What does reopening look like in YOUR state?

[pulmonarymd]

May 17, 2020 9:58:07 GMT -5 teen persuasion said:

Initially, the only people who got tested were the extreme ill patients.  As they got more tests, they tested first responders, medical workers, and those exposed to people who tested positive.  Then you could get tested if you had symptoms - had to contact your doctor for a script, and go to testing sites.

As a part of opening up the state, they expanded testing, now you can get a test if you want one, even without symptoms.  Still need to go thru your doctor for approval, but there's also antibody tests available, too. The county health director was originally saying that getting both was wrong, just get one, but that makes no sense. One tests infection now, one tests infection in the past. If you test negative for Covid-19, you could be recovered, you need the antibody test, too, to see if you were exposed previously.

Antibody testing right now is fraught with problems. There are a number of unreliable tests out there, so a negative, or positive, test may be wrong. Need to have a much better and accurate test before I would recommend anyone get it. We are still researching which test to use given how many bad ones are out there. Just another sign of how poor the feds have been at managing this pandemic.

[teen persuasion]

May 17, 2020 10:02:47 GMT -5 pulmonarymd said:

May 17, 2020 9:58:07 GMT -5 teen persuasion said:

Initially, the only people who got tested were the extreme ill patients.  As they got more tests, they tested first responders, medical workers, and those exposed to people who tested positive.  Then you could get tested if you had symptoms - had to contact your doctor for a script, and go to testing sites.

As a part of opening up the state, they expanded testing, now you can get a test if you want one, even without symptoms.  Still need to go thru your doctor for approval, but there's also antibody tests available, too. The county health director was originally saying that getting both was wrong, just get one, but that makes no sense. One tests infection now, one tests infection in the past. If you test negative for Covid-19, you could be recovered, you need the antibody test, too, to see if you were exposed previously.

Antibody testing right now is fraught with problems. There are a number of unreliable tests out there, so a negative, or positive, test may be wrong. Need to have a much better and accurate test before I would recommend anyone get it. We are still researching which test to use given how many bad ones are out there. Just another sign of how poor the feds have been at managing this pandemic.

I've been seeing reports that the infection test is also problematic, some 50% false negatives.  There was a story on the news a few days ago, a health professional flew home wearing a mask but plane had no social distancing.  He developed symptoms, self isolated, symptoms progressed to the point he had breathing trouble, got admitted to the hospital, had 4 tests before he tested positive, despite seeming an obvious case by symptoms.  It was the Abbott test, he mentioned 50% false negatives as the reason to keep retesting.

A later news report mentioned timing of testing (presymptomatic vs 2 day vs more days symptomatic) also leading to high % false negatives.

When Cuomo was asked about test quality, he said the tests used  here were all our state's tests, and other tests were vetted against our tests (they were the standard, was the implication).  FWIW

[Blonde Granny]

Thank you for answering my question. I've been in the house since the last Wednesday in February, then on the next Saturday the VA sent emails telling us our volunteer positions were over until further notice. In case anyone wondering, It's NOT fun!!!! And this old Granny is beginning to get a little pissed over the entire situation.

[Mardi Gras Audrey]

My 3 year old had some symptoms yesterday. I called our health system’s advice line and was pretty disappointed. I told the nurse he is in a day care (DH and I are both essential workers) and the response was basically just watch him. Didn’t even mention testing. I pushed the issue because he had been at daycare on Friday (symptoms started midday Saturday) and want to be able to tell them if he is positive. Response was like, no, just keep watching him. He doesn’t need a test since he hasn’t been in contact with a known covid case.

How do u know if someone is positive if u don’t test them? And then say people with symptoms shouldn’t be tested because they haven’t had known contact? The lack of logic there was mind boggling.

I ended up driving to the urgent care and getting the doc there to do it (he was in agreement that the kid should be tested). Are waiting for the results today.

The other irritating part? The advice line refers u to one of their urgent care centers but doesn’t have the correct hours. They have the regular hours. If u have covid symptoms, U can’t be seen inside and the hours for their outside/covid clinics are shorter than the regular centers. But u can’t get a human directly when u call the reg centers to ask (get a phone tree of recordings with only the regular hours listed). Have to drive there and chance it

[Happy prose]

I don't understand the whole thing. We are tentatively scheduled to return to work June 8. Prior to return, they will test everyone twice, two days apart. You need two negatives to get in the door. What good is that? Are there stats on how many asymptomatic people tested positive? I would guess very few. And of course you're negative today, but could get the virus tomorrow. 

The other part I don't understand- numbers have come down a bit in NJ. That's great, but we've all been hiding! It's not like we've killed the virus, just hid from it. What changes when we all come out?

My co-workers also concern me. I'm compromised, so have been very diligent- no stores, have not seen family, friends, etc. I know for a fact on Mother's Day weekend, my co-workers all cheated! Should I be thrown into a building with these folks? I imagine their behavior will get worse as more things open.

Should I return to work on June 8? (Very large office) I have the option of not returning, but I think it would be frowned upon. They have been paying us full salary. I'm also scared because there is talk of layoffs. Normally this would be done by seniority, and I wouldn't get touched. Is it legal for them to chose the employees that are working at home first? 





 

[Deleted]

May 17, 2020 9:39:44 GMT -5 Blonde Granny said:

This may be a strange question, but here goes: Everyone keeps talking about "testing" more and more of it....just who where and how are they testing They haven't tested anyone where I live, a couple at the VA may had been...but if no one tests us normal people staying at home who the hell are they testing??

The criteria for testing in my area is you have to meet multiple qualifications, including active symptoms and presumed exposure to someone who has a confirmed case.

There have been 100 tests to date in our county of 8K.

This whole "anyone who wants a test can get one" is complete bullshit.

As to the "acceptable death number" the current prediction is over 140K by summer, and that seems "acceptable" to someone. I assume with the new wild abandon of all the newly "liberated", that number will grow.

The simulation killed off I think it was 64 million worldwide and millions in the US. And, we seem to be following that, except they assumed we would have leadership that we lack so that doesn't bode terribly well for the numbers.

[giramomma]

May 17, 2020 10:24:06 GMT -5 Happy prose said:

Should I return to work on June 8? (Very large office) I have the option of not returning, but I think it would be frowned upon. They have been paying us full salary. I'm also scared because there is talk of layoffs. Normally this would be done by seniority, and I wouldn't get touched. Is it legal for them to chose the employees that are working at home first? 

At my work, the metric for *special* furloughs is work output.

We have to document what we do during the day. I'm also fortunate that it's easy to track my production.

I will have to take either 4 or 5 furlough days for the next 6 months, based on my salary.

Other people in a different side of our business, have to take 6 furlough days, due to their salary. In addition, those that have not produced will get a special furlough, in that their hours will be reduced because they haven't been working a solid 40 a week. I think the special furloughs will be announced Monday.

They are fortunate that it won't be layoffs. That said, our department won't function if they lay off 2/3 of the workers.

[pulmonarymd]

May 17, 2020 10:14:24 GMT -5 teen persuasion said:

May 17, 2020 10:02:47 GMT -5 pulmonarymd said:

Antibody testing right now is fraught with problems. There are a number of unreliable tests out there, so a negative, or positive, test may be wrong. Need to have a much better and accurate test before I would recommend anyone get it. We are still researching which test to use given how many bad ones are out there. Just another sign of how poor the feds have been at managing this pandemic.

I've been seeing reports that the infection test is also problematic, some 50% false negatives.  There was a story on the news a few days ago, a health professional flew home wearing a mask but plane had no social distancing.  He developed symptoms, self isolated, symptoms progressed to the point he had breathing trouble, got admitted to the hospital, had 4 tests before he tested positive, despite seeming an obvious case by symptoms.  It was the Abbott test, he mentioned 50% false negatives as the reason to keep retesting.

A later news report mentioned timing of testing (presymptomatic vs 2 day vs more days symptomatic) also leading to high % false negatives.

When Cuomo was asked about test quality, he said the tests used  here were all our state's tests, and other tests were vetted against our tests (they were the standard, was the implication).  FWIW

All tests have false negatives and positives. For example, the rapid influenza test is about 60% accurate. The test for COVID is based on PCR, so it is one reason it can be positive after people recover. Reasons for false negative include poor/inadequate sampling, and low viral load, such as one can see early in the infection. This is one reason there is a saying that the a diagnosis is based 80% on history, 15% on physical findings, and the rest on lab/x-ray. This is why having a high index of suspicion for a diagnosis is important, and why patients sometimes get frustrated because we don't order a test. An x-ray/lab result needs to be interpreted in context.

Having a bad test is worse than having no test at all, because making a diagnosis on the basis of a bad test can really hurt someone. If you can't test, the possibility of a diagnosis remains in your view. Part of why this can be really difficult

[Blonde Granny]

I thank everyone, but still...all we hear on TV is "we need more testing".. OK fine , go find people to test. Dragthem off the street corners, go door to door, but give it rest....Walk thru Walmart with test kits and test the people shopping there. Stop them in and out of these now open restaurants.....And if you don't want to, then shut your mouth and go away.

[thyme4change]

A medical practice around here advertised they were doing the anti-body testing. It was on Facebook, so there were a lot of people asking questions in the comments. They answered them, but read them like a lawyer, and they say nothing.

(All paraphrased from memory)

Q) Which test is this?
A) the test is made by a reputable company in an FDA facility
Translation: this is not an FDA approved test

Q) what is the accuracy rate?
A) this test has a very good accuracy rate
Translation: this test hasn't been proven, and probably has a terrible accuracy rate

Etc.

[oped]

Lots of asymptomatic people test positive. That’s how we know they are asymptomatic...

[pulmonarymd]

May 17, 2020 12:30:29 GMT -5 thyme4change said:

A medical practice around here advertised they were doing the anti-body testing. It was on Facebook, so there were a lot of people asking questions in the comments. They answered them, but read them like a lawyer, and they say nothing.

(All paraphrased from memory)

Q) Which test is this?
A) the test is made by a reputable company in an FDA facility
Translation: this is not an FDA approved test

Q) what is the accuracy rate?
A) this test has a very good accuracy rate
Translation: this test hasn't been proven, and probably has a terrible accuracy rate

Etc.

Looking to make money on it. When you have lack of leadership, you get the wild west

[saveinla]

For anyone who wants to get tested, Rite Aid is sending messages that they have testing available in select locations. 

I am not ready to go to Rite Aid, so I have not looked much more into it. It's a partnership with Verily. 

[The Walk of the Penguin Mich]

May 17, 2020 10:58:23 GMT -5 pulmonarymd said:

May 17, 2020 10:14:24 GMT -5 teen persuasion said:

I've been seeing reports that the infection test is also problematic, some 50% false negatives.  There was a story on the news a few days ago, a health professional flew home wearing a mask but plane had no social distancing.  He developed symptoms, self isolated, symptoms progressed to the point he had breathing trouble, got admitted to the hospital, had 4 tests before he tested positive, despite seeming an obvious case by symptoms.  It was the Abbott test, he mentioned 50% false negatives as the reason to keep retesting.

A later news report mentioned timing of testing (presymptomatic vs 2 day vs more days symptomatic) also leading to high % false negatives.

When Cuomo was asked about test quality, he said the tests used  here were all our state's tests, and other tests were vetted against our tests (they were the standard, was the implication).  FWIW

All tests have false negatives and positives. For example, the rapid influenza test is about 60% accurate. The test for COVID is based on PCR, so it is one reason it can be positive after people recover. Reasons for false negative include poor/inadequate sampling, and low viral load, such as one can see early in the infection. This is one reason there is a saying that the a diagnosis is based 80% on history, 15% on physical findings, and the rest on lab/x-ray. This is why having a high index of suspicion for a diagnosis is important, and why patients sometimes get frustrated because we don't order a test. An x-ray/lab result needs to be interpreted in context.

Having a bad test is worse than having no test at all, because making a diagnosis on the basis of a bad test can really hurt someone. If you can't test, the possibility of a diagnosis remains in your view. Part of why this can be really difficult

And to piggyback on this, the reason why you can have a false positive with the PCR is that you have had the disease, are well and your body is still shedding viral particles.  RT-PCR does not discriminate between dead or live viral RNA.  Everyone sheds dead virus after a viral disease, I think that I read after the measles, dead viral particles are shed for up to 6 months after you are cleared of disease, and no one knows how long they are shed after COVID.

So you can have a false positive PCR, a negative or positive antibody test (depending where you are in infection) and not be infectious.  Optimally for the antibody test, by testing for both IgM and IgG, you could cover a wider spread of time.  IgM is the first response, but it starts to decline as IgG ramps up.  Interesting enough, despite this being a mucosal disease, I wonder why no one has looked at secretory IgA?  This response comes from immune cells in the lymph nodes that are adjacent to mucosal tissues, and it makes far more sense to look here.  If this is the case, the vaccine makers might be smarter looking for an mucosal vaccine (either oral or nasal) to stimulate the immune system this way.  

[Mardi Gras Audrey]

May 17, 2020 12:28:02 GMT -5 Blonde Granny said:

I thank everyone, but still...all we hear on TV is "we need more testing".. OK fine , go find people to test. Dragthem off the street corners, go door to door, but give it rest....Walk thru Walmart with test kits and test the people shopping there. Stop them in and out of these now open restaurants.....And if you don't want to, then shut your mouth and go away.

The problem is that they aren’t even wanting to test symptomatic patients. The rationale is “you can’t say for sure you were exposed to someone who tested positive so we won’t test”. Ok, then what for the person with symptoms? Once u are feeling better, u are back out in public but can be spreading it. But you were never “officially” diagnosed so you may or may not be spreading it.

In our case, I work in a hospital and my children are in daycare. I stick my head in the sand and say he can go back to daycare after 24 hours without fever because he wasn’t diagnosed with covid/tested and I can go back to the hospital because I have no symptoms and haven’t been in contact with a known case.

What if my child has it though? I am possibly spreading to all of my patients and coworkers. Plus all the kids at the daycare and their families. And he was the day before symptoms showed up. Was he spreading it before symptoms showed up?.

Let’s get him tested because he has symptoms. Then if he is the known case, our family self quarantines for 14 days and I tell the daycare so they can sanitize and tell other families. Hopefully, this would stop the spread.

By not testing and sticking our head in the sand, we don’t know and it can just keep going and spreading.

[pulmonarymd]

May 17, 2020 13:10:58 GMT -5 Mardi Gras Audrey said:

May 17, 2020 12:28:02 GMT -5 Blonde Granny said:

I thank everyone, but still...all we hear on TV is "we need more testing".. OK fine , go find people to test. Dragthem off the street corners, go door to door, but give it rest....Walk thru Walmart with test kits and test the people shopping there. Stop them in and out of these now open restaurants.....And if you don't want to, then shut your mouth and go away.

The problem is that they aren’t even wanting to test symptomatic patients. The rationale is “you can’t say for sure you were exposed to someone who tested positive so we won’t test”. Ok, then what for the person with symptoms? Once u are feeling better, u are back out in public but can be spreading it. But you were never “officially” diagnosed so you may or may not be spreading it.

In our case, I work in a hospital and my children are in daycare. I stick my head in the sand and say he can go back to daycare after 24 hours without fever because he wasn’t diagnosed with covid/tested and I can go back to the hospital because I have no symptoms and haven’t been in contact with a known case.

What if my child has it though? I am possibly spreading to all of my patients and coworkers. Plus all the kids at the daycare and their families.

Let’s get him tested because he has symptoms. Then if he is the known case, our family self quarantines for 14 days and I tell the daycare so they can sanitize and tell other families. Hopefully, this would stop the spread.

By not testing and sticking our head in the sand, we don’t know and it can just keep going and spreading.

It is an effective strategy to keep the numbers down. Long term not so much. But they are just following the lead of the idiot in chief. If you test the numbers get bad. All about optics. Who cares if people die as a result

[teen persuasion]

And suddenly my region meets those pesky hospitalization metrics.

The state must have tweaked the hospital/death numbers (because we haven't met the 14 day declines). Almost every region suddenly has zero or near zero numbers. Previously our net hospitalization number was 28 (when I posted this morning), and now it's zero! Deaths are 3. SOMETHING changed in the reporting or counting by the state.

So we just need the contact tracers (which I thought we'd already met) to open. Surprise! Everyone was hoping to get to open June 1, if a decline could hold.

Not ready...

[pulmonarymd]

May 17, 2020 13:16:12 GMT -5 teen persuasion said:

And suddenly my region meets those pesky hospitalization metrics.

The state must have tweaked the hospital/death numbers (because we haven't met the 14 day declines). Almost every region suddenly has zero or near zero numbers. Previously our net hospitalization number was 28 (when I posted this morning), and now it's zero! Deaths are 3. SOMETHING changed in the reporting or counting by the state.

So we just need the contact tracers (which I thought we'd already met) to open. Surprise! Everyone was hoping to get to open June 1, if a decline could hold.

Not ready...

Is it possible that they were combining confirmed and suspected cases.? Also possible that there were corrections on the dates people were hospitalized? Lots of data to collect for this, and if things have calmed down they could have gone back and reviewed things. Hope it continues to improve for you

[teen persuasion]

This was the monitoring dashboard this morning (first number is days of decline, second number is actual number of cases/deaths):

This afternoon:

[pulmonarymd]

May 17, 2020 14:37:15 GMT -5 teen persuasion said:

This was the monitoring dashboard this morning (first number is days of decline, second number is actual number of cases/deaths):

This afternoon:

If tracked correctly, hospitalizations are the most important metric. They will change faster than deaths, go ven how much lag time their is with deaths.

[teen persuasion]

Look at all those zeroes!  Hospitalizations went to zero overnight, even in NYC?  From 820 ?  These are 3 day averages.

Sorry, they changed the measuring stick somewhere.

[buystoys]

I saw an interview with someone from Colorado (?) that said their numbers changed drastically once they removed all the presumptive Covid cases and the cases where the person who died had Covid but it wasn't the contributing factor to their death.  I had read a few weeks ago that there was a suspicion the numbers were being over-reported.  Don't remember where I read that, though.  It makes sense, kind of. 

[apple 2]

May 17, 2020 16:50:22 GMT -5 buystoys said:

I saw an interview with someone from Colorado (?) that said their numbers changed drastically once they removed all the presumptive Covid cases and the cases where the person who died had Covid but it wasn't the contributing factor to their death.  I had read a few weeks ago that there was a suspicion the numbers were being over-reported.  Don't remember where I read that, though.  It makes sense, kind of. 

Just curious,  how can you have covid but it didn't contribute to your death,?

[Deleted]

"The number of Houston-area coronavirus cases is at 14,394 with 376 deaths, 5,552 recoveries".  This is according to local media and some dispute it on the grounds that elderly and disabled have died with Covid-19, not because of Covid-19.  Nope, not going to try to rationalize that with my neighbor who buried her MIL, or the one whose Mom is still fighting in the hospital.  Nope, not going to try that at all.   

In the meantime, even more venues can open tomorrow including gyms, office buildings and manufacturing facilities. 

In other news, the annual Galveston Topless Jeep weekend resulted in 50+ arrests, multiple shootings, and countless exposures.  

[Deleted]

And this "Texas had its highest single-day increase in new coronavirus cases Saturday, according to numbers from the Department of State Health Services."  But the gyms and salons and everything else are OPEN!

[Mardi Gras Audrey]

May 17, 2020 16:57:49 GMT -5 apple 2 said:

May 17, 2020 16:50:22 GMT -5 buystoys said:

I saw an interview with someone from Colorado (?) that said their numbers changed drastically once they removed all the presumptive Covid cases and the cases where the person who died had Covid but it wasn't the contributing factor to their death.  I had read a few weeks ago that there was a suspicion the numbers were being over-reported.  Don't remember where I read that, though.  It makes sense, kind of. 

Just curious,  how can you have covid but it didn't contribute to your death,?

If you got hit by a bus or were in a car accident that killed you and happen to have covid, it wasn’t the covid that killed you. With the lack of testing, I would think it is more likely we are underreporting deaths than overreporting

[oped]

We are under counting. But that doesnt fit the admin’s desired narrative.

[pulmonarymd]

There is no doubt we are missing deaths. In my state if you compare last April to this April and add the official covid deaths to last years total, there are 500 unaccounted for. If we were talking about heart attacks, no one would have a problem. But because of political reasons, we can’t have people die from covid. Ridiculous. There will always be undercounting with diseases like this

[oped]

www.nytimes.com/2020/05/13/opinion/coronavirus-us-deaths.html?smid=fb-share&fbclid=IwAR0mDuO0KJFd2z4aK7uqjsKXr9JxRhiU36bZ69hWVK56bOxAxHwNIuu5Ta8

But Even the National Review ....

www.nationalreview.com/corner/the-difficulty-of-flu-comparisons/?fbclid=IwAR1FqU04gjTfJHXs67fmdabY2NpTL-R7ev43V4atw_wpWubBeTziWkrsFSo

[Deleted]

May 17, 2020 16:57:49 GMT -5 apple 2 said:

May 17, 2020 16:50:22 GMT -5 buystoys said:

I saw an interview with someone from Colorado (?) that said their numbers changed drastically once they removed all the presumptive Covid cases and the cases where the person who died had Covid but it wasn't the contributing factor to their death.  I had read a few weeks ago that there was a suspicion the numbers were being over-reported.  Don't remember where I read that, though.  It makes sense, kind of. 

Just curious,  how can you have covid but it didn't contribute to your death,?

Well, there's a big hoopla in my town right now because an 88 year old in then nursing home with heart disease had a heart attack and died and it was called a covid death because he had tested positive when they tested the entire facility.  Makes no sense because the nurses say he was having no respiratory symptoms. He has a history of heart trouble and had had a massive heart attack a few years prior to being put in the nursing home.