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28 Nov, 4 tweets, 1 min read
That is a really interesting question, and I don’t know the answer, but I am going to guess. I think it is artifactual, rather than natural. If I understand correctly, deaths go through a review process by the state epidemiologists before reporting and my guess is that may lead
to batching. The dates are not marked, but if you start at the end - Nov. 27 and work your way backward, it appears that the low points are likely weekend days. Then if you look at the pattern, it appears that it is 5 days of much higher numbers followed by 2 days of lower
numbers - weekdays vs. weekends? My guess is that the epidemiologists and their teams just review fewer cases on the weekends (we all need a break). Alternatively, if that is not the explanation, then I would guess it is a reporting issue, where fewer health care providers who
report deaths have staff over the weekends to make those reports. Cases don’t get this level of review and get reported in a more automated fashion by labs that do operate on the weekends, so, I think that is why cases don’t show this exact pattern.

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Dr. David Pate Profile picture
29 Nov
From my interview last Wednesday on @IdahoMatters on @KBSX915:

MICHAEL: We wanted to first talk about a letter circulating by Dr. Jim Souza of St. Luke's, in fact, you addressed this during Leadership Boise last week with Dr. Souza at the meeting. He talks about how their
modeling predicts in December our hospital systems will be at the brink. He writes, quote, "The full spectrum of care will not be available to everyone if we are resource-constrained." So even though it may seem obvious to you, explain to us, because bone doctors work on bones,
ENTs work on ears. Why would hospitals treating a pandemic surge mean these other types of health services might be denied?

PATE: Yeah, Tom, this is really an important point, and I suspect few Idahoans really understand the gravity of the situation. So what happens is that if a
Read 15 tweets
Dr. David Pate Profile picture
28 Nov
It is a bit hard to say without understanding the exact kind of work you do and interactions with others, but here is some general stuff.
1. Are you sure there is no way to require people that are going to be coming into your office to wear masks? This is your biggest risk.
2. Time and distance will be another issue. If the people you interact with really can’t be forced to wear masks, I would try to put as much distance between you and them and make your interaction as brief as possible.
3. The plexiglass will help a little with droplet
transmission, but won’t likely be any help with airborne transmission. We just had a case of suite mates infected when 20 feet from each other, but in the same office without masks. Obviously, this was airborne transmission, not droplet.
4. @TScofi just replied as to a
Read 4 tweets
Dr. David Pate Profile picture
27 Nov
Thank you! You should have followed your dream. I used to pass out every time I would go into a hospital. In high school, for career day, it was me and 24 girls, who went to the hospital. They took us to the NICU and I saw a baby with a gastroschisis. I passed out, and
unfortunately, none of the girls did. My parents tried to suggest maybe I wasn’t cut out for medicine. So, in college, I volunteered at a hospital and asked them to put me in the grossest place they have. They put me in the SICU. It was where I met my future wife- she was a nurse
in that unit. Finally, I stopped passing out after my first year in medical school when we went to the urology unit. You know how they say on the tv ads for ED medications that if you experience an erection lasting more than three hours, you should call your doctor? Well, you
Read 4 tweets
Dr. David Pate Profile picture
27 Nov
Thank you for this question, because I want to correct this assumption. I am not at all suggesting that the only way that teachers could be infected outside of school is by not being careful. We see the same thing in health care. While some health care workers definitely were
infected at work, especially early on in the pandemic, it is far less common and in fact, most infections in health care workers are in the community rather than in hospitals. There are plenty of ways health care workers and teachers can be infected, even when trying to follow
public health guidance. The biggest risk is families. The teacher may be very careful, but have a spouse who is an essential worker who is infected through work and then infect the teacher. Many teachers are also parents of older children who, and though the teacher is being,
Read 7 tweets
Dr. David Pate Profile picture
26 Nov
I take it to mean that there are people who will not survive, but because hospitals are being overwhelmed and the other facilities/services we normally would use - nursing home, hospice, etc. are also being overwhelmed or not accepting these patients, we are having to provide
these services at home. It is yet another sign in addition to hospitals pausing non-emergency services, hospitals on contingency status, at least one hospital on diversion status, calling up the National Guard to help provide additional manpower to hospitals, calling up the
Medical Reserve Corps, asking for retired health care workers to consider returning to the work force, some medical clinics closing because they cannot be staffed with all the health care workers out in isolation or quarantine, etc. that indicate that my prediction that we are
Read 5 tweets
Dr. David Pate Profile picture
8 Nov
Great question. Complicated answer. We know distancing and wearing masks work to prevent the spread of this virus. In the schools that do this conscientiously, even if not perfectly, we’re generally mot having problems. But, I think the community spread is getting so high, and
with the emergence of the
normal respiratory and influenza viruses, I am getting concerned and watching the school data carefully. I fear we could see a change in the transmission characteristics. I am getting to the point of considering whether we are getting to the point that
all extra-curricular activities that can’t be conducted virtually may need to be paused. I am particularly agonizing over kids in special education and those with mask exemptions. For right now, I think I can say for the moment, yes, but if things continue to get worse, my answer
Read 4 tweets

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