Covid, Margaret, Christine Whipple discussed on The World and Everything In It
This is especially true for the number one risk. Risk factor, which is simply being elderly. colloquially we may use the expression died of old age, but medically speaking. We can't rate that on a death certificate. There's a chain of events the immediate cause underlying causes contributing causes so adept certificate might say cardiorespiratory failure meaning the heart stopped breathing stopped, but then what caused that? Was it say heart attack? Okay? What caused the heart attack? What were the contributing factors? The. Only real exception is sudden. Traumatic events were person really was fine until an accident happened otherwise, there's a chain of causes and along those lines one attribute of Covid nineteen that's now coming into focus is that it causes a hyper coagulated will state that means a state where the blood is too prone to clotting, so it can cause problems with the heart and the circulation, and that means that someone who had a fetal stroke or heart attack while sick with cove, nineteen may well have had it because of being sick with covid nineteen gathering information like that to help us understand. The situation is one of the main reasons that we handled certificates that way. Did Not know that. Christine whipple also wondered whether the reimbursements hospitals are getting from the federal. Government for treating cove in nineteen patients influences how they classify deaths. Hospitals have a financial incentive to say. Someone died of Covid nineteen, even if other health issues might have played a role in it. The short answer is no or at least not specifically for Covid nineteen. The system does reward hospitals for treating sicker patients. There's more work and it uses more supplies, and there are also penalties. If patients do worse than average, so hospitals do want to be sure they're staying on top of everything. That's wrong with a given patient. The Cares Act. The Corona Virus Act. Did also provide for a comparatively small. Additional payment for cove, one nineteen patients. On the flip side, the penalties for documenting inaccurately are pretty severe and more than that inflating the number of covid nineteen deaths would be really counterproductive financially for hospitals, because they can't go back to doing elective procedures until their areas settled down, and they're losing far more money from not doing elective procedures than they're gaining from that little boost to the Medicare rates. There is also a number called quote excess deaths that helps us to understand the situation. If we zoom out a little, it looks at the number of deaths in a given time period compares it to the number. We'd more typically have at that time of year. I'm not aware of any other major changes to public health, so I think it is reasonable to assume the great majority of the difference is due to corona virus. Hey I do want to say one other thing here, though which kind of ties in with us. As far as the numbers go, what is throwing things off? Is this phenomenon of double-counting? Some areas are doing something. That's not a statistical good idea, and that's counting each positive test as a separate case of corona virus, so if someone gets sick, has a positive antigen test. down. He's feeling better. A couple of weeks later gets another antigen test. It's still positive. Gets another antigen tests and a couple of weeks. It's negative now once an antibody test and that's positive. That could get counted as three positive tests. Obviously, he's only one person so that is throwing a monkey wrench into the statistics in some areas. Listener Margaret, Duncan wrote in to ask a question about getting together with her small group. Of Church it plans to start meeting again. Without social distancing the group also shares a weekly meal together. Now Margaret says she seems to be the only one worried about it. It's also important to note that all of the members of her small group are over sixty five, so Margaret wants to know. What is your opinion Dr Horton about groups like this starting to meet up again. I wish I knew churches. Some of this will always have to do with an individual's attitude towards risk, but a lot has to do with the area if your area has very few cases, and the local authorities feel like the situation is generally under control I. Don't think it's reckless to say okay. We're going to take a small chancer. Here in Pittsburgh where we had a lot more cases. I wouldn't recommend that yet. My church is starting to meet again, but we're taking a lot of precautions. Social distancing masks, people also not sending as loudly as the as the usually would. Maybe, that's a good thing to and here in my part of Missouri I would feel comfortable doing that, so that's the location assessment of risk onto the next question now like a lot of people listener Bryan Hughes will be going back to his office soon. Here's his question. I'm nervous about getting infected with Kobe. Through droplets in the air or more specifically by the Ajax System, my office building I'm also concerned because my wife has thirty four weeks pregnant and has a heart defect. Would you suggest that I try to continue to work at home or just wear a mask at all times and hope for the best? I'd be more worried about getting the virus from being close to someone with that, so a lot probably depends on the layout of this listeners office is one of those open layout offices that had been really popular lately. Where people are all getting together and talking, or is it what we used to think of as an office building where each employee had his or her own little office? Are He and his co workers able to keep a healthy distance from each other? Do people have and use masks? Now with his wife situation, that is a little trickier. We played it very safe when we were expecting, and my wife was otherwise in good health. Many of us in healthcare had these personal rituals. It almost made me think of the ritual washing was we read about in the Old Testament? Washed before leaving work drive home and nobody was allowed to touch me until I showered and changed into other clothes, food road to work in disposable containers, so things that I had there would not come back into the house. That sort of thing, so deaf working from home isn't a realistic for this listener..