I thought I would combine this thread as I don't want to dilute this forum.
Just wanted to throw out some thoughts and also mention that it gets confusing because not only is so much information being thrown at us. Many times it changes every day. And, it doesn't change just because there is a change in the Covid-19 situation. It's because in many cases, they don't know what they are doing -- understandably so to some degree.
At first, we were seeing patients with cough and/or fever. But, we only do telemedine now. Sometimes the story changes, and I will see them after a temperature is normal and the cough is mild. We do NOT do any swabs of any kind. If it looks like strep, it gets penicillin. Influenza A and B are waning, but if they want Tamiflu, here you go. I will do RSV on an infant under six months, but that is waning also.
Do I feel bad about it? No f......n way. The CDC of the state of Maine has N95 masks, gowns, goggles and shields. They have gloves. But, they will not give them to healthcare workers or doctors because they are being rationed to:
Hospital employees, ED workers, firemen, policemen and EMT. Ok, I get EMT and ED. EMT probably gets the closest to patients who may have the virus and they come in intimate contact. Police? Are you saying that police come into contact with the virus more than we do? WTF. And, firemen. Now some firemen do EMT work, but a lot just fight fires. I am guessing when they go into a burning building they aren't too worried about Covid-19. Plus, their respirators look a little better than the N95s. If you have cough and fever, you go to the ED. When the ED or state complains, then send me PPE.
And, while you are at it, maybe a little appreciation. I was trying to keep patients out of the ED. Now, I couldn't care less. And, I don't mean the governors and CMS who are helping tremendously with Telehealth. Just the overall feeling of the above.
And, don't forget we can't test patients. We aren't allowed. I hear stories here about drive-through testing. There should be a sign. Hello automobile inhabitants. If you are on a ventilator or hospitalized or you are wearing an orange jump suit, then no need to stop.
On Humira? Who cares? On Methotrexate? Who cares. On Vincristine? Sure, we will stick this swab up your nose and hey we will even send it to the state lab. Good luck getting it run. Probably by day 14 if the specimen is still good.
But, you can always do like VP Pence. You can do your own test. How? He explained it on national TV. Just stick this swab in your nose. I guess you can do the req and the label and put it in the media yourself. Still won't get run.
That's why we don't have numbers. We don't need no stinkin' numbers. It's pretty easy to count those on ventilators and in hospital wards. And, count the inmates and multiply by a certain number.
What really pisses me off is I call the CDC and they say how many N95s do you want? How many gowns? A week later nothing. So, I call. Oh you have to go online and fill out the form. So, I do, and I order what I need. I get an email a week later. We looked at your order. Unfortunately at this time, we can only send to ED doctors, hospital employees, policemen and firemen. But, maybe later. If we remember you.
And, only Bert would do this. But, when there was a complete shortage of testing kits, I emailed the NYT at their hotline for stories and I WhatsApped the Washington Post. Yes, they monitor that. Just thought it would be interesting to look into we had no kits in Washington, yet I had over 150 testing kits at my office. Only I can't use them. Thought it would be interesting to look into.
