Post from an Infectious Disease MD

[WinterBorn]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

 

[WinterBorn]

Below are the guidelines referred to by Dr. Ketterer in the post above.


"
Coronavirus Q+A with Doctor Dan Ketterer (Version 4.1, updated 4/7/20)

My name is Dr. Daniel Ketterer, and I am an Infectious Disease physician practicing in Atlanta, Georgia. My purpose in writing this guide is to address some of the most pertinent questions regarding SARS-CoV-2 / COVID-19, and to provide guidance for what you can do to help your family and society.


This guide is for educational purposes, and is designed to be a primer on SARS-CoV-2/COVID-19 for the layperson. It is not intended to provide individualized medical advice or replace the advice of your physician. This guide features Level 1 and Level 2 learning. Each question will have a concise and correct Level 1 answer. On some questions, there will be a link to the Level 2 explanation after the Level 1 response. Level 2 responses will be longer and more detailed, but no less essential. If you have time, try to read the Level 2 explanations. By breaking the guide up in this way, I can get the most important points for a variety of topics quickly, and the rationale behind my statements and opportunities to learn will also be available to those interested.

This guide is as current as of the revision date above. Science changes with new information, and I recommend regularly reviewing WHO, NIH, and CDC and your local health department websites.
https://www.who.int/health-topics/coronavirus
https://www.nih.gov/coronavirus
https://www.cdc.gov/coronavirus/2019-ncov/index.html

Please share this guide on Facebook by hitting the “Share” button below this post. As I update the guide in the future, the shared posts will also automatically update so you are sharing the most current version at all times. If you have friends with large social-media footprints, or friends with access to celebrities, encourage them to read and share this guide.
I will not be able to respond to questions posted either in the comments or via messenger. If you think you are experiencing symptoms of COVID-19 contact your physicians office via phone or telemedicine routes or call 911 if you are experiencing shortness of breath.
I am also OK with re-posting this guide on other social media platforms or websites with a few caveats. Please copy the entire guide and make sure to update it as new versions come out. Also, please do not monetize it in any way. Everyone involved in this project is a volunteer that cares about saving lives through education, and this message is too important to have motivations questioned.
Follow me on Twitter @PusDoctor

With education and a rational, evidence-based approach, we will save lives together.
Daniel Ketterer M.D.
--- /--/-?
Coronaviruses are a large family of viruses primarily found in animals, but some can also infect humans. There are 7 known coronavirus strains that infect humans: 4 cause a cold-like illness, and 3 have caused more serious illnesses.
The 3 known to cause serious illness are:
SARS-CoV-1, the virus that caused the 2003-2004 Severe Acute Respiratory Syndrome (SARS) outbreak
SARS-CoV-2, the virus that causes Coronavirus Disease of 2019, also known as COVID-19
MERS-CoV, the virus that causes Middle Eastern Respiratory Syndrome
Using HIV as an analogy:
HIV is the virus that can cause the clinical syndrome known as AIDS; likewise, SARS-CoV-2 is the virus that can cause the clinical syndrome known as COVID-19.

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COVID-19 is different and much more serious than seasonal influenza.
Unlike seasonal influenza:
There are no approved treatments for COVID-19.
There is no protective vaccine for SARS-CoV-2 available yet.
There is no herd immunity (a large percentage of the population being immune to a disease) to help limit the virus from being spread broadly.
The probability of developing severe lung disease (called Acute Respiratory Distress Syndrome or ARDS), multi-organ failure, heart attacks, and dying is higher with SARS-CoV-2.

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The two most common initial symptoms are fever and cough. Less common initial symptoms include: diarrhea, fatigue, abdominal pain, loss of smell, muscle or joint aches, and headaches.

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The average has been 5-6 days with a range of 2-14 days. This is why those potentially exposed are being asked to self-quarantine for 14 days.

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Unfortunately, some of the symptoms of seasonal allergies can mimic COVID-19. However, there are some useful (but not 100% conclusive) aspects to consider:
1)Have you had prolonged close contact exposure (i.e. a family member in the same household) with an individual with known COVID-19? If so, this increases the likelihood one’s symptoms are due to COVID-19.
2)Fever over 100.4 ℉/38℃ is a very common symptom of COVID-19, but an infrequent symptom of seasonal allergies.
3)If antihistamines relieve your symptoms, this is more suggestive that your symptoms are due to allergies.
Ultimately, none of the three above tips are entirely foolproof, and social distancing and testing are still advised.

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No. This is why testing for COVID-19 often also involves influenza and other viral illness testing.

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The majority of cases are spread 2 ways:
:
This is the primary method the virus is spread. This means the infectious virus particles found in the respiratory secretions of those infected with SARS-CoV-2 are being transmitted when in close contact with an uninfected person. If these secretions get in the mouth, nose, or eyes of an uninfected person, they can be infected. Specific activities responsible for droplet transmission include:
--Sneezing
--Coughing
--Kissing
--Talking to or breathing on someone (if within very close range)
:
Fomite transmission means an environmental surface gets contaminated with virus from an infected person’s respiratory droplets, an uninfected person touches that surface, then touches their mouth, nose, or eyes. An example of fomite transmission would be an uninfected person touching a tissue someone with COVID-19 recently sneezed into, and then that uninfected person touching their mouth, nose, or eyes.
Of note, this is thought to be a possibility of infectious spread, but likely much less so than droplet respiratory transmission.
For Level 2 information on close contacts and fomite transmission, click this link:
bit.ly/Level2CCfomite

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. Infectious viral shedding of SARS-CoV-2 has been detected 24-48 hours before symptom onset. On average, symptoms start 5-6 days after exposure, but can range from 2-14 days. This is why it is important to undergo a 2-week self-quarantine after a high-risk exposure, and also why many states are now imposing shelter-in-place orders. These steps help limit the spread of infection that can occur before someone shows symptoms.

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The CDC estimates that somewhere between 5-13% of new COVID-19 infections occurred from - individuals. Pre-symptomatic transmission means an individual is infected with the virus and infecting others, but has not yet had any symptoms of COVID-19. This typically occurs in the first week after being exposed.
implies a person is infected with SARS-CoV-2 and does not develop any symptoms of COVID-19 at any point, but is still spreading the virus. This is uncommon, and is thought to account for 1-3% of cases of COVID-19.

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There is no evidence at this time to suggest any cases have been due to airborne transmission.
A very detailed Level 2 explanation on airborne transmission and infectious dose, and why it is critical to understand how this virus is transmitted, can be found here:
bit.ly/Level2airborne

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Check your state and local guidance to see if mask wearing is encouraged.
Those working in healthcare facilities should wear masks while at work.
Social distancing of a minimum of 6 feet while in the community should be your primary method to prevent transmission, and reduce pre-symptomatic and asymptomatic spread of the virus.
Level 2 discussion on mask use can be found here: bit.ly/Level2masks

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No. See bit.ly/Level2airborne

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The probability of infection is extremely low outside due to the larger volume of air and wind. Regardless, employ social distancing at all times in the community.
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The outcome depends on multiple factors, namely if you are at high risk for severe disease, i.e. those with advanced age (over 60), congestive heart failure, structural lung diseases like COPD or asthma, hypertension, immunocompromised or requiring immunosuppressive medications, diabetes, or pregnant. For the cases from China, 80% of those with the virus had mild illness and recovered, 14% developed severe disease (pneumonia, breathing issues) requiring hospitalization, and 5-6% developed critical disease like ARDS, organ failure, or heart attacks, requiring ventilators and other critical support interventions in the ICU.
The biggest predictive value for severe disease and death is age over 60. Young to middle-aged adults without the above health problems are more likely to only have mild disease and more likely to recover from pneumonia or ARDS. Children also tend to get milder disease (see below).
Most individuals that get infected can spread the disease for up to 7-12 days after the onset of symptoms, but the highest likelihood of infecting others is in the first few days after symptoms start.
On average, people with mild illnesses, such as those with isolated fever and cough, can expect to take 2 weeks to fully recover. Those with more severe illness, such as pneumonia, breathing difficulties, ARDS or heart involvement, can take 3-6 weeks to fully recover if they do not worsen to the point of critical illness or death.
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It is recommended that until we have large scale testing kit availability a way to test people without putting uninfected persons at risk, those with mild symptoms (fever, cough), and who do not have the high-risk factors mentioned in the previous question should stay at home and self-quarantine.
Testing ability has increased in many major cities, but some areas are still struggling with demand. If you are concerned that you or a loved one may have COVID-19, and have risk factors for severe disease, I recommend contacting your physician’s office to set up a telemedicine appointment to see if you should be screened for COVID-19.
Individuals in high risk fields for both acquisition and transmission (such as health care workers), should also consider testing if they become symptomatic. Finally,those with worsening shortness of breath symptoms or high risk of developing severe disease should seek testing.

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There are now 2 methods being utilized for testing:
The first involves testing for the genetic material of the virus from swabs of the nose and throat.
The second is a blood test to see if you have been exposed.
Level 2 discussion on the two methods of testing can be found here: bit.ly/Level2testing

--- ?
The swab and blood test, if positive, confirms that a person has been infected with the virus.
However, both tests can be falsely-negative early in the disease, usually before symptoms start.
See Level 2 discussion on limitations of tests here: bit.ly/Level2limitations

--- “ ” , “ ”?
is typically performed by your local health department to identify people that may be spreading the virus and those they may have infected. Those potentially infected by a known COVID-19 patient are contacted and told to monitor for symptoms and self-quarantine.
However, if the number of COVID-19 cases overwhelms the resources of the health department, they will not be able to utilize their limited resources for contact tracing. This is where “flattening the curve” comes in. means using measures like social distancing, shelter-in-place, and working from home to reduce the total number of COVID-19 cases at any given time. Doing this has two major benefits:
1)Health departments effectively contact trace cases and reduce further spread.
2)The hospital system is less likely to be overwhelmed by a large number of COVID-19 patients presenting at the same time. Since the number of health care workers and tools we need to effectively take care of COVID-19 patients is limited, by spreading out the infections over time, we can reduce the likelihood of running out of essential supplies and treatments.
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There are recommended medications right now for SARS-CoV-2/COVID-19. All medications currently being used are being used on an experimental and compassionate-use basis and do not have robust clinical trial data to show efficacy against COVID-19.
This includes treatments that have been touted in the media to be effective against SARS-CoV-2 such as chloroquine/hydroxychloroquine, remdesivir, and IL-6 blockers like tocilizumab.
Many medications have shown potential to stop the virus in laboratory settings, but this does not always reflect how well a drug will do at stopping an infection in the body.
Additionally, hoarding of these medications has occurred, limiting the ability to use them on severe COVID-19 patients for clinical trials. Some people using these medications without physician guidance have developed toxicities or died.
As treatment guidelines are developed, I will update the guide with their recommendations.

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The first vaccine against SARS-CoV-2 went into human testing on 3/16.
However, this vaccine has to be tested extensively for safety and manufactured on a large scale. The earliest a vaccine is expected is in the first half of 2021.
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If you were either:
1)Exposed in the last 4 days to a COVID-19 positive individual
2)Tested positive for COVID-19 and have had symptoms for less than or equal to 4 days
You may be eligible to enroll in a medication study conducted by the University of Minnesota in which you are sent hydroxychloroquine or placebo.
For details and to sign up for this clinical trial, please visit https://covidpep.umn.edu
Medication trials like this one are how researchers will determine which treatments are effective for COVID-19.

--- -, -?
Early in the pandemic, the risk of family members getting COVID-19 was about 10%. However, by utilizing social distancing, mask wearing for the sick, and cleaning surfaces, the risk of a family member getting COVID-19 drops to about 3%.
This is why it is absolutely critical to have a plan ready based on guidance from the CDC, WHO, and NIH on how to care for sick individuals in case a family member gets COVID-19.
https://www.cdc.gov/…/down…/COVID19_FAQ_HouseholdReady-H.pdf
https://www.cdc.gov/coronavirus/…/if-you-are-sick/index.html
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This result depends on your employer's guidelines and advice from your physician.
Guidance on criteria for returning to work will update based on testing availability, particularly if the rapid blood testing is widely available and if it is shown we develop protective immunity after exposure.
The CDC does provide some guidance on this, but please note, the link below is intended for healthcare providers as the intended audience.
https://www.cdc.gov/…/2019-ncov/hcp/disposition-in-home-pat…

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Soap and water is very effective against the virus and can be used for hand hygiene and for cleaning surfaces.
Additionally, you can make your own bleach wipes at home using the following recipe:
Mix 1/3 cup of bleach per gallon of water. You can then use paper towels soaked in the solution to make your own disinfectant wipes. Always remember to use gloves and wear eye protection for splashes, and to only use in well-ventilated spaces.

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There is no evidence at this time to suggest that this virus reactivates after one recovers from infection.

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This is very unlikely to occur. See the link for more information: bit.ly/Level2Pets

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Yes. Those under 20 years old typically only develop a mild flu-like illness, and are much less likely to progress to severe disease or die. This may be due to how their immune system responds to infections.
The most important thing to remember if you are in a household with anyone under the age of 20 is that they are just as likely as adults to get infected with the virus. They can then spread the virus to people that have a higher likelihood of getting severe disease. It is important learns proper hand hygiene and social distancing.
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There have not been cases of babies being delivered that have been sick with this virus.
A few cases have raised questions for in-utero transmission, although this is not conclusive at this time.
You can read more here: bit.ly/Level2preg
--- -- /?
There is no evidence of this occurring at this time.
While the virus has been detected in the stool rarely in severe disease, it has not been shown to be a method of transmission at this point.
However, there are certain practices you should be doing anyway to reduce the possibility of spreading fecal-oral diseases:
1)Close the toilet seat lid when you flush. This reduces the probability of toilet bowel contents being expelled into the environment.
2)Wash your hands with soap and water after using the bathroom.

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It is unlikely that one can get COVID-19 from food. The FDA and other international food safety organizations have stated that food is NOT thought to be a method of transmission of SARS-CoV-2. However, until fomite transmission is better understood, it may still be theoretically possible.
To reduce this possibility, order foods served hot or reheat them after you receive in an oven or microwave. Also, consider supporting restaurants that are asking employees about symptoms, checking for fever, and providing paid sick leave for those who get the virus.

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Fomite transmission, as I mentioned above, is thought to be a distant secondary form of transmission to droplet transmission. That being said, one can never completely eliminate all risk of acquisition, and if excessive surface-disinfection measures being taken are causing wasting of limited resources and mental strain, it may not be worthwhile to do these things.
The lab studies of how long a virus remains viable on surfaces need to be interpreted with caution as these scenarios may not be applicable to real-life conditions. The studies do not reveal if the virus can still cause infections in people if they touch these contaminated surfaces and their face hours or days after an the surface was contaminated.
Focus your disinfection of surfaces to those most likely to be contaminated with high amounts of virus. These would be surfaces that someone with COVID-19 might have gotten respiratory secretions on or touched with their hands. Cleaning repeatedly-touched surfaces like door handles, elevator buttons, hand-rails, keyboards, and telephones are the highest priority.
If you are concerned about surfaces you have contacted potentially being contaminated, remember, the simplest and most effective tool in your arsenal is to wash your hands for 20 seconds and abstain from touching your face.
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No.
From the NIH: “There is no scientific evidence that any of these alternative remedies can prevent or cure the illness caused by this virus (SARS-CoV-2).”
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This is unknown at this time. We do form antibodies (proteins made by your immune system that fight infections) against the virus as I mentioned before in the Level 2 section on testing. We still don’t know how effective they are for fighting the disease and how long they stay in the body.
Early data in monkeys re-challenged with the virus show that monkeys didn't get sick on a second exposure if they had antibodies.

--- - , ?
Possibly. Studies are being conducted right now transfusing antibodies from plasma donations of those who have recovered from COVID-19 into the sickest patients in the hospital. There is not enough data to suggest this is an effective treatment at this time.

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This area is rapidly changing and the best advice is to speak with your physician as each person’s medical need for a medication can vary.

___________________________________________________________________________

*** , , . ***

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These numbers mean absolutely nothing to your overall safety and do not need to be repeated on social media. Why do the numbers not matter?
1)The number of cases WILL increase due to increased availability of testing detecting those with milder symptoms.
2)The number of cases will increase with disease spread.
3)The death rate will appear to be higher than it actually is in the beginnings of a pandemic since available testing is being used on the sickest individuals who end up in the hospital.
Knowing these numbers on a moment-to-moment basis will do nothing to help you if you or a loved one are exposed to SARS-CoV-2, they will simply increase existential dread and panic.
Assume the virus it is in your community even if you have no reported cases, and use social distancing at all times. The lack of reported cases in your specific community may be due to a lack of testing availability or those with mild symptoms not presenting for testing.

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Consider abstaining from coronavirus news outside of international reputable medical sources including the NIH, WHO, CDC, or your local health department.
Think about this question for a moment: In all of the time you spent watching or reading news coverage about coronavirus, and checking social media for updates, how much have you actually learned what you should be doing in the pandemic?
This is the purpose of this guide---education, not alarm, is the key to reducing cases of COVID-19 and saving lives.
Understanding this disease, and developing a plan on how you can help yourself and your community, reduces anxiety of the unknown.
Some news organizations continue to focus on cases and deaths and political failings to stop the virus for good reason: you will keep watching and returning to them if you feel uninformed, scared, confused, or filled with vitriol. This generates views, clicks, and advertising revenue. These incentives do not align with the public good of reducing harm from this disease.
If you feel disconnected by not reading the news, limit yourself to your local city paper, which will likely focus on how coronavirus is affecting the community around you, and point to ways you can help your community.
Alternatively, if anyone reading this guide has a suggestion for a news source that is providing pragmatic information, and not focusing on political failures and cases/deaths, please let me know in the comments.

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Due to the coronavirus pandemic, many hospitals are facing severe blood shortages. Blood donation facilities are taking special precautions to keep you safe from coronavirus exposure. There have been cases of giving or receiving a blood transfusion causing COVID-19. Please consider donating blood so others do not die from conditions requiring transfusions.
Currently, less than half of those living in the US can donate blood. However, it is worth checking for changes in the FDA guidelines for blood donations regularly if you are restricted from donating.
As of 4/2/2020, the restriction on men who have sex with men (MSM) and women who have sex with MSM has been reduced by the FDA from a 12-month restriction since last sexual act to 3-months for blood donation.
For more information on if you are eligible to donate blood please see the link below. At the time of writing, this link has not been updated to reflect the recent change in FDA policy on MSM.
https://www.redcrossblood.org/…/eligibility-criteria-alphab…
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With people being told to shelter-in-place or self-quarantine, anxiety about the unknown is now common. We need to be proactive about early identification of signs of worsening mental illness and help each other.
I have provided a large list of resources at the end of this guide for mental health assistance.
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There has never been a more critical time to quit smoking than now. Poorer outcomes and death have been seen in those with lung disease, uncontrolled hypertension, and poorly-controlled diabetes.
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When around groups of people in an enclosed environment, try to keep a 6-foot distance from others.
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This is important even if you are alone to reduce the chance of surfaces in your environment being contaminated with the virus.
If you are at home sick, put on a mask anytime a caregiver is within 6 feet of you.
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Encourage locations that cause people to congregate close for prolonged periods of time (churches, concert venues, bars, etc.) to suspend activities or use webcasts. We as individuals need to be responsible for reducing the spread of SARS-CoV-2. Do more than not show up: help stop the spread in the community through direct activism.
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Do not spread photos of empty store shelves on social media. What starts as someone posting a photo of an empty toilet paper shelf, prompts others to simultaneously go out and wipe store shelves clean out of fear of shortages. Posting the photos creates a self-fulfilling prophecy. The grocery supply chain has not been disrupted, and shortages are simply due to unnecessary overbuying exceeding expected demand.
Additionally, do not post news stories about new and unproven medications against COVID-19 or new routes of transmission.
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When you are cleaning surfaces that may be contaminated, pay attention to the chemical contact/kill time of the product you are using against SARS-CoV-2. This means that once you use the disinfectant, be it a wipe or a spray, you must leave it on the surface and visibly wet without wiping, rinsing, or touching the surface for the duration of the contact time before it is safe to use.
If the information is not on the product label, there is an easy short-cut to determine the contact time:
Simply bookmark the following link on your phone:
https://www.epa.gov/…/list-n-disinfectants-use-against-sars…
Now look at the label of the product in question and find the “EPA Registration Number” which is on the back of all disinfectants. Type that number (including the hyphen) into the search box and you will see the contact time as well as recommended surfaces to use it on.
For example, if you are wiping down a grocery cart handle with a Lysol wipe, punching the EPA number (777-114) into their database shows a contact time of 10 minutes for SARS-CoV-2. This would mean you would have to wipe your grocery handle and wait 10 minutes before touching it to ensure the surface is clean for SARS-CoV-2. Waiting 10 minutes for your shopping cart is probably something you don’t want to do, so check your products before you buy them in this database.
When in doubt about if you contacted a contaminated surface, wash your hands as soon as possible, and don’t touch your mouth, nose, or eyes.

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Use 70% isopropyl alcohol either as a pre-packaged wipe or with a microfiber cloth. Do not use this on any “holes” on your phone (charging ports, speakers, etc). If your phone screen is cracked and you are worried about liquid damage, I recommend putting a glass screen protector over your cracked screen, and then cleaning that surface.
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Don’t worry about stores not having hand sanitizer or bother making your own. Soap works as well or better. You should also wash your hands for 20 seconds using the method I link below.
https://www.who.int/gpsc/clean_hands_protection/en/

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If the boxes haven’t been opened, see if your local hospital will accept them. We are experiencing severe shortages and your donation can absolutely save lives.
___________________________________________________

This guide was written in the memory of Li Wenliang, Marcello Natali, and the countless medical heroes who have given their lives to save their communities from this disease.
Special thanks to the following: bit.ly/CovidCredits

 

[Jitss617]

I live by the constitution! Not some guidelines

 

[WinterBorn]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

 

[Jitss617]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

Aww you gotta go back to work you poor little baby lol

 

[WinterBorn]

I live by the constitution! Not some guidelines

You live by lies.

And there is nothing unconstitutional about anything posted above.

They are recommendations from a physician on the frontlines of this mess.

 

[progressive hunter]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

 

[Jitss617]

Are you in Venezuela need some good doctors

 

[WinterBorn]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

Aww you gotta go back to work you poor little baby lol

Nope. My company has elected to maintain the same staffing and field work we currently have in place.

And I have not stopped working. I have been maintaining safety training and safety rules the entire time. Technology is a wonderful thing.

 

[WinterBorn]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

No, you do not. He is focused on the disease itself and the contagious nature of that disease.

I have donated money and food to local food banks. They are open and running. I suggest you do the same.

 

[WinterBorn]

Are you in Venezuela need some good doctors

Look Jitssie, the above information is solid info from a highly trained specialist and is intended to help. I am not going to argue about bullshit with you. If you want to go back to work, then go.

 

[progressive hunter]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

No, you do not. He is focused on the disease itself and the contagious nature of that disease.

I have donated money and food to local food banks. They are open and running. I suggest you do the same.

the food banks are going empty as we speak and you and I cant refill them for very long,,,

his focus is single minded and lacking in reality of the whole situation,,,

 

[Sun Devil 92]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

Yes, I will read that massive post.

 

[WinterBorn]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

No, you do not. He is focused on the disease itself and the contagious nature of that disease.

I have donated money and food to local food banks. They are open and running. I suggest you do the same.

the food banks are going empty as we speak and you and I cant refill them for very long,,,

his focus is single minded and lacking in reality of the whole situation,,,

Ok. But he is not trying to solve the whole situation. His goal is to protect people and patients. And to prevent another wave of patients that cannot be treated effectively.

 

[WinterBorn]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

Yes, I will read that massive post.

The information is there for anyone who wants to read it. If you don't, that is fine.

 

[progressive hunter]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

No, you do not. He is focused on the disease itself and the contagious nature of that disease.

I have donated money and food to local food banks. They are open and running. I suggest you do the same.

the food banks are going empty as we speak and you and I cant refill them for very long,,,

his focus is single minded and lacking in reality of the whole situation,,,

Ok. But he is not trying to solve the whole situation. His goal is to protect people and patients. And to prevent another wave of patients that cannot be treated effectively.

and in doing so left out some huge things,,,

 

[WinterBorn]

Per Gov Kemp, Georgia will begin reopening businesses this Friday.

A friend of mine posted this on FaceBook. He is an Infectious Disease Specialist in Atlanta. I asked if I could post this on a message board, and he gave me an enthusiastic approval.

I am not going to argue the relative merits of reopening businesses when we are still seeing so many new cases. I am posting this for your information.


"A reminder:
Despite some states stating you can open for business, it doesn't mean you have to or should.

1) there is still not widespread testing for those who need it, antibody testing has not been rolled out at a sufficient level and we still aren't entirely sure of of antibody (IgG) positivity=immunity
2) there is still no effective medical treatments for COVID-19 other than supportive care. We are experimenting with medications that were never intended or developed for coronavirus and trials of their efficacy are ongoing.
3)There is still widespread PPE shortages for healthcare workers and we are not set up to face another big wave of simultaneous infections. It will lead to people that might have survived COVID-19 dying.

If our politicians could be in the room with me with the two COVID-19 patients I saw 5 minutes ago in the ICU and saw what it looks like to drown on dry land alone. To see the gowns and masks reused over and over because of PPE shortages.
The frustration and tiredness of everyone that's on the front lines of this for the last several months.
I don't think they would make the same decision.
The good news, we in the medical community are still fighting non-stop. My approach was to spend nearly all my waking time researching and translating current medical literature into easy-to-understand pragmatic guidance to keep people from getting sick and having to go to the hospital. Please read my guide (it's on my Facebook wall below this post) if you haven't yet. I'm working on version 5.0 now, but the information is still valid.
Prevention is better than reaction, and we are still in prevention mode because this is still in the community and if cases are "slowing down" it doesn't mean you are at the end."
It means we are at the middle.
The first of probably many middles for coronavirus until we have an effective vaccine.
If an effective vaccine rolls out, there's still questions of how long it will be until one gets it, who gets vaccinated first, how much it will cost, and what to do about anti-vaxxers.
These are things we need to think about NOW before the vaccine is even close to done.
Preparation, not reaction. Education, not fear is what keeps people alive right now.
Plans of what we need for staged reopenings have been developed by medical societies and I will be talking about it in version 5 of my guide.
The states that are reopening have this information and they are choosing to ignore it.
Please share with everyone, especially Brian Kemp on his Twitter. While you are there, ask him how massage therapists and beauty salons will social distance please.

I'm not seeing where hes considered the civil unrest from people starving and deaths that would result from it,,,

No, you do not. He is focused on the disease itself and the contagious nature of that disease.

I have donated money and food to local food banks. They are open and running. I suggest you do the same.

the food banks are going empty as we speak and you and I cant refill them for very long,,,

his focus is single minded and lacking in reality of the whole situation,,,

Ok. But he is not trying to solve the whole situation. His goal is to protect people and patients. And to prevent another wave of patients that cannot be treated effectively.

and in doing so left out some huge things,,,

Those huge things are not in the purview of an infectious disease physician. He presented information.

How the information is used is up to the reader.

 

[EvilCat Breath]

Without people working there are no taxes. No taxes means no police or fire department. Someone has to do the business of civilization or there us no civilization. We are the level of an impoverished African nation standing in line at a UN feeding station.

Keep this up and there will be no hospitals. Maybe a few clinics.

 

[WinterBorn]

Without people working there are no taxes. No taxes means no police or fire department. Someone has to do the business of civilization or there us no civilization. We are the level of an impoverished African nation standing in line at a UN feeding station.

Keep this up and there will be no hospitals. Maybe a few clinics.

The two people who live in this household have been working every day. Lots of people are working from home, and many are still going to work. Civilization has not fallen.

What I have posted is simply recommendations and guidelines. Whether you follow them or not is up to you.

 

[Admiral Rockwell Tory]

Weird for a Q&A, but the questions did not post when I copied and pasted his entire post. But you can figure out what the question in on most of them.

I will try to fix the glitch tomorrow. Tonight I am tired and frustrated.

Stay safe everyone.

Yes, I will read that massive post.

The information is there for anyone who wants to read it. If you don't, that is fine.

Your post was reported for being too damned long!