我家儿医刚发来的信,写得真好(版主更新:1楼内增加纽约家庭医生提供的信息)

P
Peppa5
Mark好好看看
p
pinkiee
As Chief Medical Officer I am asked daily about advice to Caduceus patients about the Coronavirus; now called Covid-19. Wanting to keep the advice timely and factual, it is very difficult to separate the facts from hysteria. But someone has to do it, so here are the recommendations for Caduceus patients from the CMO. First realize there are FOUR different bugs going around now plus the threat of Covid. Let's look at each... 1. A bacterial infection is currently on the rise-sore throat, productive cough, fever, maybe sinus symptoms. If you are fit and healthy, it may wear itself out in 3-5 days. If you are very young or very old, frail, or sickly, it may lead to pneumonia or sepsis. An antibiotic is effective, and we may be able to swab for it, or do a blood test or xray to make an accurate diagnosis. 2. A viral syndrome with low grade fever, sneezing, cough, can be difficult to differentiate from a bacterial one at first. Even an experienced provider may need testing to tell the difference. It is usually less serious and runs its course over 2-3 days. Antibiotics do not work for a typical virus. We are seeing a fair number of these cases now, on par with this time of year. 3. NEITHER of these are the "flu". Influenza is a totally separate animal. High fevers, aches, abdominal distress, dry cough, and feeling like you've been run over by a truck are common symptoms. It can be diagnosed via a swab in the office. There are special influenza antibiotics (eg Tamiflu) that help reduce the symptoms and duration. The "Flu" seems to have peaked and even gone in Orange County for 2020. In my personal practice we haven't had a positive case since Feb 15th. The Health Department confirms we should see very few new flu cases in March. 4. Covid-19 begins as a typical viral illness- sneezing, coughing, low grade fever. But there are serious differences. Fortunately, we have not had a lot of cases in Southern California--at least not officially diagnosed. But the virus can be spread for two weeks before symptoms appear. In that time, hundreds of people have been put at risk. It is spread by droplets, so simply being near an infected person can spread it if they cough or sneeze. And the 88,000 cases (as of this writing) is misleading since those are CONFIRMED cases. At least 10 times that number have occurred but just not tested for. There is hope that as a cold weather bug, it will fade away with warmer weather. Yet it is still growing at over 1,000 cases a day being reported world wide; the same number as late January when it first appeared. If more kits were available, you can estimate how many new cases are actually occurring. To hear an official say "we have this under control" is irresponsible. To hear people on social media say "There were more flu deaths, life goes on" is just idiotic. For one thing, the flu deaths were over an entire season. This pandemic has just begun.For another, would these same people take a vacation to beautiful downtown Baghdad? Stroll thru the streets of Sinaloa Mexico? Of course not because we know that is dangerous. Covid 19 should also be considered dangerous. What is the difference between an epidemic and a pandemic? An epidemic refers to a condition spreading rapidly. A pandemic is an epidemic spreading throughout the world. We are now in a pandemic. The flu was not a pandemic. As CMO, I am advising the following measures for our patients at least thru March: 1.If you are sick, don't travel. In fact don't leave the house if possible. Of course this is always common sense. But now you run the risk of being quarantined if it is considered possible you harbor Covid 19. Many countries are screening passengers for even low grade fever. Flight attendants are instructed to report anyone they feel is showing signs of infection. If you have a fever you will be detained. and not just sent home, but put in isolation. 2. If you are not sick, but very young, very old, frail, or sickly avoid ALL non-essential travel, or areas where crowds circulate. That means malls, theme parks, churches, even ball games. Going to a school or office may only expose you to dozens of close contacts. But a crowded day at Disney will expose you to THOUSANDS of people who may be incubating Covid. If you are fit and relatively healthy, use common sense. Avoiding crowds and non essential travel may seem like overkill but it isn't just about protecting you- its keeping an unknowing carrier from spreading the virus to thousands of uninfected people. We do not advise staying home from work or school, but if you can cancel that trip to Europe or postpone the day to Universal Studios, it will go a long way to stopping the spread and protecting yourself and your family. 3. If you do travel in March, realize there is a high chance of disrupted travel. You may be not allowed to leave your area or be house confined. Bring your own thermometer, your own cold meds, and an extra supply of your prescription meds in case you are stuck somewhere for weeks. Have documentation of your health insurance with you. Realize you may find tourist venues closed, events canceled, and long lines at areas where screening is going on. 4. Common sense dictates frequent hand washing. Remember the rule is to wash singing "Happy Birthday" to allow enough time to wash. If you are using hand sanitizers like Purell, five seconds is sufficient. Avoid touching other people if possible, maybe a thumbs up instead of shaking hands. Prepare your own meals as much as possible. If you must cough or sneeze in public, cover the face or turn away. Normal face masks are insufficient to block Covid--you'll need to look for N 95 masks. But if your coughing enough to need the mask --STAY HOME! If you are wearing the mask to protect yourself its probably not necessary if you are fit and healthy. 5. If you feel you may have one of those three conditions at the beginning of this blog, DO NOT ignore it. Use Mouse Calls or video visits to talk to your provider. If you feel you must come to the office, alert us so we can swab you or draw your blood in the comfort of your car. If you need to be seen in an exam room, you will be escorted thru the lobby if you alert us in advance. ALL respiratory type infections should be seen and worked up during this crucial time. Covid testing is done at the health dept. IF World wide screening is effective IF everyone follows these FIVE simple rules IF Covid is a cold weather bug only The pandemic will be history. Otherwise we may witness a pandemic unseen in our lifetimes. Gregg DeNicola MD
Chief Medical Officer

版主更新用户Caffeine家庭医生提供的信息纽约市:
- 那个犹太律师上了ventilator。人本来肥胖,以前得过多次肺炎,所以这次以为也是普通肺炎,去bar mizvah等社区活动打倒一帮人。他状况不是特别好。
- 病床:bellevue开始加床做准备了
- 他们(一个私人practice)尽量不让病人跑er。我和她分享了武汉的一些教训,他们基本都是在避免这些情况。

后两个让我觉得后台他们还是在做准备的。cdc乌龙,希望别的可以补上。

ocyoyo 发表于 3/4/2020 7:26:41 PM

Thank you so much for your post!! Your kids is in good hand!
H
HereIam
As Chief Medical Officer I am asked daily about advice to Caduceus patients about the Coronavirus; now called Covid-19. Wanting to keep the advice timely and factual, it is very difficult to separate the facts from hysteria. But someone has to do it, so here are the recommendations for Caduceus patients from the CMO. First realize there are FOUR different bugs going around now plus the threat of Covid. Let's look at each... 1. A bacterial infection is currently on the rise-sore throat, productive cough, fever, maybe sinus symptoms. If you are fit and healthy, it may wear itself out in 3-5 days. If you are very young or very old, frail, or sickly, it may lead to pneumonia or sepsis. An antibiotic is effective, and we may be able to swab for it, or do a blood test or xray to make an accurate diagnosis. 2. A viral syndrome with low grade fever, sneezing, cough, can be difficult to differentiate from a bacterial one at first. Even an experienced provider may need testing to tell the difference. It is usually less serious and runs its course over 2-3 days. Antibiotics do not work for a typical virus. We are seeing a fair number of these cases now, on par with this time of year. 3. NEITHER of these are the "flu". Influenza is a totally separate animal. High fevers, aches, abdominal distress, dry cough, and feeling like you've been run over by a truck are common symptoms. It can be diagnosed via a swab in the office. There are special influenza antibiotics (eg Tamiflu) that help reduce the symptoms and duration. The "Flu" seems to have peaked and even gone in Orange County for 2020. In my personal practice we haven't had a positive case since Feb 15th. The Health Department confirms we should see very few new flu cases in March. 4. Covid-19 begins as a typical viral illness- sneezing, coughing, low grade fever. But there are serious differences. Fortunately, we have not had a lot of cases in Southern California--at least not officially diagnosed. But the virus can be spread for two weeks before symptoms appear. In that time, hundreds of people have been put at risk. It is spread by droplets, so simply being near an infected person can spread it if they cough or sneeze. And the 88,000 cases (as of this writing) is misleading since those are CONFIRMED cases. At least 10 times that number have occurred but just not tested for. There is hope that as a cold weather bug, it will fade away with warmer weather. Yet it is still growing at over 1,000 cases a day being reported world wide; the same number as late January when it first appeared. If more kits were available, you can estimate how many new cases are actually occurring. To hear an official say "we have this under control" is irresponsible. To hear people on social media say "There were more flu deaths, life goes on" is just idiotic. For one thing, the flu deaths were over an entire season. This pandemic has just begun.For another, would these same people take a vacation to beautiful downtown Baghdad? Stroll thru the streets of Sinaloa Mexico? Of course not because we know that is dangerous. Covid 19 should also be considered dangerous. What is the difference between an epidemic and a pandemic? An epidemic refers to a condition spreading rapidly. A pandemic is an epidemic spreading throughout the world. We are now in a pandemic. The flu was not a pandemic. As CMO, I am advising the following measures for our patients at least thru March: 1.If you are sick, don't travel. In fact don't leave the house if possible. Of course this is always common sense. But now you run the risk of being quarantined if it is considered possible you harbor Covid 19. Many countries are screening passengers for even low grade fever. Flight attendants are instructed to report anyone they feel is showing signs of infection. If you have a fever you will be detained. and not just sent home, but put in isolation. 2. If you are not sick, but very young, very old, frail, or sickly avoid ALL non-essential travel, or areas where crowds circulate. That means malls, theme parks, churches, even ball games. Going to a school or office may only expose you to dozens of close contacts. But a crowded day at Disney will expose you to THOUSANDS of people who may be incubating Covid. If you are fit and relatively healthy, use common sense. Avoiding crowds and non essential travel may seem like overkill but it isn't just about protecting you- its keeping an unknowing carrier from spreading the virus to thousands of uninfected people. We do not advise staying home from work or school, but if you can cancel that trip to Europe or postpone the day to Universal Studios, it will go a long way to stopping the spread and protecting yourself and your family. 3. If you do travel in March, realize there is a high chance of disrupted travel. You may be not allowed to leave your area or be house confined. Bring your own thermometer, your own cold meds, and an extra supply of your prescription meds in case you are stuck somewhere for weeks. Have documentation of your health insurance with you. Realize you may find tourist venues closed, events canceled, and long lines at areas where screening is going on. 4. Common sense dictates frequent hand washing. Remember the rule is to wash singing "Happy Birthday" to allow enough time to wash. If you are using hand sanitizers like Purell, five seconds is sufficient. Avoid touching other people if possible, maybe a thumbs up instead of shaking hands. Prepare your own meals as much as possible. If you must cough or sneeze in public, cover the face or turn away. Normal face masks are insufficient to block Covid--you'll need to look for N 95 masks. But if your coughing enough to need the mask --STAY HOME! If you are wearing the mask to protect yourself its probably not necessary if you are fit and healthy. 5. If you feel you may have one of those three conditions at the beginning of this blog, DO NOT ignore it. Use Mouse Calls or video visits to talk to your provider. If you feel you must come to the office, alert us so we can swab you or draw your blood in the comfort of your car. If you need to be seen in an exam room, you will be escorted thru the lobby if you alert us in advance. ALL respiratory type infections should be seen and worked up during this crucial time. Covid testing is done at the health dept. IF World wide screening is effective IF everyone follows these FIVE simple rules IF Covid is a cold weather bug only The pandemic will be history. Otherwise we may witness a pandemic unseen in our lifetimes. Gregg DeNicola MD
Chief Medical Officer

版主更新用户Caffeine家庭医生提供的信息纽约市:
- 那个犹太律师上了ventilator。人本来肥胖,以前得过多次肺炎,所以这次以为也是普通肺炎,去bar mizvah等社区活动打倒一帮人。他状况不是特别好。
- 病床:bellevue开始加床做准备了
- 他们(一个私人practice)尽量不让病人跑er。我和她分享了武汉的一些教训,他们基本都是在避免这些情况。

后两个让我觉得后台他们还是在做准备的。cdc乌龙,希望别的可以补上。

ocyoyo 发表于 3/4/2020 7:26:41 PM

Mark
s
singdna
我转发到next door了
b
borabora
Thanks for sharing.
f
frida
写得很好,保存了,晚上打算简化后也给孩子们科普一下,大人还好点,年纪小的孩子在学校还是很让人担心的~
m
mlb
我家孩子学校很早的时候就已经发邮件要怎样避免新冠 和如果有疑似怎样处理, 各个专科医院也发各种注意通知, 邮件和信件。城区也有发通知到户,这都是东部都还没有疑似的时候发的, 坐标新英格兰地区,我觉得按照这些准备好, 提高警惕, 为什么一定要像网上很多人一样慌到失去理智, 到处鼓动疯抢食物和医疗用品。武汉是之前人民不知情才出现恐慌, 现在基本信息都知道,怎样防御也很清楚, 检测也是可以无条件检测,也不知道还要慌什么。 我这样说大概又会有人要我不慌死全家了。
i
iloveapplebeez
这个应该发到网上让大众读 让当权者用
z
zl3341
我家孩子学校很早的时候就已经发邮件要怎样避免新冠 和如果有疑似怎样处理, 各个专科医院也发各种注意通知, 邮件和信件。城区也有发通知到户,这都是东部都还没有疑似的时候发的, 坐标新英格兰地区,我觉得按照这些准备好, 提高警惕, 为什么一定要像网上很多人一样慌到失去理智, 到处鼓动疯抢食物和医疗用品。武汉是之前人民不知情才出现恐慌, 现在基本信息都知道,怎样防御也很清楚, 检测也是可以无条件检测,也不知道还要慌什么。 我这样说大概又会有人要我不慌死全家了。
mlb 发表于 3/5/2020 1:02:25 PM

g
germanica
问一下,为什么是chloroquine啊,google了一下是个管疟疾的药啊?
zx1269 发表于 3/5/2020 11:50:12 AM

这个药被发现治新冠 国内已经在用了
d
dudupiggy
感谢分享👍👍👍👍👍
飞飞猫
感谢分享