2 hours ago, DEagle7 said:

It's a **** situation but what's the alternative for skilled nursing facilities taking these patients though? Unless the family is willing and able to take care of them, or willing to pay for private care, it's really either make SNFs take them or keep them in the hospital forever.  A good friend of mine is an NP/manager at a SNF in Philadelphia and they essentially are putting all the COVID patients in the same building.  It's a Fing nightmare but again what are the alternatives?

There's quite simply no alternative than forcing facilities with the most vulnerable populations to accept actively infected patients. None. 

LMFAO, imagine believing this.

It bears repeating:

The White House is doing what it should be doing for the country.

Everyone is tested. The sick are quarantined and their contacts are traced.

 

There seems to be no plan in this direction for citizens. You're on your own.

2 hours ago, vikas83 said:

As for the re-opening question, we need to recognize that one size fits all isn't working and should be abandoned. The NYT piece a couple weeks ago was right -- we don't all need to live by NYC's rules. NY, NJ and CT have almost 50% of the deaths in the US, and frankly NYC will continue to be a petri dish cesspool until they close the Subway. I would recommend the following:

1. Begin re-opening most of the country and begin relaxing social distancing guidelines as appropriate

2. Restrict travel to and from the NYC area

3. If a new outbreak occurs -- restrict travel and try to contain the outbreak in that area. Now, this requires much more testing capacity in order to quickly identify an outbreak and contain it before it spreads. This is where our failure on testing really bites us in the arse. But, if we get the testing capacity, if there is a breakout in Philly, then shut down travel in and out of Philly for a bit.

4. Be honest about the true reality -- most people are eventually going to get COVID. We need them to get it to hopefully develop herd immunity. We flattened the curve and didn't overwhelm the hospital system at the start -- sadly, we haven't spent the last 2 months building up supplies needed.

This is what we should be doing, but the morons in charge wasted 2 months and didn't ramp up testing, PPE, ventilators, etc. Stop acting like we won and sending ventilators overseas -- excess capacity isn't a bad thing and is what we need to re-open.

I have said on other threads that there are very few people on here who I actually take the time to read their posts and see the intellect and logic behind them. This is a great example of one. 

Man, Democrats are the absolute worst. Can you imagine thinking this is appropriate?

2 minutes ago, Toastrel said:

It bears repeating:

The White House is doing what it should be doing for the country.

Everyone is tested. The sick are quarantined and their contacts are traced.

 

There seems to be no plan in this direction for citizens. You're on your own.

it's a clown world. one day, cheeto is saying he's leaving it up to the states. the next day, he's encouraging folks to convince their democratic governors to open things back up. there is no plan other than to deflect. 

26 minutes ago, Phillyterp85 said:

It is a crappy situation, but there is an alternative.  Transfer the sick COVID patients to the alternate care facilities that have been set up and keep them there until they are no longer contagious (typically 8-10 days after symptoms start), then send them to the nursing home.   The alternate care facilities that have been set up have the capability to treat sick patients (not critically ill, but sick).  But they have not been sending sick patients there.  Well then what was the point of having acute care experience requirements to ensure those facilities are staffed with physicians and nurses that have the competency to treat sick patients if you're not going to let them do what they are trained to do?

Just curious - why are they not doing this?  Why move someone covid-19 positive into a nursing home if capacity exists elsewhere?

5 minutes ago, Kz! said:

Man, Democrats are the absolute worst. Can you imagine thinking this is appropriate?

Oh, is it time to get outraged about stories two months old again?

Just now, Dave Moss said:

Just curious - why are they not doing this?  Why move someone covid-19 positive into a nursing home if capacity exists elsewhere?

I think the people in leadership roles who are making decisions on what to do, do not have the proper field experience to be able to handle a situation like this.  And that's why poor policy decisions are being made.    

 

6 minutes ago, mr_hunt said:

it's a clown world. one day, cheeto is saying he's leaving it up to the states. the next day, he's encouraging folks to convince their democratic governors to open things back up. there is no plan other than to deflect. 

As always, it's all about blame/credit with Trump.  He doesn't want to impose anything, because he doesn't want the blame if it fails or is criticized, but he wants the credit for any improvement, so he gets his opinion out there while pretending like he has no actual authority to achieve the goals he's set out.  It puts him the role of media personality, which is the only role he likes, instead of person in charge with actual responsibilities, which is a role he terrified of.

A barber who continued to cut hair at a shop in New York over the past few weeks in violation of the state's stay-at-home order has tested positive for COVID-19, the disease caused by the coronavirus, according to the Ulster County Department of Health and Mental Health.

In a statement Wednesday, the county health commissioner advised anyone who received a haircut in the past three weeks at a barbershop on Broadway in the city of Kingston, about 20 miles north of Poughkeepsie, to seek testing for the coronavirus. The statement did not identify either the barber or the shop.

35 minutes ago, Phillyterp85 said:

It is a crappy situation, but there is an alternative.  Transfer the sick COVID patients to the alternate care facilities that have been set up and keep them there until they are no longer contagious (typically 8-10 days after symptoms start), then send them to the nursing home.   The alternate care facilities that have been set up have the capability to treat sick patients (not critically ill, but sick).  But they have not been sending sick patients there.  Well then what was the point of having acute care experience requirements to ensure those facilities are staffed with physicians and nurses that have the competency to treat sick patients if you're not going to let them do what they are trained to do?

Eh that depends on what the capacity they have and how long you think those facilities can stay open given the reopening going on and the percentage of workers at those facilities that are volunteer based. I don't see it as a sustainable long term (months long) solution. You also have to consider the difference in capabilities of the 2 groups.  A lot of people (not saying you)  hear "nursing facility" and think of small apartment facilities where someone brings meemaw pudding cups, but true skilled nursing facilities can handle very sick and complicated patients with significant comorbidities and even manage end of life conversations/management.  The alternate care facilities are great and underutilized IMO, but have largely been pieced together by rag tag groups of volunteers and are spotty in their coverage making their capabilities kinda limited.  I agree they could be used more than they are but I have serious doubts about their ability to replace entirely the role of SNFs for COVID.

23 minutes ago, Kz! said:

There's quite simply no alternative than forcing facilities with the most vulnerable populations to accept actively infected patients. None. 

LMFAO, imagine believing this.

LMFAO imagine being this ignorant about the actual role and capabilities of nursing facilities yet still feeling confident enough comment on the subject.

2 minutes ago, mr_hunt said:

A barber who continued to cut hair at a shop in New York over the past few weeks in violation of the state's stay-at-home order has tested positive for COVID-19, the disease caused by the coronavirus, according to the Ulster County Department of Health and Mental Health.

In a statement Wednesday, the county health commissioner advised anyone who received a haircut in the past three weeks at a barbershop on Broadway in the city of Kingston, about 20 miles north of Poughkeepsie, to seek testing for the coronavirus. The statement did not identify either the barber or the shop.

yeah but he owned the libs !!!!!!

2 minutes ago, Phillyterp85 said:

I think the people in leadership roles who are making decisions on what to do, do not have the proper field experience to be able to handle a situation like this.  And that's why poor policy decisions are being made.    

If I had to guess patients are being moved into nursing homes because nursing homes are considered part of our healthcare apparatus.  Not for any nefarious reasons like some posters are implying.

Admittedly, I know very little about this topic though.

https://www.nbcphiladelphia.com/news/coronavirus/pennsylvania-ag-opens-criminal-probes-into-nursing-homes/2394287/

https://www.citizensvoice.com/news/pa-had-an-early-plan-to-protect-nursing-home-residents-from-the-coronavirus-but-never-fully-implemented-it-1.2627041

 

Statewide fail.  

13 minutes ago, DEagle7 said:

Eh that depends on what the capacity they have and how long you think those facilities can stay open given the reopening going on and the percentage of workers at those facilities that are volunteer based. I don't see it as a sustainable long term (months long) solution. You also have to consider the difference in capabilities of the 2 groups.  A lot of people (not saying you)  hear "nursing facility" and think of small apartment facilities where someone brings meemaw pudding cups, but true skilled nursing facilities can handle very sick and complicated patients with significant comorbidities and even manage end of life conversations/management.  The alternate care facilities are great and underutilized IMO, but have largely been pieced together by rag tag groups of volunteers and are spotty in their coverage making their capabilities kinda limited.  I agree they could be used more than they are but I have serious doubts about their ability to replace entirely the role of SNFs for COVID.

I don't think they would be needed long term.    Just for the surge in volume that we're currently in.   Without the big surge in COVID hospitalizations, I think you could keep the COVID patients in the hospital longer and out of nursing homes.  

Agreed about the capabilities of true skilled nursing facilities.    I have not seen data broken down this way yet, but I would imagine that the spread of the virus has been much smaller at SNF's as compared to nursing homes, due to the staff at SNF being RNs who are trained in how to operate in a high risk environment like this.  

And I'm pretty sure most governors were late to the game in making masks for all a requirement at nursing homes, which also didn't help things.  

1 hour ago, Kz! said:

American media is beneath contempt. If anything, they were treated too kindly by the protestors.

This should be moved to the Trumpbots inciting violence thread. 

Just now, Phillyterp85 said:

I don't think they would be needed long term.    Just for the surge in volume that we're currently in.   Without the big surge in COVID hospitalizations, I think you could keep the COVID patients in the hospital longer and out of nursing homes.  

Agreed about the capabilities of true skilled nursing facilities.    I have not seen data broken down this way yet, but I would imagine that the spread of the virus has been much smaller at SNF's as compared to nursing homes, due to the staff at SNF being RNs who are trained in how to operate in a high risk environment like this.  

True, but considering how long term this process is likely to be I would think they'd have to turn to nursing facilities eventually.  With numbers starting to plateau IMO it's better those facilities figure out contingency planning for taking those COVID cases now than piecing it together on the fly in the event of a bad secondary wave, especially since they're a better place for the more complex patients right now anyway.

I think a big failing is providing these facilities with more specific guidelines of how to do this safely though.  The facility my friend manages is fortunate to have a relationship where they can reach out to Penn to discuss their plans  and while the situation is absolutely awful they've managed it relatively well. But unfortunately many won't be the further you get from medical hubs.  Maybe I missed this already happening but it would be nice if the CDC or some medical society gave them some basic framework and helpline resources.  It's far from a perfect situation and could absolutely be handled better with more nuance, but I really do think it's the lesser evil in a lot of ways.

10 minutes ago, Dave Moss said:

If I had to guess patients are being moved into nursing homes because nursing homes are considered part of our healthcare apparatus.  Not for any nefarious reasons like some posters are implying.

Admittedly, I know very little about this topic though.

I don't think it was for nefarious reasons.  I mean, they couldn't keep each COVID patient hospitalized for 10 days in a hotzone city during the surge as we would have ran out of capacity.  So yes, the patients that were healthy enough to be moved (but still contagious) had to be moved somewhere.  But I don't think it was a good to move them to places that aren't equipped to handle operating in a high risk environment like this.  (let alone mandate that the facilities take them). 

Number of days with declining number of new COVID-19 cases:

United States: 1 day

California: 1 day

Wisconsin: 0 days

San Diego County: 1 day

Over 2,000 COVID-19 deaths in the US yesterday (for first time in a week). During the 1,654 days of U.S. involvement in World War II, we suffered 419,400 casualties, or about 254 per day.

"We think we’re going to have a vaccine in the pretty near future, and if we do we’re going to really be a big step ahead,” Trump told a reporter Friday at a White House event detailing U.S. efforts to develop a vaccine.

 

"And if we don’t, we’re going to be like so many other cases where you had a problem come in, it’ll go away at some point, it’ll go away,” Trump said. "It may flare up and it may not flare up, we’ll have to see what happens, but if it does flare up we’re going to put out the fire and we’ll put it out quickly and efficiently. We’ve learned a lot.”

4 hours ago, vikas83 said:

As for the re-opening question, we need to recognize that one size fits all isn't working and should be abandoned. The NYT piece a couple weeks ago was right -- we don't all need to live by NYC's rules. NY, NJ and CT have almost 50% of the deaths in the US, and frankly NYC will continue to be a petri dish cesspool until they close the Subway. I would recommend the following:

1. Begin re-opening most of the country and begin relaxing social distancing guidelines as appropriate

2. Restrict travel to and from the NYC area

3. If a new outbreak occurs -- restrict travel and try to contain the outbreak in that area. Now, this requires much more testing capacity in order to quickly identify an outbreak and contain it before it spreads. This is where our failure on testing really bites us in the arse. But, if we get the testing capacity, if there is a breakout in Philly, then shut down travel in and out of Philly for a bit.

4. Be honest about the true reality -- most people are eventually going to get COVID. We need them to get it to hopefully develop herd immunity. We flattened the curve and didn't overwhelm the hospital system at the start -- sadly, we haven't spent the last 2 months building up supplies needed.

This is what we should be doing, but the morons in charge wasted 2 months and didn't ramp up testing, PPE, ventilators, etc. Stop acting like we won and sending ventilators overseas -- excess capacity isn't a bad thing and is what we need to re-open.

My only regret is that I have but one like to give.

10 minutes ago, Toastrel said:

"We think we’re going to have a vaccine in the pretty near future, and if we do we’re going to really be a big step ahead,” Trump told a reporter Friday at a White House event detailing U.S. efforts to develop a vaccine.

 

"And if we don’t, we’re going to be like so many other cases where you had a problem come in, it’ll go away at some point, it’ll go away,” Trump said. "It may flare up and it may not flare up, we’ll have to see what happens, but if it does flare up we’re going to put out the fire and we’ll put it out quickly and efficiently. We’ve learned a lot.”

Really committing to an answer there.... 

2 minutes ago, Smokesdawg said:

Really committing to an answer there.... 

90th percentile IQ stuff right there.

9 minutes ago, Smokesdawg said:

Really committing to an answer there.... 

You can literally see the gears turning in his head, thinking, "how can I cover my a** here.  Oh, I'll just say everything, that way I'll be right even if I'm wrong."  Meanwhile, no one actually gets any information, which is the whole point.  Such strong leadership.

20 minutes ago, Toastrel said:

"And if we don’t, we’re going to be like so many other cases where you had a problem come in, it’ll go away at some point, it’ll go away,” Trump said. "It may flare up and it may not flare up, we’ll have to see what happens, but if it does flare up we’re going to put out the fire and we’ll put it out quickly and efficiently. We’ve learned a lot.”