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Medical professionals, ONLY, address this/these question(s)
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Legend [16646]
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Medical professionals, ONLY, address this/these question(s)
Mar 21, 2020, 2:17 PM
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No opinions from the 'Holiday Inn Express' crowd, please.
So...some are up in arms over the lack of testing kits and that millions should have been on hand. With that in mind, are all/many test kits the same? They can be used to identify multiple 'bugs'. There is no variability within test kits...they're all the same?
If there should be millions of test kits at the ready...shouldn't the supplies to validate the tests also be at the ready? Articles are out lamenting the lack of supplies to conduct the tests for 'Yea/nay'.
TIA to the professionals who reply...and those who let them! 
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Legend [15907]
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I am not able to speak to the specifics here...
Mar 21, 2020, 2:32 PM
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What I can say is the test had to be developed in response to the new virus. Not sure how we would have had even 1 test kit on hand for something we didn't know to test for.
We do use one type of swabs and test across the board for viral panels: flu A, flu B, RSV, metapneumovirus, etc...
The lack of supplies on hand, imo, is more in reference to PPE; masks, gowns, gloves, bacterial/viralcide wipes, etc.
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Orange Blooded [2638]
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Is there a reason why other countries
Mar 21, 2020, 2:40 PM
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Were able to provide more testing and do it more efficiently? And would the pandemic team that was in place (and cdc personnel) that were removed made a difference in that?
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Legend [16646]
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Thanks, Soy...
Mar 21, 2020, 5:31 PM
[ in reply to I am not able to speak to the specifics here... ] |
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I had seen reference to the test labs themselves running out of supplies to validate the tests. That could account for delays in reporting results.
Simply an almost unreal time we're in. Take care...you and the other medical/diagnostic pros here!
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Orange Blooded [2663]
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Legend [16646]
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Are you a medical professional?
Mar 21, 2020, 10:00 PM
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If not...butt out! Find another thread to troll, but this one had a specific intention, and some legitimate professionals have tried to share their expertise, not their bloody politics!
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All-In [40100]
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The tests I have access to specifically test for Coronavirus 19.
Mar 21, 2020, 2:41 PM
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They likely would not have been created before it was a human illness. My clinic has 30. We are still just barely testing. And no positives in my county yet. So we have more than we need and supposedly any that we use are replaced the next day. So if we test 5 we get 5 the next day. I’m not speaking for all locations because that would vary greatly but we have “enough” at my location for now.
As soywaker suggested, Ppe is lacking. I’m wearing the same n95 mask for a week now. It may be worse in California, ny etc. this is by far more than what it is designed for. As I understand the 95 means it keeps out 95% of respiratory droplets. The problem is after a week I’m sure it’s not 95%. There are a few reasons to test. One would be epidemiological to follow and know numbers. Another is to test contacts of positives. Finally, clinically we often say you don’t test if it won’t change your treatment. So far I’m only testing people that have 2/3 of cough, sob, and fever. To be clear I live in Arkansas and I think you’ll find every area has different concerns etc. I can’t imagine soywaker out in California or those in NY Seattle etc.
Message was edited by: lovingit®
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110%er [5249]
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Is there a way to re-sterilize or re-use an N-95 mask?***
Mar 21, 2020, 2:45 PM
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All-In [40100]
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Many are spraying/cleaning with alcohol periodically.
Mar 21, 2020, 2:48 PM
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This is just my opinion— I don’t know if this is accurate but I’m convinced as a solvent, that the alcohol breaks down the material further. I have no facts to back that up. We actually were able to order n95 masks from our usual suppliers this week and they say we will actually get them. So that is a positive. Can’t speak for icu in California like soywaker. Ideally they would be changing more frequently than me. We have some chicken farmers that did donate some of their n95 masks to us so we are actually a little better off now than a few days ago.
Message was edited by: lovingit®
Message was edited by: lovingit®
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CU Guru [1257]
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Re: Many are spraying/cleaning with alcohol periodically.
Mar 21, 2020, 4:22 PM
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We managed to buy all of our N95 respirators from the local hardware store. Our guidelines are reuse 5 times or until soiled. I would not feel comfortable utilizing a mask that had been sprayed. I also was part of a webinar this week that had a recent study showing no statistical difference in effectiveness between Level 3 surg. masks and N95 respirators. However, if I have a choice I'm going for the N95. I'm in SC.
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All-In [40100]
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Good to know thanks. I do feel better with the n95.
Mar 21, 2020, 4:30 PM
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Since I can barely breathe in it, it has to be better right? One advantage I found was we have a frequent patient who is quite smelly and I couldn’t smell her at all. That’s ugly I know but true. I have a feeling a lot of us not in surgery or icu are wearing the n95 mask because of the cdc guidelines that say if you are wearing glasses and n95 mask and are exposed to a positive patient, you are still low risk and don’t have to be quarantined. From what I’m hearing they will backing off on some of that as they need the workers there.
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All-American [587]
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Re: Is there a way to re-sterilize or re-use an N-95 mask?***
Mar 21, 2020, 3:18 PM
[ in reply to Is there a way to re-sterilize or re-use an N-95 mask?*** ] |
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Sterilizing will help kill viruses that land on the mask, but even an N95 does not filter out viruses. Pore size is 3 microns, whereas COVID-19 is 1 micron. Now, when multiple viruses are in a single droplet, the droplet is far bigger than 3 microns, so that helps, but it is still not a full-proof barrier.
That being said, it's the best we have, but for some reason regular joes thought they needed cases of them for walking on the sidewalk as if COVID-19 is raining from the skies
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110%er [5249]
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Totally agree, just wondered about
Mar 21, 2020, 3:21 PM
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the feasibility for those in need of fresh masks, if there is a way to safely recycle them, or re-sterilize and give them to an already infected patient in the hope to minimize transmission
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Commissioner [990]
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Re: Totally agree, just wondered about
Mar 22, 2020, 1:06 PM
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I saw a hospital in Nebraska using ultra violet rays. Would this be effective?
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Orange Blooded [2638]
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All-In [40100]
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thanks. I wouldn’t necessarily say I’m at the front line yet.
Mar 21, 2020, 2:54 PM
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But will take all the prayers I can get. The healthcare workers in Italy, Seattle, NYC, Cali etc are just absolute heroes and deserve all our prayers.
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Legend [16646]
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So..
Mar 21, 2020, 4:32 PM
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@tigerrag86 and @TD Tigers, are you medical professionals?
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CU Medallion [56714]
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Re: So..
Mar 21, 2020, 4:57 PM
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Or even better, medical professionals that slept at a Holiday Inn Express last night?
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Freshman [5]
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Re: Medical professionals, ONLY, address this/these question(s)
Mar 21, 2020, 7:19 PM
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Clemson, MUSC graduate, long time lurker, joined today just to answer your question. I work in laboratory medicine. Part of the problem with the tests was a lack of reagents. Made in China. Still a problem. Also, lack of nasal swabs. #1 maker: China. #2: Italy. If you are getting a test from a reliable source, such as from a hospital or major lab such as Quest, Bioreference, or something through your local health department, yes those are reliable. Now there are home tests. I don’t know about their reliability. And if it comes back negative, did you send an adequate sample (do you trust you did a good job)? With it being cold/flu season, flu should be ruled out first. That result back in 15 minutes. At our hospital, our lab has a respiratory panel that will also test for multiple other viruses. So yes, there is a lack of supply. And now with so many people wanting the tests, we are running out of personal protective equipment that is needed to protect the healthcare workers who are obtaining the tests.
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110%er [6095]
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if it wasn’t clear before, it’s crystal clear now. US needs
Mar 21, 2020, 9:10 PM
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an ability to manufacture items on US soil, even if we have to subsidize those industries. Trump (politics aside) was the only politician concerned about China three years ago. He caught flack about it from Republicans. No wise investor put all his money in one asset. We are solely dependent on China for far to many things
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110%er [9666]
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What’s this about bugs?
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Mar 21, 2020, 9:36 PM
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Hadn’t heard about that?
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Recruit [83]
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Re: Medical professionals, ONLY, address this/these question(s)
Mar 21, 2020, 9:41 PM
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Retired MD here (plumber)- question- Have not seem anywhere about the false positive and false negative rates of the test??? Anyone? Link would be great. TIA
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All-In [40100]
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have Not and I think it will depend on the tests. The ones that we will end up
Mar 21, 2020, 10:27 PM
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With that test in office will likely have a significant false negative rate (based off other rapid tests). But the false positives will likely be low. If I come across specifics I’ll post it here.
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Orange Blooded [3545]
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As a physician, I’ve wondered about the testing
Mar 21, 2020, 10:36 PM
[ in reply to Re: Medical professionals, ONLY, address this/these question(s) ] |
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Being used myself, esp as to false positive and negative rates. With something that so often has little to no symptoms , the testing being used hopefully hasn’t been so rushed as to have a high false positive rate. Seems unlikely given what we know about the epidemiology of this virus but I’ve wondered. I’m sure now that we’re getting some lab heavy lifters involved in production, the tests are robust enough, with the screening test having a super low false negative rate.
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Orange Blooded [3545]
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Re: As a physician, I’ve wondered about the testing
Mar 21, 2020, 10:43 PM
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A quick google look at actual medical journal articles shows some of the initial tests to be less than ideal when using pharyngeal swabs as the source with a 66-80% sensitivity range and a PPV of only 65% but a NPV of 83%. I do believe that was early data and with new test modalities being available Im sure those numbers are , on aggregate, better now.
Message was edited by: tigerpathmd®
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Oculus Spirit [93606]
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Oculus Spirit [93606]
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