Besides the falsehood of his claim, the irony is that if the US had started testing earlier, the demand for the test wouldn’t have been as great now. The number of infected, or suspected to have been infected, wouldn’t have been so high that it overwhelms our testing abilities due to limited resources of trained personnels and testing materials.
The lesson is, when faced with a fast-spreading disease, you need to act faster. You don’t get a second chance.
Trump wants an early return to work
I question if Trump truly believes this or just has to keep up “positive talk” for the sake of the economy. Stay positive, give the impression this won’t be long so things stay calm. Sort of an “economic mitigation.”
Wondering how this will work for places like the ED. Residents do have knowledge, but they are still in training. Hoping this is a help and not a hindrance to the attending physicians at these hospitals.
In addition, a lot of these new residents need to relocate for their residency programs…meaning finding a place to live, moving, etc. They also need to get licensed and go through some kind of orientation at their residency sites. It’s not like they can just beam up to the next place.
@WayOutWestMom your thoughts?
Do you have a link to something showing this or is it just personal knowledge (that I’m not doubting). I’m just wondering if other med schools in NY are likely to follow suit. With 4th years it’s not really a big deal - they were soon starting residencies anyway. With 3rd years they are missing a whole year+ of hands on/shadowing experience. I can see them helping with some things, esp if they’ve done the rotations for them (like my lad has already had his OB/GYN rotation, etc), but there are a lot of rotations he hasn’t had yet.
Then too, I wonder how this will affect them for matching - will they still be able to do specialties next year or are they all being put into EM or similar?
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@“Cardinal Fang” wrote:
NYU Med School is allowing third year med students to graduate now and become interns.
My dad, Princeton 1945, graduated a year and a half early to go to war, as did many of his classmates. These med students will be doing the same thing.
It looks like NYU offers an accelerated 3 year medical school curriculum. So these third year students will be graduating a month early, not a year early. These students will have completed the national match this month and will be starting their residency training on July 1.
The association of American Medical Colleges - the governing board of US medical schools - has putout a series of directives regarding Covid-19. This is the latest one, which gives advice to the nation’s medical schools regarding the use of medical students in hospital settings during this pandemic.
“Many of our students live in areas where restrictive local or state directives are in place. Our medical students can best contribute to their local and state efforts by fully complying with these restrictive directives. This way, they are help flatten the curve by avoiding getting infected themselves and serving as role models and educators for their families, friends, and communities. Our medical schools are working on ways to include students, within the above-mentioned norms and directives, in nondirect patient-contact activities. Our AAMC guidance continues to strongly support that unless there is a critical health care workforce (HCW) need locally, medical students should not be involved in any direct patient care activities, as detailed in guidance issued by the AAMC on March 17.”
“… this guidance document is intended to add to, but not supersede, an academic medical center’s independent judgment of the immediate needs of its patients and preparation of its students. The medical school dean has the authority and responsibility to make such decisions about medical students; circumstances will vary at each medical school. Schools are advised to consult with their own legal counsel when making these decisions.”
“Current medical students are students, not employees. Although they are on a path to becoming licensed MDs, they are not yet MDs.“
“At this point in the COVID-19 pandemic, our medical students’ participation in direct care of patients with or without known or suspected COVID-19 must be voluntary, not required. Opportunities to volunteer should be offered to students only if there is a critical HCW need for them to do so. Schools must document with their medical students that their participation is purely voluntary for public service or humanitarian reasons only, it will not be compensated, and it will not be considered for any required medical school course credit. The tasks students assume may evolve frequently, and there should not be any constraints on what they do related to fulfilling specific course requirements. To ensure patient and student safety, students must be appropriately supervised at all times by faculty and other health professionals acting within their scope of practice.”
@eastcoascrazy Thanks for the clarification on 3rd years. 4th years doesn’t surprise me. “Normal” 3rd years? My mind was spinning.
The rest you shared we already knew. Time will tell if/how it shifts.
Added to the above information , my own medical student - about to begin his fourth year - was notified yesterday that the next hospital /clinic rotation block (scheduled to begin March 30) has been cancelled for his entire class, and the medical school has instead designed a classroom course to replace those rotations with a four week course “Medical Management of Covid-19”, which will teach evolving best practices and methods, along with the underlying science.
With masks and other PPE in short supply, hospitals cannot afford to have them used by those who are just observing like medical students.
Exactly! Cuomo didn’t shut down soon enough. He is deflecting any possible criticism coming his way by attacking Trump. He was against NYC’s shelter in place order until the case passed way over 1,000 in NYC alone. As I said many times, my state restricted movement when we barely passed 100 cases. My entire state still doesn’t have as many cases as NYC alone but our hair salons were closed a couple of weeks ago. NY closed them only a few days ago as their numbers were shooting to the top way above any other state. I just missed my hair appointment. Now I am walking around looking like a Neanderthal while NYers still have nice hair and scream at Fed. Don’t be pawns to Cuomo.
That’s exactly why med school students and anyone else mainly observing have been switched to other things. At my lad’s school all on site rotations (vs study versions) were cancelled a while ago because they saw it coming. No one there he knows of (at his hospitals/school thinks this thing is being overblown. His info and experience definitely colors my opinion - that and caring for others more than money.
He believes it - he wants it. He saw it on Fox News. Easter is actually 2+ more weeks than what he was saying Monday - which was that we may ‘open up for business’ after the 15 day shutdown is complete (which would be March 31st).
I agree with him that we can’t be shut down forever, but the data needs to inform the decision, and not some arbitrary date right now. If we can get testing completely ramped up and the protective equipment, ventilators, and staff, we can begin a slow ‘power up’ of the economy based on location and the health of each citizen (more vulnerable should stay on lockdown). That may take us to Mid-April, late- April, early May - who knows. Maybe we WILL get some luck after all with anti-virals.
His mistake is giving fake specific figures. Hopefully no one will ever forget the shameful lies he told at the CDC that millions and millions of tests were available for anyone who needed it (that was on Friday March 6th - when he was dressed in his golf clothes since he was on the way to Mar-a-Lago for the weekend - for some big shindigs where a bunch of people were infected with CV). This is not a lie that can be forgiven as ‘Trump being Trump’ or boastfulness. This is a lie that shows that you really can’t believe anything he says.
A problem is that other flus, colds and health issues are not stepping aside to give COVID19 a solo number. You can get a double, triple, how ever many, whammy and the COVID19 can be the deal closer in making a person deathly ill.
I was wondering about hypertension. Talking to family member who was telling me most of the fatalities tended to have other issues in the mix. Not all, rarely anything is “all”, but in addition to medical conditions, there are lifestyle and other issues that can make a person higher risk to succumb to a medical hit. The list can be long and include things that are not considered a big deal or at all.
So even the death figures are not solid as is the case in any epidemic as we look for the involvement of a certain agent. If we are testing all deaths for COVID19 these days, which I doubt we are.
I’d like to see antibody testing out there soon and widespread. Then an increasing segment of the population can get out there. Yes, I know one can be reinfected. Since such tests not being as widely tested as the COVID19 dx tests, hard to say what positive antibodies mean. The possibilities are there, however.
I saw some speculation that the risk factor with hypertension is one class of drug that is used to treat it. ACE inhibitors supposedly could allow deeper penetration of the virus into the lungs. I have no idea if this is true, but people on drugs like lisinopril might want to look into whether it would make sense to use a different class of drug. It is not obvious to me why high blood pressure alone would be a problem, assuming no other cardiovascular problems that would inhibit circulation and/or removal of fluid from lungs, but I am not a doctor…
How many people over 70 don’t have either or some of these factors - high blood pressure, diabetes, and heart disease (is that defined as someone on cholesterol medication)? I believe those are the 3 conditions being mentioned as the most common combination in fatalities.
There is a lot of talk about Italians and smoking - making their population more susceptible, but I haven’t actually seen that in any medical press. My understanding is that obesity (very common here, not so much in Italy) is also a factor. So they may cancel each other out when comparing figures of underlying risk from Italy to US.
China and the United States are very similar in terms of diabetes prevalence. I think the US is slightly higher, but not by much.
ETA: for example, see here: https://www.indexmundi.com/facts/indicators/SH.STA.DIAB.ZS/rankings
One of my kids has type 1 diabetes, and is 30. I can’t find any info on elevation of risk for younger type 1’s. Blood sugars triple with illness but with pump and CGM, that can be manageable. The scary thing is whether hospitals will allow the devices (docs and nurses aren’t trained in type 1) and who would manage it if/when a type 1 is not able to self-manage. In the past I have managed my kid in the hospital but I would not be allowed in. I can get her blood sugars on my phone and could advise them but doubt that would be allowed either. Thinking too much about this. My kid is 3,000 miles away.
I wonder if Trump is setting things up so that the states refuse to ease up restrictions, in which case he can blame economic impact on governors.
@dietz199 wrote:
That article you linked was written by Betsy McCaughey. She was big on the Trump campaign. Not to say that the article may or may not be completely or partially inaccurate, but I would pass on anything written by John Podesta, Steve Bannon, Betsy McCaughey etc., due to it likely being at least suspiciously tainted by personal biases.
I wish the media would be more judicious with our headlines and characterizations.
Trump backed drug… the widely used and discussed drug combo from French researchers. Being used in hospitals here and around the world right now to save lives . Good lord.
This is a really interesting day by day comparison of Michigan and Ohio actions including when schools and colleges closed etc. I live in Michigan but have been “sheltered in place” and working from home since March 13.
https://www.cleveland.com/news/2020/03/compare-coronavirus-cases-in-ohio-michigan.html
https://www.cnn.com/2020/03/25/health/coronavirus-state-actions-wednesday/index.html
Our own CDC is sadly missing in action. Does anyone know who Robert Redfield is?