Thoughts on #COVID19 after a busy telehealth shift:
1. Vast majority of folks very low risk, mostly want to know if they need to change their behavior.
The answer is YES. We will all have to change our habits- if we haven't already- to mitigate spread of disease.
1/x thread
1. Vast majority of folks very low risk, mostly want to know if they need to change their behavior.
The answer is YES. We will all have to change our habits- if we haven't already- to mitigate spread of disease.
1/x thread
2. Many want to know whether to avoid & protect loved ones. Again, answer is YES, regardless of testing. If u have any symptoms of contagious illness, stay home, isolate yourself & for goodness sake do not spend time with anyone age 60+ or w/ underlying health conditions
2/x
2/x
... REGARDLESS of whether you've been tested. I know it's inconvenient.
Inconvenience is better than serious illness.
3. If ur sick & well enough to be at home **even if you have COVID/ traveled to CDC Level 2/3 region/ had a known COVID contact** we will still send u home 3/x
Inconvenience is better than serious illness.
3. If ur sick & well enough to be at home **even if you have COVID/ traveled to CDC Level 2/3 region/ had a known COVID contact** we will still send u home 3/x
Q: "But I'm sick, why shouldn't I seek care?"
A: to reduce likelihood of getting COVID if u don't have it already (up to 50% of 2003 SARS transmitted in health care settings) & to ensure front-line health care workers (RNs, docs, EMTs) can care for seriously ill loved ones
4/x
A: to reduce likelihood of getting COVID if u don't have it already (up to 50% of 2003 SARS transmitted in health care settings) & to ensure front-line health care workers (RNs, docs, EMTs) can care for seriously ill loved ones
4/x
4. Ideally we'd have testing centers separate from ERs for those with mild illness BUT we do not right now, so don't come in unless you are having difficulty breathing/ aren't acting right.
If you are not sure please speak to an ER doc virtually: mountsinai.org/appointment/te…
5/x
If you are not sure please speak to an ER doc virtually: mountsinai.org/appointment/te…
5/x
Last, not least.
Dear employers: please STOP requiring documentation for people to stay home/ work from home. People know when they're sick and shouldn't be at work, and it's a poor use of health care resources (in general, but particularly in an outbreak situation
Fin 6/6
Dear employers: please STOP requiring documentation for people to stay home/ work from home. People know when they're sick and shouldn't be at work, and it's a poor use of health care resources (in general, but particularly in an outbreak situation
Fin 6/6
More Q&A
Q-Why not test everyone?
A-Negative tests do NOT mean resume life as usual. Major limitation= detectable viral load, which takes UP TO 5 DAYS after symptom onset. Stay home & avoid older/ ill/ pregnant folks, u still have contagious illness
medrxiv.org/content/10.110… 7/x
Q-Why not test everyone?
A-Negative tests do NOT mean resume life as usual. Major limitation= detectable viral load, which takes UP TO 5 DAYS after symptom onset. Stay home & avoid older/ ill/ pregnant folks, u still have contagious illness
medrxiv.org/content/10.110… 7/x
That said, assuming sufficient viral load, the test appears to be quite sensitive & specific as per terrific podcast w Dr Fauci @NIAIDNews @JAMA_current edhub.ama-assn.org/jn-learning/vi…
In other words, if positive, you definitely have it
8/x
In other words, if positive, you definitely have it
8/x
Q: social distancing seems pointless, "I'm young & healthy, can't I just get it over with?"
A: Goal is to reduce rate of spread & "flatten curve" so healthcare system has capacity to care for seriously ill
Grandma has better shot at surviving if u get sick in July vs today 9/x
A: Goal is to reduce rate of spread & "flatten curve" so healthcare system has capacity to care for seriously ill
Grandma has better shot at surviving if u get sick in July vs today 9/x
Median incubation= 5.1 days, 97% have symptoms in 11 days. A 14-day quarantine period will still miss a handful (0.5%) but mostly lower risk cases, so probably on target.
I'm going to postpone seeing my 60+yo parents 14 days after my last ER shift
annals.org/aim/fullarticl…
10/x
I'm going to postpone seeing my 60+yo parents 14 days after my last ER shift
annals.org/aim/fullarticl…
10/x
Thus, if you feel sick AT ALL, please isolate yourself for 14 days
1st point of contact should be mountsinai.org/appointment/te…
Do not call 911 unless you feel short of breath walking across room & even then consider telehealth so we can give our coworkers a heads up. THANKS!
11/11
1st point of contact should be mountsinai.org/appointment/te…
Do not call 911 unless you feel short of breath walking across room & even then consider telehealth so we can give our coworkers a heads up. THANKS!
11/11
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