control and we should start going back to work and life.  Staying home for another month isn’t going to wipe the virus off the planet.  It’s always going to be a threat now.  We locked down to avoid a disaster movie coming to life, but now that we’ve accomplished that, it’s time to slowly and safely open things back up and let people go back to work and provide for their families.  

That is what is happening. 

6 minutes ago, DrPhilly said:

That is what is happening. 

Not really because wolf extended the lockdown for majority of the state until June 1st and the counties in the yellow phase still have a lot of limitations.  And to get to his 50 per 100k threshold is next to impossible.  At this rate it will be 6 months before we’re back to anything close to being fully open 

20 minutes ago, DBW said:

Not really because wolf extended the lockdown for majority of the state until June 1st and the counties in the yellow phase still have a lot of limitations.  And to get to his 50 per 100k threshold is next to impossible.  At this rate it will be 6 months before we’re back to anything close to being fully open 

Slow rollout.  That's what you said right?