NO it is not good! Hospital should set tent or similar facility in front of the entrance of ER to pre-screen the patient. Or have some other way to prevent a person to walk inside ER freely even with a mask! Italy learnt this lesson hard. One case may stop the ER working a day because ER has to deep clean. And also maybe infect other sick people waiting in ER. This factor is part of the reason why Italy has such a high death rate now!
Hospital should set tent or similar facility in front of the entrance of ER to pre-screen the patient. Or have some other way to prevent a person to walk inside ER freely even with a mask!
Italy learnt this lesson hard. One case may stop the ER working a day because ER has to deep clean. And also maybe infect other sick people waiting in ER.
This factor is part of the reason why Italy has such a high death rate now! 梅干茶泡饭 发表于 3/4/2020 1:47:31 PM
Hospital should set tent or similar facility in front of the entrance of ER to pre-screen the patient. Or have some other way to prevent a person to walk inside ER freely even with a mask!
Italy learnt this lesson hard. One case may stop the ER working a day because ER has to deep clean. And also maybe infect other sick people waiting in ER.
This factor is part of the reason why Italy has such a high death rate now! 梅干茶泡饭 发表于 3/4/2020 1:47:31 PM
yes it is actually not something "creative" but a common practice written in any basic public health book.
The problem is that it needs government to assistant setting up tent or similar stuff. Italy set those up in the northern region. Then it is still not enough because now some patients start to walk into ER in the south.... Setting them up is not cheap but better than pollute an ER.
But it will alarm the public and make people panic... which I don't give a shit!
The cost of closing down an ER is very very high during such an outbreak!
ER room is difficult to clean, especially in NYC where everything is crowded...
Trump will understand that! He built buildings he will understand the importance of having some mobile unit
1 min ago CDC expands coronavirus testing criteria to all US patients with a doctor’s order From CNN's Arman Azad The US Centers for Disease Control and Prevention dramatically expanded the testing criteria for the novel coronavirus today. The CDC formally removed earlier restrictions that limited coronavirus testing of the general public to people in the hospital, unless they had a close contact with a confirmed coronavirus case. According to the CDC, clinicians should now “use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.” The new criteria formalizes Vice President Mike Pence’s announcement, made Tuesday night, that “any American can be tested (for coronavirus), no restrictions, subject to doctors’ orders.” Unless a patient had close contact with a confirmed coronavirus patient, the earlier criteria limited testing to people who had been hospitalized with both a fever and respiratory symptoms. Some context: Questions remain about whether the United States can meet a possible surge in testing demand. Two coronavirus tests in the United States currently have Food and Drug Administration emergency use authorizations and are in use nationwide. These include CDC test kits, which have been distributed to public health laboratories across the country, and another test designed and used by New York state. Under rules issued Feb. 29, the FDA is also allowing hospitals, private companies and laboratories to develop other diagnostic tests that can be used before the FDA issues an emergency use authorization.
1 min ago CDC expands coronavirus testing criteria to all US patients with a doctor’s order From CNN's Arman Azad
The US Centers for Disease Control and Prevention dramatically expanded the testing criteria for the novel coronavirus today. The CDC formally removed earlier restrictions that limited coronavirus testing of the general public to people in the hospital, unless they had a close contact with a confirmed coronavirus case.
According to the CDC, clinicians should now “use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.”
The new criteria formalizes Vice President Mike Pence’s announcement, made Tuesday night, that “any American can be tested (for coronavirus), no restrictions, subject to doctors’ orders.”
Unless a patient had close contact with a confirmed coronavirus patient, the earlier criteria limited testing to people who had been hospitalized with both a fever and respiratory symptoms.
Some context: Questions remain about whether the United States can meet a possible surge in testing demand.
Two coronavirus tests in the United States currently have Food and Drug Administration emergency use authorizations and are in use nationwide. These include CDC test kits, which have been distributed to public health laboratories across the country, and another test designed and used by New York state.
Under rules issued Feb. 29, the FDA is also allowing hospitals, private companies and laboratories to develop other diagnostic tests that can be used before the FDA issues an emergency use authorization. fish_fish 发表于 3/4/2020 2:55:43 PM
1 min ago CDC expands coronavirus testing criteria to all US patients with a doctor’s order From CNN's Arman Azad
The US Centers for Disease Control and Prevention dramatically expanded the testing criteria for the novel coronavirus today. The CDC formally removed earlier restrictions that limited coronavirus testing of the general public to people in the hospital, unless they had a close contact with a confirmed coronavirus case.
According to the CDC, clinicians should now “use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested.”
The new criteria formalizes Vice President Mike Pence’s announcement, made Tuesday night, that “any American can be tested (for coronavirus), no restrictions, subject to doctors’ orders.”
Unless a patient had close contact with a confirmed coronavirus patient, the earlier criteria limited testing to people who had been hospitalized with both a fever and respiratory symptoms.
Some context: Questions remain about whether the United States can meet a possible surge in testing demand.
Two coronavirus tests in the United States currently have Food and Drug Administration emergency use authorizations and are in use nationwide. These include CDC test kits, which have been distributed to public health laboratories across the country, and another test designed and used by New York state.
Under rules issued Feb. 29, the FDA is also allowing hospitals, private companies and laboratories to develop other diagnostic tests that can be used before the FDA issues an emergency use authorization. fish_fish 发表于 3/4/2020 2:55:43 PM
1）首先医护提供病人口罩，强调病人必须一直带口罩，不得脱下。
2）30天之内有无出州，有无出境，有无旅游，有无接触任何中国/亚洲/其他国家来的人
3）除了发烧有无以下症状，咳嗽，胸痛，气喘，呕吐，腹泻，症状什么时候开始。
4）验血，胸片 x-ray，nose swap 流感测试。
根据病人的症状，情况，以上测试结果，决定是否测试新冠。
大家来评评这个流程是不是 bullet proof？
再看一次： 根据病人的症状，情况，以上测试结果，决定是否测试新冠。
俺也是这么觉得，CDC 有5亿在手啊。
刚好像通过了一个bill，不止5亿了
当然有，这是 given 啊。
光拿钱不办事。主要是没有竞争者。搞得再烂也没问题。要是外包给韩国或者中国，早就测上了。又便宜又快。
胸片加血常规，就能判断疑似了。中国也不是人人都测吧。这个流程医学上没毛病。
太贵，不会照。
OMG 那做的不够
他们应该都去湘雅培训，湘雅老早就在医院门口搭帐篷分流了。
后来在方舱医院，都是湘雅的培训怎么分流
yes
it is actually not something "creative" but a common practice written in any basic public health book.
The problem is that it needs government to assistant setting up tent or similar stuff. Italy set those up in the northern region. Then it is still not enough because now some patients start to walk into ER in the south....
Setting them up is not cheap but better than pollute an ER.
But it will alarm the public and make people panic... which I don't give a shit!
The cost of closing down an ER is very very high during such an outbreak!
ER room is difficult to clean, especially in NYC where everything is crowded...
Trump will understand that! He built buildings he will understand the importance of having some mobile unit
百万kits是个笑话，这周肯定指望不上，下周天知道。
我听说ct照后必须等一小时为了消毒。消毒不好还容易交叉感染。求证。
日本本月将出一小时有结果的 kit :https://www.japantimes.co.jp/news/2020/03/04/business/test-kit-detect-coronavirus-one-hour-may-released-march/#.Xl_88KhKg2w
俺支持外包给日本，CDC那几亿 绝对够用了。
那个是指在所有的实验室机器上，累积可以跑100万个测试。。
但根本没考虑基层取样/测试等各种瓶颈。。
就美国ER这种几小时看一个的效率，100万？周末前全美加一起能测几千个已经要烧香了。。
没一上来就测新冠，这个我能理解。问题是以上测试要几天出结果？别弄个3-5天后，等结果出来后再测新冠还来得及吗？
然并卵，那3000万没医保的，1000万非法移民，还不是一样自生自灭？
全民医保可以提上日程吗?
问老川。。。
为了Make america great again，不好外包吧？
以上测试半小时可以出结果，昨天发烧去了urgent care，流程差不多。
没CT验你妹个肺炎
还swab 中国说了几百万次了上呼吸道不准
为什么不听
美国人的自大和不可一世要栽在这里了
挺好挺周到的
CT看保险公司是否认为是medically necessary, 做了保险公司不给cover医院还是病人掏腰包？做了阴性谁掏钱？
这样的试剂盒正在开发中。。。
只有医生觉得是 medically necessary， 就应该保险公司付钱。
CT在美国医院很容易做，而且急诊跟CT室在设计的时候就连着的--因为中风的病人，要最快的时间做CT确定诊断，缺血性的中风以便在窗口期溶栓。
我觉得X-线比CT在这个时候更好。 武汉封城，大家都涌去CT带来的交叉感染也不少。 根本没有时间消毒。 我同学在武汉做放射科医生，说是几台CT做到不停down机。
别的城市我不清楚。 纽约公立医院，连非法移民都看病都没有问题。 不存在保险的问题。大家真不用担心美国医院的资源问题。 当年在公立医院轮转，见过非法移民一人就耗费数百万美元还在医院好好住着的。
这些人都学不会的吗？ 等x光出症状，还不是CT，黄花菜都要凉了好么？
牙医跟真正的医院是两码事。 大部分人没有严重的问题，当然没有做过CT。 美国医院住院医都可以order CT，算不上什么高端检查。我觉得纽约这家ER的流程应该是为了避免交叉感染。 肺炎本身常规应该用x-ray初筛。 而且portable xray很方便，造成的交叉感染能大大减少。
嗯，把收费的都测一遍，免费的吗要考虑考虑，lol
CT做完一个，消毒复杂吗？容易交叉感染吗？