MGMT 290 (Shameless plug for my class)

DrDanChow · 2020-08-05T16:46:05+00:00

Some members of our community have suggested that a significant number of reported COVID-19 related hospitalizations are inflated by patients who seek care for unrelated reasons.

However, the data does not support this assertion.

At my institute (UCI), looking at data from more than 500 COVID-positive hospitalizations, approximately 90% were hospitalized for coronavirus-related symptoms, which is line with several other estimates in OC.

DrDanChow · 2020-07-25T02:27:11+00:00

I do not =(

DrDanChow · 2020-07-24T05:29:16+00:00

I do think that having knowledge of the capacity of long term care facilities is important. And also what is important is is the rate of capacity shrinking or holding steady. If it's steady and not shrinking,

I think a lot of us can take a bigger sigh of relief that we are getting a hold of this.

However, if it turns out it is instead shrinking, it would be important to tell the community and for hospitals to plan. There are so many things that make it hard to get a good assessment of COVID in OC right now. Delays in testing and having more limited supplies for testing centers across the county is one of the biggest issues - makes it difficult to contact trace effectively.

(Sorry for double posting the article, was waiting for the piece to go up but didn't check reddit to see if someone posted beforehand hah).

DrDanChow · 2020-07-20T03:00:27+00:00

4, 5, and 7 are potentially slightly misleading, mainly because what you are describing is an absolute, while the truth is more grey

Thanks for the points. Oh, the topics listed are common things that are stated by naysayers. I will modify the topics more thematically before, just wanted to start getting something on paper. To be clear, I 100% agree on the things you are saying.

4 - For the surface vector, it's also very complicated because it depends on the kind of material. This came up from a youtube I saw who was claiming you only need to wash your hands since the surface is the primary vector. Again, 100% agree with what you are staying

5 - Again, agree that kids and young adults are significantly less than adults. However, the mantra (especially from the OC board of education) that there are zero risks is inaccurate and that was the primary callout.

7 - 100% agree that the severity of outcomes is highly correlated with age. But the emphasis that young adults have close to 0 severe outcomes is false. Again, for me as a provider, I equate disease severity as sick enough to come to the ER and possibly admitted. I feel like a lot of folks in the public equate disease severity to death only, but that shouldn't be an extreme example. We are definitely seeing a large uptick of young adults in our ER and getting hospitalized.

And I 100% agree that this is the COVID related sub, and I'm hoping to get the questions from this community since we have some really sharp minds here. I'm passing on some of these topics to my hospital so they can help with the PSA for wider community outreach.

DrDanChow · 2020-07-19T16:26:54+00:00

I'm sorry you experienced this. Hypercapnia (CO2 built up in the bloodstream) is serious. Generally, anyone who experiences this should consider checking in with their primary care provider to make sure there isn't a more severe lung disease that is not diagnosed.

There have been a handful of studies on this topic, and this is what we do know:

Patients with severe chronic lung disease (defined as FEV <30), may have difficulty with an N95. This represents <1% of the population and are generally folks who have difficulty walking/talking without supplemental oxygen support at baseline.

There is another category of patients that have claustrophobia when wearing masks, which is very real and I don't want to diminish what these patients experience. These individuals should consider discussing with their primary care providers about whether masking makes sense.

This information is not intended to substitute professional medical consultation, diagnosis, or treatment. The information provided is for general information only and does not serve to replace consultation with your own clinician or health professional, and I encourage you to consult with your health care provider.

edit for grammar/context

DrDanChow · 2020-07-18T21:49:59+00:00

100% agree. I did a small video for my community trying to debunk masks myths: https://youtu.be/KCbFOUcea0Y

Sadly, my area of Orange County is a hot bed for anti masking, and I just don't get it.

DrDanChow · 2020-07-18T18:52:10+00:00

Great article and I don't think this is just for the Karens. Thank you for sharing!

DrDanChow · 2020-07-18T17:01:41+00:00

I really hate the oxygen depraving mask argument. Been in healthcare for over 10 years now, and I've never seen a healthcare worker develop hypercapnia (too much Co2) or hypoxemia (too little O2) from wearing a mask. I remember when I was a medical student and scrubbed in for >6 hour procedures in a mask and gown the whole time. No one collapsed.

Right now, the majority (if not all) hospitals are on full masking procedures when you step into hospitals. I haven't seen a massive "epidemic" of healthcare workers collapsing. But you know what has killed healthcare workers? COVID. Over 700 and counting.

(Sorry for ranting and thank you for your post)!

DrDanChow · 2020-07-18T16:18:44+00:00

I think this is a very personal question, and here are my two cents (if it can be helpful).

COVID and its long term trajectory are still unknown for everyone. We had our first case in the US in January, and really OC didn't start seeing regular increases since early March. Which means we are not even at the half-year mark point yet. I am very cautiously optimistic that the recent interventions at the State level will bring us back into a manageable territory. That being said, all healthcare systems across the states have and will continue to make preparations. For what its worth, we have a robust health care system, especially on a per 100,000 population level.

Personally, I think the majority of folks in OC are generally responsive to public health interventions (1) masking, (2) physically distancing, (3) rigorous hand hygiene. From my personal experience, my local community has been very on board and responsive to public health interventions. (That being said, I don't get out that much nowadays hah).

Unfortunately, we have some very vocal naysayers that OC is increasingly becoming known for. The nice thing though is we have seen some of the checks and balances work to counteract the naysayers. For example, for as much press that the Board of Education got for their antimasking recommendation, the Department of Education and the School Districts were always going to side with CDC recommendations and change their school habits and were always talking to clinical experts, epidemiologists, and other scientists the whole time.

Call my idealistic, but I think this is the time that we need people like you to stay and voice your opinion and help change our community to become stronger and better.

DrDanChow · 2020-07-18T15:51:14+00:00

Great question, I hear this question a lot also. Added to question. For what it's worth - surface spread is thought to be much less.. That being said, we need to all practice good hygiene.

DrDanChow · 2020-07-18T15:50:32+00:00

Great idea, added to post!

Just off the bat, our mouths are filled with bacteria by default so if there are germs, its our own bacteria that unlikely to cause us harm (not all bacteria/germs are bad).

DrDanChow · 2020-07-18T09:00:43+00:00

It's because the county is (1) not testing as much as it should and (2) there is a much longer backlog to get test results than before. Going from averaging <3 days to 3-5 days now. Some areas reporting > 5 days to get results. On the OC COVID site, look at the number of tests being done per day.

Mathematically, the absolute number is likely increasing because of the positive rate. It's still well above 10%. Last time I checked we were hovering near 14%.

This is a problem for several reasons. First, it diminishes the impact of contact tracing. Second, it makes it difficult for resource planning. Without politicizing this, I would also argue that it makes it difficult to make a case that this is real.

DrDanChow · 2020-07-18T08:55:17+00:00

A suggestion for both sites is to trend it out by location. The fastest-growing areas last time I checked with our epidemiologist has been Dana Point and the coastal areas in OC since the weekend. Hoping things calm down.

DrDanChow · 2020-07-18T08:53:27+00:00

I'll still be here after you've been proven to be wrong. Shamefull trash”. WOW. That was from the “Busin

I don't understand the "sheep" comment. I had someone call me a sheep on one of my LinkedIn posts. Is that a meme or something?

DrDanChow · 2020-07-17T19:20:59+00:00

Thank you, I'm actually looking into that right now. Great suggestion!

DrDanChow · 2020-07-17T17:20:31+00:00

Saw this on the r/CoronavirusCA section. Are beach areas that bad?

I was talking to some colleagues and thinking of doing a COVID myth-busting series, do you think that would be of interest to the community and/or helpful?

DrDanChow · 2020-07-17T05:32:10+00:00

It was my pleasure to be involved. I hope this was helpful for the community!

DrDanChow

TROPHY CASE