I'm in a very salty mood today. My fiance and I made the decision yesterday to postpone our wedding reception to 2021. We are still going to get hitched on the originally planned date, but in front of a much smaller group of immediate family. I know we will find a bright side, but it still sucks. DAMN COVID-19.
My nephew and his fiancee sent out cards last week delaying their wedding until next year. It had been scheduled for October. I think they did the right thing, and my wife and I thought they should do what you intend to do, but they are waiting.Originally Posted by donlapalma
There's nothing civil about this war.
I feel your pain. My Fiance and I already got fleeced out of about $2500 by the nationwide closing of Noah's event venue. Now it's likely we'll have to cancel our Jan 2021 planned wedding date thanks to our state's regulations over COVID-19, and because of so many couples like yourself already being forced to reschedule into 2021, it's unlikely we'll get a date earlier than 2022.
It's a real bummer. But she and I will get married on time at least, even if it's a small thing.
As of last night, the people I personally know who have had Covid-19 grew to: 13. None in direct contact with me.
Female age 50: Lost smell months ago, never got it back. No other symptoms.
Kids age 11-18 X5: mild cold symptoms for a couple days, diarrhea for a day.
Adults age 44-50X3: One temporary smell loss, and short of breath a couple days, two mild cold symptoms.
Adults age 22-35 X4: Mild cold symptoms a couple days.
These obviously represent the vast majority of community cases. I am not in the ICU seeing those cases.
This isn't true for several reasons:
1. The relationship between viral load and infectivity is well established in HIV, for example, but its relevance to respiratory diseases is not well established, to my knowledge. It is not even clear whether viral load is not reflective of disease severity in this context, either. There is also good evidence that the opposite was true (children are infectious for longer than adults) for H1N1. So, definitely not an assumption to take for granted. I am not aware of any studies establishing or refuting this relationship in COVID-19.
2. Specifically in the context of that graph, it's not clear how viral load is measured (PCR? PFUs?) or what sample tissue (nasal swab? blood? sputum? BALF? urine?) was collected.
3. Pursuant to 2, depending on how they measured viral load, the values presented on the graph may not be very representative of the actual quantity of actively replicating virus. PCR based techniques for quantifying "viral load" in influenza, for example, are extremely treacherous as the reaction amplifies any/all influenza RNA - including fragments of dead virus (this is actually a problem I am working through in lab right now).
4. Even if we accept that 1-3 aren't problems, the graph still doesn't show appear to show a significant difference in viral load among the groups. The bars representing the standard error overlap across all test groups (even after log transformation....), which implies the (minimal) differences between these groups are statistical noise.
Friend of mine's brother-in-law just died from it. Didn't know the guy but my sympathies to my friend. It's real and not going away.
We've finally placed a hold on elective surgeries again.
Continuing to set new records for #'s of floor and ICU patients.
I'm waiting for that to happen here. We had almost dismantled all of the ICU surge teams - I think we are down to two, staffed by anesthesia crit care and CT surgery. Wonder if they will end up being activated again.
Our governor enacted a mask ordinance (all indoors places accessible to public + outdoors areas where 6+ ft of distance from others is not possible) that went into effect at midnight. Wonder if that will help. Guessing it depends on the mix of voluntary compliance and ordinance enforcement - not a lot of hope there will be enough of either.
My brother recently had two teenage children die in his ICU after all heroic measures were taken. Neither child had any "underlying conditions." 15 and 17 years old. Pretty scary.
Michigan did a pretty good job at planning 10 years ago when they built their Children’s Hospital and designed a 30-bed, expandable RICU for pandemics that opened for the first time from March to May. I’m literally listening to the virtual hospital townhall regarding the institution’s COVID response as I type this. I full expect to be manning the RICU by November since it’s run by my division and will probably be sending my family back to our permanent home.
Despite what I wrote above, I still fall in the camp that some degree of economic re-opening is needed to prevent secondary morbidity/mortality from social distancing (undiagnosed conditions, suicides, substance abuse, etc.). However, titrating the right amount of economic activity with strain on the healthcare system is going to be very difficult on a national level for the next 1-2 years which is my estimation for how long this pandemic is going to last. Every municipality is different and can tolerate varying degrees of reopening. Moreover, I remain unconvinced that universal facial masking is doing much to slow this pandemic. This is especially true when it comes to cloth masks that are likely being worn for days without proper washing (N95s that are worn for up to 8 hours are another story).
Ultimately, I think that we need some very creative ways at caring for the COVID patients while minimizing the impact on hospitals that need to be able to maintain steady surgical revenue streams and address the other myriad of conditions that are not going to take a break. Most medical centers experienced negative margins for FYI20 that ended in June, and another year of losses due to COVID will devastate some of the marginally performing centers. One idea is to use the roughly 20K VA medical center beds as COVID care centers since they often affiliated with nearby academic medical centers and duplicate services that are already provided by civilian centers (often with better outcomes). However, we need to start planning these contingencies NOW since any major initiate will require massive staffing shifts. Otherwise, hospitals can expect to hemorrhage $3M/day for the entire Fall and Winter like they did for a couple of months this past Spring.
Last edited by Sensei; 07-17-2020 at 02:33 PM.
I like my rifles like my women - short, light, fast, brown, and suppressed.
Reply With Quote