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All-In [40129]
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One issue with the testing:
Mar 21, 2020, 4:24 PM
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I tested my first patient on Monday. It is going through LabCorp who is one of, but probably the biggest private lab companies in America. (To be honest this is an assumption but I think is true). Anyways, I still don’t have the result back and it’s Saturday. My county still has zero cases. But, in the unlikely event this turns back as positive, then we’ve already been operating as “oh we don’t have corona virus here yet” for 5 days. Imagine those who’ve been doing it longer have quicker results now. But we are operating on old data and the person i tested would either be really sick by now or possibly symptoms much better to resolved. The typical argument then is why test if it doesn’t alter your treatment—though I do think it’s important to know if in the area. I do think the point of care testing that has been approved will be helpful. But with all of these there are false negatives.
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Legend [18407]
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Re: One issue with the testing:
Mar 21, 2020, 4:38 PM
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5 days. Unreal. But doesn't surprise me. They're not used to operating real time. Even though our health care is the best in the world, we've been asleep at the wheel for this type of attack.
We are prepared in our eoc for a large scale attack and can mobilize quickly but not in such a large geo area.
We'll learn a ton from this outbreak. Unfortunately, it'll probably come at a cost to some needlessly
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All-In [40129]
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Agreed, I was in the military before and thought they would be
Mar 21, 2020, 4:43 PM
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More prepared than my group was. But I called a buddy that was still in and they weren’t even wearing masks or screening people which I found odd. They weren’t following the cdc recommendations at that time—likely are now. Agree with your point about preparedness. Have already talked to office manager about going forward keeping an amount of Ppe including n95 in stock. Also told him that everything we are doing needs to be in a binder so we can literally pull it off the shelf if something like this happens again. But as you say, learning a lot but at an unimaginable cost.
Message was edited by: lovingit®
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All-TigerNet [12550]
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Can I ask you if this process sounds normal:
Mar 21, 2020, 4:49 PM
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Wife is a pharmacy tech. A tough job, requiring a lot of personal responsibility, super clean background. In this situation, they are expected to be there through thick and thin to the bitter end. People have to be able to get their meds. Pharmacies have to stay open. SHe is in a retail pharmacy, Sam's Club. Not one sick day off in her whole life, not one.
Yesterday was a regular day off. She as Sunday off one weekend and Friday, Saturday and Sunday off on alternating weekends. So she was off yesterday,
woke up with "minor body aches",
6 p.m. temp of 99.9
7 p.m. temp of 100.6
7:40 temp of 100.7
no cough, no nausea ever.
Called Kaiser last night at 7:40 and they put a triage nurse on the line. She asked a long battery of questions, then gave advice to reduce fever. Said a doctor would call us this morning at 8:40. The doctor called at 8:20, asked anoter round of questions, many of them the same and then ordered her to self-quarantine for 14 days. Sent email to contact employer. We called the pharmacist where she works and told the news and showed the email. No mention of a test of any kind.
My wife feels very bad because she doesn't miss days and also feels she is letting her employer down. Or feels they may think she is scared to go in, but she is not. Although her boss has been super today, she must be going crazy thinking about getting a fill in until April 4th. My wife never wanted t miss 14 days, but the doctor said to and she has to consider her customers are much older people that come to get their medicine.
To top it off, the temperature was over 100 all day todday as well until the last check 30 minutes ago and it was 98.4. She really wants to contact her boss and say she feels much better and feels like she could work, but doesn't know if she should contact the doctor and ask if she can go, or just take the 14 days and be sure not to infect. I think, at this point, with the temp back to normal so fast, it is not likely that it was Covid. She is 47 so I guess she could have had it and was too strong for it to do much. But the whole situation is very strange with how quickly it evolved yesterday. Maybe we acted too fast at those temps, but the tv makes it look like you can't let it get ahead of you. Did we overreact? Is there a way to now call and go into work?
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All-In [40129]
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That sounds like an individual call on the doctors part.
Mar 21, 2020, 4:59 PM
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But every state and community are a little different. Without a known exposure, high risk travel, and without cough or sob, I likely wouldn’t have tested her. I do think it was reasonable to keep her at home as opposed to testing because most people will do fine and won’t benefit from treatment. I don’t want to say anything against another provider bc they are privy to your community and specifics of the case. I likely wouldn’t have automatically quarantined her though. We have a business here who is sending everyone who has cough or fever to me before they can return to work. We would have shut the entire business down if I quarantined. It is tough bc there are obviously guidelines but a lot of individual opinions. If in a community on the brink of shutdown it may make more sense than in one like mine where there isn’t a positive yet. Hope that’s helpful. I’m sure her provider is looking out for the community and her safety. She could try to be re-evaluated by that provider or call boss but really it’s a tough call
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All-TigerNet [12550]
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Thank you, your reply is very helpful and
Mar 21, 2020, 5:07 PM
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makes perfect sense. We are in Atlanta, so as you say, we have more happening in the community and that might be why the decision was such. I think there have been 13 deaths in Georgia, with most in the metro area.
Regarding the call back to the emplyer and doctor, you are right there also. It is a tough call. Do it and feel better about going back to work. Don't do it and just stay out of the way and make less fuss and be glad the fever went away. We aren't sure, but I thnk she is going to start by texting employer for advice.
Thanks again for your reply and thanks for the great job yall do. And I might add, the nurse and doctor we spoke with last night and this morning were wondrful professionals.
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Legend [18407]
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Re: Thank you, your reply is very helpful and
Mar 21, 2020, 5:54 PM
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What I've always been told by my doc is 48 hours fever free without any fever reducer. Then again, I'm different, it's long been a pet peeve of mine over peeps going to work sick. I would think the responsible if in fact she does go back, to wear masks and gloves. Doesn't have to be an n95...
But, suppose she does have a mild case of covid, and I come get my meds that she inadvertently touched my med bottles. I know my wife and I both would probably die. Late 60's, obese, heart and copd.
Tough tough call. Be safe.
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All-TigerNet [12550]
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Exactly, and that's why it seems the
Mar 21, 2020, 6:12 PM
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decision to self quarantine is irreversable for the next two weeks no matter how much better she feels. She has customers she adores that are in their 80s and 90s. She brags on how they come walking in so great for their age, etc. Don't know what this 24 hour spell of fever was about, but in this climate, can't take a chance on it for herself, and especially for others that may not be able to fight it.
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All-Conference [401]
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Re: Thank you, your reply is very helpful and
Mar 21, 2020, 6:55 PM
[ in reply to Re: Thank you, your reply is very helpful and ] |
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Most hospitals are working to develop a prelim test but still have the 3-4 days confirmation test from LabCorp or Quest
Our hospital system is recommending at least 5 days and >72hrs without fever or symptoms
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All-In [40969]
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All-In [40969]
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I've been running a low fever since Wed
Mar 21, 2020, 7:32 PM
[ in reply to Can I ask you if this process sounds normal: ] |
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back to normal the last 8 hours or so.
I called my Doc Thrus and asked what to do. He said come in. The only way they would test was if the fever was over 100.4 and there was also Respiratory problems. Had to have both. A few days ago you also had to travel over seas. If you meet the criteria, then you have to have 2 different flu tests come back negative. One of the tests gets sent off so you wont get tested for at least a couple days. After that you have to have 2 positive COVID-19 tests and they each take about 3-5 days to get back.
He sent me home and told me I could go to work the next day. I didn't, I worked from home. I will probably work from home Monday too.
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Legend [15492]
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Re: I've been running a low fever since Wed
Mar 21, 2020, 7:38 PM
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back to normal the last 8 hours or so.
I called my Doc Thrus and asked what to do. He said come in. The only way they would test was if the fever was over 100.4 and there was also Respiratory problems. Had to have both. A few days ago you also had to travel over seas. If you meet the criteria, then you have to have 2 different flu tests come back negative. One of the tests gets sent off so you wont get tested for at least a couple days. After that you have to have 2 positive COVID-19 tests and they each take about 3-5 days to get back.
He sent me home and told me I could go to work the next day. I didn't, I worked from home. I will probably work from home Monday too.
I hope you feel better my friend. I hate that they are rationing Covid-19 tests. We need more tests. If, God forbid, you had it, you could have been spreading it to others without knowing it. I'm sure you've stayed isolated, but many haven't or can't. Waiting for symptoms to appear makes no sense. We need more tests,tests, tests!
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All-In [40129]
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There are some things we all could have done better. But
Mar 21, 2020, 9:54 PM
[ in reply to I've been running a low fever since Wed ] |
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I kind of thought it was silly that a week ago we were still and are asking if any travel to China or overseas. At this point, travel to Little Rock for me or Raleigh/Wilmington/Charlotte for you is more likely. It’s community spread for most now. Just to still make it difficult, I had two positive flus this week. Hoping it will go away so we can just say it’s most likely Coronavirus at some point. I get what you’re saying about the testing. I’m no expert on that. Some that think we should test everybody I just wonder when it stops. In other words we test you and you’re negative. Great but what about next week or the week after that. What would be great is to have an ab test to see if you had it. Because then I think you’re golden and you can just go and do. Some questions though are can you be infected twice. There was one person supposedly who was but I’m not sure if we know if that is usual or not. Then some think it can and will be a seasonal thing. I sure hope not. Course then our immune systems won’t all be naive to it at least.
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Legend [15492]
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Re: One issue with the testing:
Mar 21, 2020, 7:21 PM
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The FDA has approved a test that gives results in 45 minutes. The problems is that everyone should be tested. If we wait till symptoms appear, you may have already infected 20 other people. Identify the infected and quarantine them.
This could be really bad. Gov. Newsom of California wrote Trump a letter requesting a Navy Hospital ship be moved to LA harbor. Newsom said they project 56% of the population will be infected in the next 8 weeks. That's 25.5 million people. We haven't had test kits and now most infections are community infections. It's out there and people are spreading it without knowing they have it.
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All-In [44109]
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One of my patients had a test on Monday and results still aren’t back yet.
Mar 21, 2020, 8:09 PM
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That was sent to the state public health department. The hospital has since started doing their own in-house tests. They drew her test yesterday and results were back this morning (she is negative, as predicted). This was crucial, as she needed urgent surgery and it was delayed since Wednesday to wait on her test result to be back.
I’m hoping the new tests with faster turnaround time, including the one that reportedly provides results in 45 minutes, is accurate enough to rely upon. As you stated though, there will surely be false negatives.
Thank you for the care you are providing!
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Oculus Spirit [77440]
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Re: One of my patients had a test on Monday and results still aren’t back yet.
Mar 21, 2020, 8:18 PM
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You as well JK!!!
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All-In [27366]
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All-In [40129]
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That is terrible. I’d be interested in how fast her decline was. It sounds like
Mar 21, 2020, 10:12 PM
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She just felt bad but not anything terrible. Then she said it felt like something was in her lungs and then she’s dead. You would think there would have been a decline. That’s the thing though less say she tests positive. If she is mainly just flulike then it would be typical to observe them at home. Now someone likely should check on them frequently. I’d love @soywaker opinion on this but as I understand it the people who don’t do well go into ards or ards-like process. This is terrible but as devils advocate just because she tests positive earlier doesn’t mean she would have been treated any different. That’s the scary part. Course we don’t know all the details.
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Legend [18407]
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Re: That is terrible. I’d be interested in how fast her decline was. It sounds like
Mar 21, 2020, 11:36 PM
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You be safe and please seek immediate help if she starts feeling worse. We really don't need to read something like this again...
I hope the experts can at least learn something valuable about this case.
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