Steeleballz

The rapid test will be less sensitive than the PCR method. I haven't seen the data on it yet. If it's anything like the rapid flu tests, we would be confident of positive results, but we would have to confirm negatives with a more sensitive method.

We were supposed to get a rapid method next week that has a 15 minute turnaround per kit, but I hadn't heard any updates when I left on Friday. It usually takes them a few days to get new methods up and running. I think the next few weeks should see a very big jump in the capacity and turnaround for these.

It is still too long, but the reference lab is at maximum capacity and they can't catch up. They ran out of test kits early on and were backlogged with several thousand tests and they can't catch up. I imagine other places have had similar scenarios. The methodology doesn't lend itself well to rapid testing, but hopefully the proliferation of rapid test kits will help. We can't control what reference labs do, unfortunately. We have been adding testing internally when we need to, but they don't want to do non urgent testing internally. The tests themselves take about 4 hours start to finish in batches of 20. I don't know directly what they are doing, but I have heard they are getting more people trained to actually do the testing so they can do it 24:7.

It varies by state (and probably by hospital). We do some of our own testing which maxes out at 60 tests per day with same day turn around time. Those are prioritized to admitted patients first and then to staff with symptoms that could be Covid-19. We send ER patients who are not admitted (mild symptoms) and outpatients to a reference lab and the turn around time for those results can vary from a few days to maybe 10 days at worst.

Same thing we've been talking about since day 1. The death rate is not static. If people are not social distancing and too many people get the illness at the same time, the healthcare system is overwhelmed and many more of those serious/critical cases become deaths instead of recovered. That happened in both Italy and in NYC. People doing these analysis can't just completely detach from the fact that this is a pandemic disease to which we have no immunity. You can't analyze the statistics the same way you do last years flu season. This is much more fluid. We can mitigate it or we can allow it to get worse and the range of numbers changes drastically.

It probably will to an extent. I don't think they are pretending that they have the data correct with any degree of accuracy or precision. Remember at one point they were looking at a 3-4% death rate. It is way down from that now, and probably will be much lower in the end. That doesn't make it any less of a problem in the short run, but it does give a better outlook for the future if this sticks around as a seasonal illness.

Technically, you don't know the chief cause of death. I mean there are thousands of people out there whose cardiovascular systems are ticking time bombs, but they might live for years. Currently Covid-19 is reportable because of the pandemic. It may end up more like flu in the future. Right now they are trying to track the numbers and location so it is all reported that way. By reported, I mean to the CDC. I'm not sure if the death certificate has to say Covid-19 or not.

The worst thing I see people do sometimes is grab the front of the mask and lift it off. They contaminate their hands and spread whatever was on the mask onto their face.

As I said, unlikely they will be doing many medical autopsies on people who die of Covid-19. Autopsies are rarely done if the cause of death is known. They are generally requested by the coroner when the cause of death is suspicious or unknown, or by the family for reasons such as medical malpractice.

The difference is all Covid-19 deaths are reportable. Flu is only reportable in the <18 age group. Reporting of adult flu deaths is not mandatory. If someone comes in with flu and dies of a heart attack, it doesn't have to get reported as flu. If someone comes in with Covid-19 and dies of a heart attack, it still has to be reported as Covid-19 (with additional etiology).

Someone will challenge it in court, and if it makes it to the SCOTUS, they will cite precedent and allow state governors to continue to do this.

If people still have symptoms they are retested. Believe me, we go through the drill every day at work. They test us PDQ if we have symptoms. We will get results back same day or next day. They don't want us spreading infection around the hospital obviously, but they also don't want to pay us for sitting at home.

Under current guidelines, negative people can go back to work without risking everyone they come in contact with. Positive people stay home. It would be helpful to get that negative result back in say 2 days rather than in 20 days.

There are 3 different strains of flu virus causing illness this year and all have been widely circulating since late fall, which is kind of unusual. Even given that, we are looking at another 2-3 weeks and 2020 US deaths caused by Sars-CoV2 will pass the cumulative totals for all 3 flu strains.

You can look at flu reporting to see how much of the actual number is estimated. They model a certain percentage of people not seeking treatment, a certain number dying of co-morbidities and things like that. The reverse of the video is also true. Every year people die of heart attack or pulmonary failure that was brought on by flu, but never counted as flu because testing was not done. The person might have stayed home and fought through severe symptoms, then left so weak they succumb to something else. Anyway long story short, lots of estimates and assumptions if you want to look at the method. https://www.cdc.gov/flu/about/burden/how-cdc-estimates.htm Covid-19 is going to be reported in a similar way as flu. If a person tests positive and dies, it's going to be listed as Covid-19 related and reportable to the CDC. Contrary to the video, this is highly regulated. For Covid-19 it will also be directly tied to reimbursement. They don't generally do autopsies on patients with a confirmed primary cause of death being a highly infectious disease just to see what else was going on, and they can't just make up another cause of death. They can list contributing factors if known. We have a specific form from the CDC for patients who die of Covid-19. It lists all known preexisting conditions on the form. It also asks other specific information such as if there are any other contributing diagnosis or etiology for the illness.