COVID-19/corona virus mega thread/prepping thread

[TechMan]

For Ben and Millcreek

[Perd Hapley]

I hope the out-of-state workers put together a class-action suit against New York. It would fall, of course, but the state government should be forced to own what they're doing.

[zxcvbob]

I hope the out-of-state workers put together a class-action suit against New York. It would fall, of course, but the state government should be forced to own what they're doing.

For what, racketeering?  (that would be interesting...)

[Ben]

For Ben and Millcreek

[img]https://i.redd.it/puzqvudhhgx41.jpg

 

[Ben]

https://www.nytimes.com/2020/05/08/upshot/health-jobs-plummeting-virus.html

I wonder if this will be the new normal. From the ambulatory side, I see telemedicine as continuing and growing after the current crisis goes away.

Millcreek (or any of the professional healthcare folks here), what, in your opinion, is the current state of telemedicine? My insurance offers it, but I've never tried it. I'm amenable to it as part of my health care, but don't know much about benefits vs detriments.

[MillCreek]

For Ben and Millcreek

If this was available, we would have it at the hospital and clinics entrances!

[BobR]

Think about you visits to the Dr, did you really need to be there? Now that they can bill the same for a video visit as they do a face to face there isn't much  of a reason to have you come in. I dont see a lot of need to actually see a Dr. in person uses you need them to a actually listen to your lungs or something to make a diagnosis. The VA has been doing telemedicine for a while and it works well.i think the general medical community will embrace it and it will just get better.

Bob

[MillCreek]

Millcreek (or any of the professional healthcare folks here), what, in your opinion, is the current state of telemedicine? My insurance offers it, but I've never tried it. I'm amenable to it as part of my health care, but don't know much about benefits vs detriments.

One interesting thing that has come out of the COVID crisis has been the tremendous upsurge in virtual visits, usually via Zoom or other video messaging platforms. What really got this started is that the Feds said they would pay for it, and then they subsequently said they would pay for it at the same rate as an office visit.  Many of the private payors (Premera, the Blues, Kaiser, etc.) followed suit.  We think that once the nose, and then the body, of the camel is inside the tent, it will be difficult to pull the camel back out.  So we are planning that reimbursement for virtual visits is here to stay.

There are many types of office visits that can be done virtually just as well as you in a gown sitting on the exam table. Obviously not anything requiring a procedure, an immunization or palpating your abdomen or the like, but routine followups, refills of meds, psychotherapy, adjusting meds based on lab values, monitoring of chronic conditions and new onset of minor illnesses (URI, UTI, a rash) can in many cases be done virtually.  We are thinking that maybe up to 50% of primary care visits can be done this way.  

We have been doing them for just over three weeks now and the majority of patients love it.  Especially the elderly who are nervous about coming into the hospital or clinic due to concerns over COVID exposure.  The young techy patients also love it.  They don't have to get dressed up, drive to the office, park, and sit in the waiting room, so it is much more efficient for the patient's time.  Some of the providers like it and others are more 'meh' about it.  

I think if you have the opportunity, you should try it and see how you like it.

[Hawkmoon]

Millcreek (or any of the professional healthcare folks here), what, in your opinion, is the current state of telemedicine? My insurance offers it, but I've never tried it. I'm amenable to it as part of my health care, but don't know much about benefits vs detriments.

I'm not a healthcare professional, but I'm finding the limitations of "telemedicine."

Case 1: My cardiologist. I have a 6-month follow-up appointment for next week. I've been informed that it will be a "virtual" appointment. I don't know what virtual meeting app or program or system his practice uses, but it doesn't matter because I use a desktop computer that doesn't have a microphone and doesn't have a web cam. So it's going to be telephonic.

At every "real" appointment, before I see the doctor they take vitals and run an EKG. Obviously, they can't do that over the phone -- even if I had a web cam. As it happens, a few years ago the VA hospital set me up with a blood pressure machine, which also records pulse rate. And a couple of years ago I bought a pulse oximeter. And I own a scale. So I can take vitals. My cardiologist knows this, because I've shared my personal records with him in the past. Coincidentally (for those who believe in coincidence), not long before the coronavirus arrived I bought from Amazon a "personal EKG." It's a little, hand-held device. It doesn't produce a hospital-grade, 12-lead EKG, but ti does produce a graph, which I can download, print, and forward to the doctor. I showed it to the doc at my last appointment and he thought it was cute. Now he thinks it's great, because I can run EKGs for a day or three before the appointment and upload those along with my vitals, and he'll have something to look at when we talk.

Case 2: I had a call today from one of the doctors at the VA hospital, in response to a question I had left several days ago about a possible injection where I had cut a toe. He wanted to do a virtual appointment. They use an app called Doximity. The deal was that he called on my cell phone, not my home phone. (I didn't know they had my cell phone number -- shame on me for letting them get it.) He said he was going to hang up, send me a message from/through Doximity, and I could tap the message and that was supposed to initiate a face-to-face session in which I could use the phone's camera to let him look at the toe.

He hung up. I received the message. When I tapped it to start the chat session, I was prompted to agree to allow the app to access my phone's camera and microphone. I agreed to both ... and then I got an error message that the app had not been able to access my camera and microphone. I went through this three times, and then I gave up. The doc called back later and I explained that the connection hadn't worked for me. So I used a regular digital camera to take photos of the toe, which I then uploaded through the VA's My HealtheVet system, and he was able to access the photos from that. He then called me back and we were able to finish the discussion.

Bottom line: I'm not at all convinced that telemedicine is ready for prime time.

[MillCreek]

^^^I find this fascinating, since the VA has been one of the leaders in telemedicine for years.  They don't have to worry about getting paid, so they were a very early adopter.  Connecting virtually with the elderly has been our most challenging patient population.

[Doggy Daddy]

^^^I find this fascinating, since the VA has been one of the leaders in telemedicine for years.  They don't have to worry about getting paid, so they were a very early adopter.  Connecting virtually with the elderly has been our most challenging patient population.

Considering that you're referring to Hawkmoon, I suspect it's a paywall problem that he ran into.

[TechMan]

I had a telemedicine visit 2 weeks ago with my dermatologist and it was great.  His nurse contacted me 1 week before and went over all the standard pre-visit questions.  She asked me to take pictures of the areas that is was concerned about and be ready to upload them before the visit through MyChart.  I did as instructed and on the day and time of the appointment, I went into a conference room at work and clicked on a link that I was sent and had my visit.  The doctor reviewed my pictures and told me what he was looking for, which was a thinning of the skin from too much steroid cream.  He didn’t see any in my pictures and from my answers he said I was good, so he authorized my refill.  Overall it was a great visit and I would do it again.

[RoadKingLarry]

My wife had her last appointment with her breast doctor via telemed/webcam. She had to show the boobie on the webcam.  I tease here about being a webcam porn girl now.

[Cliffh]

I like the virtual visit idea.  Both hospitals I go to are over 100mi round trip.

So far I've only had one virtual visit.  It was supposed to have been done via computer (I had to buy a separate mic 'specially for the visit), but wasn't.  The nurse called before the actual visit was to start and tried to get me connected - it didn't work & she didn't know why.  Instead, the doc called the home phone & I put her on speakerphone so DW could listen.  Since it was just a follow-up on a test we were able to finish the visit satisfactorily.

If it's offered again I'll do it.  Beats the hell out of spending 3 to 4 hours in the car.

[Boomhauer]

I’ve been using Teladoc for four years now, work provides it as part of our health benefits. No copay required. It’s AWESOME for routine *expletive deleted*it like getting meds for sinus infections (the main thing I use it for) and the kind of stuff where you pretty much know what you need you just can’t write a prescription for it yourself. I don’t have to take off work for little visits like that and I can have the appointment on my way home from work and pick up the meds at the drive through of the pharmacy in my hometown.

If I have something to show the doc like a weird rash or something I can show them via video. It’s nice and I bet it saves a ton of money. It’s also nice because I can get the consult done at 9pm at night on a Friday. When I was a kid that’s when I always got sick and had to spend a weekend in misery until Monday morning but now I have meds within an hour and usually feel better the next day.

[Hawkmoon]

Considering that you're referring to Hawkmoon, I suspect it's a paywall problem that he ran into.

Probably not too far off.

When I first got this cell phone I read an article on protecting your privacy, and I followed the article's steps through turning off location data and giving apps access to the camera and microphone. (Which wasn't hard, since I don't do apps. If there's an app on my cell phone, it was put there by Verizon.) So it's possible the Doximity app the doctor was using encountered difficulty accessing my camera and microphone even though I tapped the box to authorize it.

I dunno. It's an Android phone (Samsung), and I find Android to be totally baffling. I know Android is supposed to be easy -- for me, it's anything but easy.

- - - - - - - -
For what it's worth, the doc I spoke with mentioned that the hospital will re-open the clinics as of June 1. So I guess the VA thinks the pandemic is somewhat under control. I hope they're right.

[WLJ]

Looks like C19 claimed Roy of Siegfried & Roy. He was 75

https://www.foxnews.com/entertainment/roy-horn-dead-covid-19

[MillCreek]

https://www.nature.com/articles/s41591-020-0820-9

https://www.latimes.com/science/story/2020-05-09/was-the-coronavirus-made-in-a-wuhan-lab-heres-what-the-genetic-evidence-shows

Based upon the current data, there is a growing consensus that the COVID virus mutated naturally in the wild to jump to humans, and it was not engineered in a lab.

[WLJ]

For Ben and Millcreek

Along those lines

    Singapore deploys Spot robot to patrol parks and remind people to socially distance – The Verge https://t.co/sNE9ATI4Pi

    — Rhys Evans (@kebabman) May 8, 2020

IT BEGINS: Singapore is testing out a robot to help enforce social distancing rules
https://twitchy.com/gregp-3534/2020/05/08/it-begins-singapore-is-testing-out-a-robot-to-help-enforce-social-distancing-rules/

[Ben]

https://www.nature.com/articles/s41591-020-0820-9

https://www.latimes.com/science/story/2020-05-09/was-the-coronavirus-made-in-a-wuhan-lab-heres-what-the-genetic-evidence-shows

Based upon the current data, there is a growing consensus that the COVID virus mutated naturally in the wild to jump to humans, and it was not engineered in a lab.

The Nature article specifically states there is no way to prove or disprove the hypothesis.

The LA Times says:

The coronavirus known as SARS-CoV-2, which was isolated from a COVID-19 patient in the U.S. Scientists say there’s no evidence to support the idea that the virus escaped from a Chinese laboratory.(National Institute of Allergy and Infectious Diseases)

Like the virus whose origin it purports to explain, the following conjecture refuses to die: The novel coronavirus was cooked up in a Chinese lab and either escaped or was intentionally released.

There's a difference between "escaped from a lab" and "manufactured in a lab". The intelligence community still seems to think there is credible evidence for one of the many hypotheses out there: That the Chinese were looking at ways to fight a natural bat virus and that bad lab protocols allowed that virus to escape. They could also have been studying natural mutation as well. The virus could still be both a natural mutation and released by humans.

Honestly, the LA Times article reeks of "Chinese virus is racist." Generally, when articles, including scientific articles, include some phrasing of "orange man bad", I look at them skeptically. The reporter could have easily written that article without including Trump bashing. Especially as it was in the Times' "science" section, not the politics section.

[Perd Hapley]

Along those lines

IT BEGINS: Singapore is testing out a robot to help enforce social distancing rules
https://twitchy.com/gregp-3534/2020/05/08/it-begins-singapore-is-testing-out-a-robot-to-help-enforce-social-distancing-rules/

https://www.bizpacreview.com/2020/04/06/surreal-drone-with-speakers-flies-over-manhattan-urging-new-yorkers-to-maintain-social-distancing-905462

[WLJ]

https://www.bizpacreview.com/2020/04/06/surreal-drone-with-speakers-flies-over-manhattan-urging-new-yorkers-to-maintain-social-distancing-905462

[Perd Hapley]

I'm not Steven Crowder's biggest fan, but here is a compilation of him calling attention to the fish-tank-cleaner-killer lady from 3rd April onward. It wasn't until late April that the local police revealed they were investigating it as a possible murder.

https://www.youtube.com/watch?v=9ptTFmzJWfg

[Hawkmoon]

And now we learn that COVID-19 is ... SEXIST!

https://news.trust.org/item/20200510222331-y953v

[charby]

Something is up, Iowa is supposed to be fully open next week, but I'm spending most of this week doing a bunch of social distancing experiments related to my job.