Well you could always:Originally Posted by Lester Polfus
1. Get yourself a Cabelas Club card and use it to pay the bill. Then you could use the rewards $ for guns and or ammo.
Or
2. If you're lucky enough to make it out of ICU after ECMO, play the lottery ASAP.
I don't know the national numbers, but our ECMO survival rate for COVID is rather, rather, rather low.
Good link. Thank you!
Ken
BBI: ...”you better not forget the safe word because shit's about to get weird”...
revchuck38: ...”mo' ammo is mo' betta' unless you're swimming or on fire.”
COVID pg 666.
PCR tests vs antigen tests may be the miscommunication. Antigen tests are not good at all and must be administered within five days of onset of symptoms. Under real world conditions you can get to about 70% specificity with the BD test. I don't know about other brands.
As Neph mentioned, some patients continue to test positive long after infection has seemingly ended, sometimes interspersed with negative tests. The ID doc here that I talked with about this called them intermittent positives, I think. As far as I know, no one has been able to recover infectious virus from these patients. I wonder if this observation is normal for most respiratory infections and had simply never been observed before.
Lastly, some labs are just better than others. Last spring we looked at bringing in a person with great experience in respiratory virus PCR test development to help get our lab-developed test online. I interviewed her, and when I explained how many tests per day we needed to run and my plan for how to do it, she told me that what I wanted was impossible and she told me why it was impossible. I thought she was much too focused on limitations rather than possibilities, and we didn't hire her. Since then we've done exactly what we planned to do, and it's worked really well. I don't know if this woman simply had bad technique, but according to her, we should be lit up like a Christmas tree with all the false positives right now. That hasn't happened. If we'd hired her, maybe we'd be having more problems. I have no idea. She knew a lot more about what we needed to do than anyone on our team. She must have had some good reason for predicting failure. Whatever the reason, I'm sure glad she was mistaken!
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I noticed that as well.COVID pg 666.
I'm not a medical expert by any stretch, but I got put on orders a few weeks ago with the national guard to work as a contact tracer here in Vermont so I've seen and spoken to a whole bunch of cases. With regards to #2 they were probably asymptomatic cases. I've seen a whole bunch of people who had no symptoms whatsoever but were covid positive and were passing it on to other people who did get sick. Talked to a whole family who all tested positive and had no idea they had it. They only got tested because a kid in one of their children's classes popped hot. The way our database works we can pretty easily see which close contacts later test positive and what symptoms they had.
With regards to #1, again no expert on this, but the info i was given is that false negatives can be a thing with pcr but in some cases for people not showing symptoms yet, they may not have waited long enough from exposure. Here in Vermont for example, the quarantine standard is either 14 days or 7 days and then a negative test. If I remember the training correctly something like 95% of cases that develop symptoms will do so by day 7, but before day 5 after exposure that number is significantly lower, where that person may have covid and still not trip a test.
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I’m an ICU physician at one of the busiest ECMO centers in the world (one of our faculty invented the technology 40 years ago). We cannulate about 150 people per year. I’ve been in the SICU for the past 4 weeks where we manage VV ECMO for respiratory failure. I’ve yet to see a COVID patient get de-cannulated and I’ve seen 2 die this month. We have 8 alive on the pump and all but 3 have been cannulated since before I arrived. The ones that have been cannulated for over a month are circling the drain, and the fresher ones show no real signs of lung recovery. Every one of them has required horse tranquilizer levels of sedation while on ECMO. This is in stark contrast to our institutional experience for non-COVID respiratory failure, and even our COVID experience in the Spring where 50% survived. Something has changed in this wave - they are younger but much sicker.
Bottom line, there is no way in hell that I’d accept ECMO for COVID as I have no desire to die a slow, agonizing death, with tubes down my throat and up my ass.
I like my rifles like my women - short, light, fast, brown, and suppressed.
I think I need to update my advance directives...
Ken
BBI: ...”you better not forget the safe word because shit's about to get weird”...
revchuck38: ...”mo' ammo is mo' betta' unless you're swimming or on fire.”
Wife has some blood clotting - not covid related. I went in with her to see her vein DR in Marietta GA. He mentioned how busy they are 1) since GA is relatively open, they are seeing patients from all over US who are not allowed "elective" vein surgery in other parts of US and 2) surge of traveling nurses, etc. due to busy state of affairs, and 3) surge of bloodcotting and amputation issues due to covid.
I think hospital survival rate depends on what docs and which nurses are running the icu's. My local hospitals long ago went to hiring nurses on a part time basis. Less group cohesion. Fewer opportunities for highly skilled to teach the others. More interpersonal bullshit.
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