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Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 01:13AM
[www.latimes.com]

This headline didn't make any sense and neither does this article but there it is in the LA Times.

I guess this is where we are now. Too understaffed and under-supplied to do what needs to be done.

Saw something similarly disturbing from Snohomish County, just north of Seattle, they will no longer do contact tracing for people who test positive, the patients will be told to do it themselves. They don't have enough staff to do that work.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: vision63
Date: March 21, 2020 01:22AM
People are beginning to panic somewhat. So many people think they have it.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 01:23AM
Quote
vision63
People are beginning to panic somewhat. So many people think they have it.

Same up here. Hope you're staying safe.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: vision63
Date: March 21, 2020 01:29AM
Quote
Lemon Drop
Quote
vision63
People are beginning to panic somewhat. So many people think they have it.

Same up here. Hope you're staying safe.

I have the choice between the Bay and L.A. and I've chosen L.A. Bigger house with yards. I had to go to a funeral yesterday (my buddy's mom died). The chapel enforced social distancing and the cemetery only allowed 20 people there. That was an ordeal. Doing my best to isolate. I figure, what if I had to live on Anne Frank level rations. I can stretch it out. I can't stop thinking about Italy.

You stay safe yourself.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: RgrF
Date: March 21, 2020 01:42AM
Can't speak to Visions environs (LA has a lot of totally different places) but the Valley (1.6 mil pop) is like death valley in terms of traffic or movement.

People seem calm and only anxious if they're stuck without enough food or resources. That doesn't seem to apply to most but to those it does it's a monumental disaster. Local school district is distributing regular school meals to anyone who happens upon one of their middle/high school locations.

People who most need this don't know this, so getting info out is now the bigger issue - not sure that this holds throughout the city but it's what's real here.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: cbelt3
Date: March 21, 2020 08:30AM
Eventually we will all get it.

And here I am.
Over 60
Asthmatic
Hypertensive
Diabetic
Type A blood

My main hope is they get an immunization before I get it.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: rjmacs
Date: March 21, 2020 08:31AM
The whole purpose of social distancing and the school closings, partial 'lockdowns,' etc. is to prevent community spread from reaching this level.

Isolation and contact tracing is only useful if you can keep contagion limited, and that requires a LOT of voluntarily public cooperation. That is what failed dramatically in Italy, and was possible in China outside Hubei province.

Los Angeles still can gain from voluntarily social distancing and self-isolation for suspected cases. It's going to be tough to turn people away from hospitals, but the standard for who can be seen in healthcare facilities is going to change. Now it's about slowing infection rates so the hospitals aren't totally overwhelmed. L.A. is huge, and there are lots of vulnerable people there. It's time for a lot of public leadership and neighborhoods coming together to stay apart.



rj
AKA
Vreemac, Moth of the Future
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Janit
Date: March 21, 2020 08:32AM
Yes, the terminology is confusing, but it is a matter of triage and epidemiological strategy.

When resources are limited, the most effective deployment of those resources will depend on the stage of the epidemic.

Early in an epidemic, when there are very few cases, it is worth testing everyone who is sick and their contacts in the hope of isolating the outbreak to them only and preventing it from getting out into the general population.

Later on, when there is widespread community infection, testing everyone can't be done because there are not enough tests. People with mild illness are simply advised to stay home and isolate. A positive test will not change that.

For people who have severe illness, testing will be done so that the hospital will know whether to isolate them within the hospital. Health care workers may be tested in order to ensure it is safe for them to continue working.

Although it would be useful to know the overall distribution of the virus in the population right now, it is just not possible to do this. This is why we have the shelter-in-place orders. At this point in the epidemic it is most effective to behave as though everyone could be infected, and to reserve the tests for only those people where a positive determination would make a difference in their treatment or deployment.

I think it is the word containment that is confusing. In epidemiology, containment means preventing a disease transition from a small number of people out into the community. The virus is now out in the community, so we are beyond this stage. The strategies for preventing further spread within the general community are different.

This is NOT about loss of hope.



Edited 3 time(s). Last edit at 03/21/2020 08:38AM by Janit.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: pdq
Date: March 21, 2020 08:56AM
Obviously, this has medical repercussions beyond Covid.

My daughter is preggers again, and last time, she was induced ASAP at 36 weeks because our granddaughter suddenly stopped growing (per ultrasound) and had some signs of distress. She nearly came to C-section.

Both mom and baby did okay, but they were obviously keeping an eye on things more closely this time. Now coming up again on 36 weeks, they called her to say they cancelled her scheduled ultrasound and told her to stay home.

> : /

Grandpa doesn’t like that. He doesn’t like that one bit.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Ted King
Date: March 21, 2020 09:30AM
Quote
cbelt3
Eventually we will all get it.

And here I am.
Over 60
Asthmatic
Hypertensive
Diabetic
Type A blood

My main hope is they get an immunization before I get it.

Damn cbelt, I feel for you. I hope you stay safe.



e pluribus unum
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 09:32AM
Quote
pdq
Obviously, this has medical repercussions beyond Covid.

My daughter is preggers again, and last time, she was induced ASAP at 36 weeks because our granddaughter suddenly stopped growing (per ultrasound) and had some signs of distress. She nearly came to C-section.

Both mom and baby did okay, but they were obviously keeping an eye on things more closely this time. Now coming up again on 36 weeks, they called her to say they cancelled her scheduled ultrasound and told her to stay home.

> : /

Grandpa doesn’t like that. He doesn’t like that one bit.

Oh gosh - that would make me very worried too. It makes sense that they want to keep your daughter out of the clinic though. I'm keeping you both, and baby, in my thoughts. Look forward to your family's joyful news soon.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 09:43AM
Quote
Janit
Yes, the terminology is confusing, but it is a matter of triage and epidemiological strategy.

When resources are limited, the most effective deployment of those resources will depend on the stage of the epidemic.

Early in an epidemic, when there are very few cases, it is worth testing everyone who is sick and their contacts in the hope of isolating the outbreak to them only and preventing it from getting out into the general population.

Later on, when there is widespread community infection, testing everyone can't be done because there are not enough tests. People with mild illness are simply advised to stay home and isolate. A positive test will not change that.

For people who have severe illness, testing will be done so that the hospital will know whether to isolate them within the hospital. Health care workers may be tested in order to ensure it is safe for them to continue working.

Although it would be useful to know the overall distribution of the virus in the population right now, it is just not possible to do this. This is why we have the shelter-in-place orders. At this point in the epidemic it is most effective to behave as though everyone could be infected, and to reserve the tests for only those people where a positive determination would make a difference in their treatment or deployment.

I think it is the word containment that is confusing. In epidemiology, containment means preventing a disease transition from a small number of people out into the community. The virus is now out in the community, so we are beyond this stage. The strategies for preventing further spread within the general community are different.

This is NOT about loss of hope.

Right - but - this is not the national message being delivered right now. They are still at "everybody who needs a test can get a test" and "we're producing millions of tests" and the drive-through test sites have miles-long lines all over the country.

Here in virus epicenter King County they are still trying to test everybody who thinks they might have been exposed, sick or not. We've obviously had local spread for several months, probably back to December. That's in addition to the social distancing, though our governor has decided for now that a "shelter in place" ordinance is not necessary, people are doing it voluntarily for the most part.

I think this very uneven distribution of health resources and patchwork quilt approach may end up doing a lot of harm. Yes responses have to be tailored to local needs, but in that case it would be helpful if the White House would just say that, and stop talking about anything except how they are getting states and cities what they need.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: mattkime
Date: March 21, 2020 10:12AM
Quote
pdq
Obviously, this has medical repercussions beyond Covid.

My daughter is preggers again, and last time, she was induced ASAP at 36 weeks because our granddaughter suddenly stopped growing (per ultrasound) and had some signs of distress. She nearly came to C-section.

Both mom and baby did okay, but they were obviously keeping an eye on things more closely this time. Now coming up again on 36 weeks, they called her to say they cancelled her scheduled ultrasound and told her to stay home.

> : /

Grandpa doesn’t like that. He doesn’t like that one bit.

I'm very sorry to hear this. I know three expecting couples. One is expecting twins. One of the things that scares me about corona virus is whether normal healthcare services will be unavailable to those in dire need. I hope the doctors made the right choice here.



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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: rjmacs
Date: March 21, 2020 10:23AM
Quote
Lemon Drop
I think this very uneven distribution of health resources and patchwork quilt approach may end up doing a lot of harm. Yes responses have to be tailored to local needs, but in that case it would be helpful if the White House would just say that, and stop talking about anything except how they are getting states and cities what they need.

Ah, but then you'd need an administration focused on the pandemic and public health, not the presidential election in November.



rj
AKA
Vreemac, Moth of the Future
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: pdq
Date: March 21, 2020 10:26AM
Quote
mattkime
Quote
pdq
Obviously, this has medical repercussions beyond Covid.

My daughter is preggers again, and last time, she was induced ASAP at 36 weeks because our granddaughter suddenly stopped growing (per ultrasound) and had some signs of distress. She nearly came to C-section.

Both mom and baby did okay, but they were obviously keeping an eye on things more closely this time. Now coming up again on 36 weeks, they called her to say they cancelled her scheduled ultrasound and told her to stay home.

> : /

Grandpa doesn’t like that. He doesn’t like that one bit.

I'm very sorry to hear this. I know three expecting couples. One is expecting twins. One of the things that scares me about corona virus is whether normal healthcare services will be unavailable to those in dire need. I hope the doctors made the right choice here.

FWIW, Matt, she's in Madison.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 11:13AM
Quote
Ted King
Quote
cbelt3
Eventually we will all get it.

And here I am.
Over 60
Asthmatic
Hypertensive
Diabetic
Type A blood

My main hope is they get an immunization before I get it.

Damn cbelt, I feel for you. I hope you stay safe.

What Ted said. We're in such a vulnerable time.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Janit
Date: March 21, 2020 12:03PM
Quote
rjmacs
Quote
Lemon Drop
I think this very uneven distribution of health resources and patchwork quilt approach may end up doing a lot of harm. Yes responses have to be tailored to local needs, but in that case it would be helpful if the White House would just say that, and stop talking about anything except how they are getting states and cities what they need.

Ah, but then you'd need an administration focused on the pandemic and public health, not the presidential election in November.

Indeed. A competent administration would also be distributing a simplified and coherent epidemiological story to the public that would reassure people that the powers in charge are analyzing every location systematically and taking appropriate action. A competent administration would have had a plan already prepared.

Trump does not have the wits to understand any of this, and his cronies don't seem to care.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: Lemon Drop
Date: March 21, 2020 12:41PM
Quote
Janit


Indeed. A competent administration would also be distributing a simplified and coherent epidemiological story to the public that would reassure people that the powers in charge are analyzing every location systematically and taking appropriate action. A competent administration would have had a plan already prepared.

Trump does not have the wits to understand any of this, and his cronies don't seem to care.

So true.

New York City now sending the same message on testing as LA. And yet from the White House this morning, still crowing about the pathetically low test numbers as if they mean something good. Very mixed message on testing.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: testcase
Date: March 21, 2020 12:43PM
We’re ALL going to die.....................









What, does anybody here really think they’re immortal? eye rolling smiley
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: deckeda
Date: March 21, 2020 10:21PM
Quote
pdq
Obviously, this has medical repercussions beyond Covid.

My daughter is preggers again, and last time, she was induced ASAP at 36 weeks because our granddaughter suddenly stopped growing (per ultrasound) and had some signs of distress. She nearly came to C-section.

Both mom and baby did okay, but they were obviously keeping an eye on things more closely this time. Now coming up again on 36 weeks, they called her to say they cancelled her scheduled ultrasound and told her to stay home.

> : /

Grandpa doesn’t like that. He doesn’t like that one bit.

It makes no sense to set a known medical need aside for a potential one.

Bottom line: They either suspect themselves or your daughter has Covid-19 or will somehow get it before the appointment, without reason or proof of either. Get them to say which it is, point-blank.

Where do they draw the line for things like this? "Sorry 'bout needing that heart bypass surgery buddy, because ya know ... "

Not saying this to make you feel worse, but sometimes an additional chat will sway cooler heads to prevail.
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Re: Los Angeles is giving up on containment , tells docs not to bother with testing
Posted by: RgrF
Date: March 21, 2020 10:50PM
There are known medical needs deemed necessary and other known needs deemed elective, sounds like they labeled your daughter as elective - if they did, that's where you draw your line, that's where the battle will be engaged.
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