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snowlurker

COVID-19 check-in

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58 minutes ago, Harbourton said:

California looks great. But they are locked down tight. One fifth of the nation's economy is there. At least Elon Musk told them to go stick it.

California looks like it is simmering. Their confirmed cases are slowly rising. I think 🤔 going forward it comes down to civil responsibility.  Our testing is much more robust now.  So it comes down to someone who thinks it is “just a cough” going to the meat processing plant, shopping without a mask, going to a house of worship, going to Musk’s plant and hanging around in the break room, going to the Ozarks pools and there we go.

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1 hour ago, Rainshadow5.8 said:

California looks like it is simmering. Their confirmed cases are slowly rising. I think 🤔 going forward it comes down to civil responsibility.  Our testing is much more robust now.  So it comes down to someone who thinks it is “just a cough” going to the meat processing plant, shopping without a mask, going to a house of worship, going to Musk’s plant and hanging around in the break room, going to the Ozarks pools and there we go.

There is risk reward with everything in life and I don't mean running around willy nilly but with reasonable precautions.  How many people will die because they were not diagnosed with cancer, diabetes ,hypertension ,etc. because they couldn't get to a doctor If you take away this concept from Americans, the result will be a worse than the disease.

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Aren't both of those "rising/falling" maps difficult to interpret because of increased testing? Or, more accurately, the "falling" is definitely great because it is falling even with increased testing, but the "rising" may not actually be rising?

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Wondering if someone could explain this to me? Came to my attention yesterday that the World Health Organization (who I thought was pretty much the official source for medical info about the virus, right up there with the CDC) says on their website about mask wearing - "If you are healthy, you only need to wear a mask if you are taking care of a person with Covid 19". The link is here for anyone who wants to see for themselves: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Am I missing something? Because if that's right, then that pretty much goes against everything that the media has been telling us for the past month and a half. It should also mean the re-opening process could move more quickly, and people shouldn't be as scared about going out in public as long as they social distance. It should be a huge story honestly.

On the other hand, if it's wrong, then how can one of the top resources of medical info get something so wrong about one of the most basic parts of this pandemic? It's like if the news and your family / friends were talking about a hurricane hitting the Jersey shore, then you check the NHC website and they have the storm going completely out to sea without much of a threat. Who am I supposed to believe?

 

 

image.png

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16 minutes ago, ACwx said:

Wondering if someone could explain this to me? Came to my attention yesterday that the World Health Organization (who I thought was pretty much the official source for medical info about the virus, right up there with the CDC) says on their website about mask wearing - "If you are healthy, you only need to wear a mask if you are taking care of a person with Covid 19". The link is here for anyone who wants to see for themselves: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Am I missing something? Because if that's right, then that pretty much goes against everything that the media has been telling us for the past month and a half. It should also mean the re-opening process could move more quickly, and people shouldn't be as scared about going out in public as long as they social distance. It should be a huge story honestly.

On the other hand, if it's wrong, then how can one of the top resources of medical info get something so wrong about one of the most basic parts of this pandemic? It's like if the news and your family / friends were talking about a hurricane hitting the Jersey shore, then you check the NHC website and they have the storm going completely out to sea without much of a threat. Who am I supposed to believe?

 

 

image.png

Right off the bat, you don't know at any moment in time if you are healthy, or an asympotomatic spreader or in the pre-systematic phase of the virus.

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11 hours ago, JimCaruso said:

Aren't both of those "rising/falling" maps difficult to interpret because of increased testing? Or, more accurately, the "falling" is definitely great because it is falling even with increased testing, but the "rising" may not actually be rising?

Once a week I post the actual national new case number.  Edit: You can mouse over the Times map too.  The one thing the Times does to remove noise is not count any county (on that map) that has fewer than 20 confirmed cases.  Hospitalization would be a better metric, but some states don't report them and the ones that do some just give accumulative numbers and not daily (one thing that NJ & NY do well).

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42 minutes ago, ACwx said:

Wondering if someone could explain this to me? Came to my attention yesterday that the World Health Organization (who I thought was pretty much the official source for medical info about the virus, right up there with the CDC) says on their website about mask wearing - "If you are healthy, you only need to wear a mask if you are taking care of a person with Covid 19". The link is here for anyone who wants to see for themselves: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Am I missing something? Because if that's right, then that pretty much goes against everything that the media has been telling us for the past month and a half. It should also mean the re-opening process could move more quickly, and people shouldn't be as scared about going out in public as long as they social distance. It should be a huge story honestly.

On the other hand, if it's wrong, then how can one of the top resources of medical info get something so wrong about one of the most basic parts of this pandemic? It's like if the news and your family / friends were talking about a hurricane hitting the Jersey shore, then you check the NHC website and they have the storm going completely out to sea without much of a threat. Who am I supposed to believe?

 

 

image.png

I do watch this doctor's videos and I can give you the link to the hamster study (it is a bit longer than this interview).  Anyway, I may be guilty of corroborative bias, but at about the 6 minute mark, maybe closer to 6:20 is the issue with this virus. 

 

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1 hour ago, Rainshadow5.8 said:

Right off the bat, you don't know at any moment in time if you are healthy, or an asympotomatic spreader or in the pre-systematic phase of the virus.

I thought the same thing at first, and you're 100% right. I watched the video and it goes along with what he says, sure we might "feel" healthy but it is to protect others more than anything. In that case I think the WHO needs to re-word what they say on their page, because "feeling" healthy is such a tricky area with this virus.

My only issue with adopting that mentality is this - at what point do we say it's OK for no one to need masks anymore, in the sense of our normal day-to-day routines? I think the common answer for many people would be "not until there's a vaccine". But even with a vaccine, wouldn't there still be at least some cases of the virus? And isn't it fair to say that a vaccine is not necessarily a guarantee, even though there are many trials ongoing at the moment?

Trust me I want to protect others as much as anyone else, but my ultimate fear with this is that someone (whether it's politicians or otherwise) is going to make mask-wearing / social distancing / etc. a requirement whether there's a vaccine or not, so I can't walk into Wawa or Target five years from now in 2025 without wearing a mask because "someone could still have the virus". I understand that may seem far-fetched, but over the past few weeks, watching states re-open on a timeline based on the political party of the governor instead of the state's actual data has not given me any reassurance.

And just so we're clear, I'm not trying to advocate against masks or turn things political, I'm just asking questions.

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https://www.forbes.com/sites/theapothecary/2020/05/26/nursing-homes-assisted-living-facilities-0-6-of-the-u-s-population-43-of-u-s-covid-19-deaths/#77b7cdc974cd

"In New Jersey, nearly 10 percent of all long-term care facility residents—954 in 10,000—have died from the novel coronavirus."

for some reason, LOL, the action that FL took very early to protect LTC facilities has rec'd little if any attention from the media however I clearly remember the foaming & frothing how swarms of spring breakers on the beaches were going to turn FL into a slaughterhouse 

"Contrast the decisions by governors like Cuomo with those of Florida Gov. Ron DeSantis. In Florida, all nursing home workers were required to be screened for COVID-19 symptoms before entering a facility. On March 15, before most states had locked down, DeSantis signed an executive order that banned nursing home visitations from friends and family, and also banned hospitals from discharging SARS-CoV-2-infected patients into long-term care facilities."

https___blogs-images.forbes.com_theapothecary_files_2020_05_COVID-LTC-2020-05-28.png.f53721bfbbc29dce6cf80403c36acdf0.png

 

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16 minutes ago, colonel_kurtz said:

https://www.forbes.com/sites/theapothecary/2020/05/26/nursing-homes-assisted-living-facilities-0-6-of-the-u-s-population-43-of-u-s-covid-19-deaths/#77b7cdc974cd

"In New Jersey, nearly 10 percent of all long-term care facility residents—954 in 10,000—have died from the novel coronavirus."

for some reason, LOL, the action that FL took very early to protect LTC facilities has rec'd little if any attention from the media however I clearly remember the foaming & frothing how swarms of spring breakers on the beaches were going to turn FL into a slaughterhouse 

"Contrast the decisions by governors like Cuomo with those of Florida Gov. Ron DeSantis. In Florida, all nursing home workers were required to be screened for COVID-19 symptoms before entering a facility. On March 15, before most states had locked down, DeSantis signed an executive order that banned nursing home visitations from friends and family, and also banned hospitals from discharging SARS-CoV-2-infected patients into long-term care facilities."

https___blogs-images.forbes.com_theapothecary_files_2020_05_COVID-LTC-2020-05-28.png.f53721bfbbc29dce6cf80403c36acdf0.png

 

I remember seeing something a little while ago that Murphy and Cuomo sent elderly Covid patients back into their nursing homes instead of keeping them in hospitals. The NY Post leans right I believe, but if it's true then that action deserves coverage no matter what people's politics are. https://nypost.com/2020/05/16/blame-governors-for-coronavirus-deaths-in-nursing-homes-goodwin/

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The WHO is full of sh$t. It has been proven that an asymptomatic person can shed the virus. At least if they were wearing a mask the airborne particulates would be reduced.

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I fully intend to follow the CDC's guidelines on masks, that's for sure.

That being said, I wonder if it's a difference in the audience receiving the message?

The CDC issues guidelines for Americans, one of the wealthiest nations and who ideally have excellent opportunities to provide masks to everyone. In contrast, the WHO issues guidelines for ALL countries, both well-developed countries with money to purchase masks and countries having far fewer resources for the purchase of masks. I wonder if the WHO's guidance was calibrated with this in mind so as to avoid a run on masks in countries where there aren't as many to go around.

 

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4 hours ago, ACwx said:

I remember seeing something a little while ago that Murphy and Cuomo sent elderly Covid patients back into their nursing homes instead of keeping them in hospitals. The NY Post leans right I believe, but if it's true then that action deserves coverage no matter what people's politics are. https://nypost.com/2020/05/16/blame-governors-for-coronavirus-deaths-in-nursing-homes-goodwin/

Yeah there is a 9/11 type commission coming with this (and the testing snafu).  Two of the biggest never agains that have to come out of this.  They should have used the field hospitals.

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5 hours ago, ACwx said:

I thought the same thing at first, and you're 100% right. I watched the video and it goes along with what he says, sure we might "feel" healthy but it is to protect others more than anything. In that case I think the WHO needs to re-word what they say on their page, because "feeling" healthy is such a tricky area with this virus.

My only issue with adopting that mentality is this - at what point do we say it's OK for no one to need masks anymore, in the sense of our normal day-to-day routines? I think the common answer for many people would be "not until there's a vaccine". But even with a vaccine, wouldn't there still be at least some cases of the virus? And isn't it fair to say that a vaccine is not necessarily a guarantee, even though there are many trials ongoing at the moment?

Trust me I want to protect others as much as anyone else, but my ultimate fear with this is that someone (whether it's politicians or otherwise) is going to make mask-wearing / social distancing / etc. a requirement whether there's a vaccine or not, so I can't walk into Wawa or Target five years from now in 2025 without wearing a mask because "someone could still have the virus". I understand that may seem far-fetched, but over the past few weeks, watching states re-open on a timeline based on the political party of the governor instead of the state's actual data has not given me any reassurance.

And just so we're clear, I'm not trying to advocate against masks or turn things political, I'm just asking questions.

Yeah I can’t answer that. I’d say no (about 2025 masking), but I could be wrong again. I may be too optimistic about a vaccine being ready for mass distribution during the first half of 2021.  I think the D and R governors should have swapped states or everyone should have just stuck to the CDC guidelines on reopening. Ok with idea of sectorizing like Cuomo did. 

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32 minutes ago, snowlurker said:

I fully intend to follow the CDC's guidelines on masks, that's for sure.

That being said, I wonder if it's a difference in the audience receiving the message?

The CDC issues guidelines for Americans, one of the wealthiest nations and who ideally have excellent opportunities to provide masks to everyone. In contrast, the WHO issues guidelines for ALL countries, both well-developed countries with money to purchase masks and countries having far fewer resources for the purchase of masks. I wonder if the WHO's guidance was calibrated with this in mind so as to avoid a run on masks in countries where there aren't as many to go around.

 

Sometimes I think that might have even been the thinking here given how the toilet paper ran off the shelves. Then again the thinking might have changed as March progressed. I am sure there are examples of non masked countries doing relatively ok with this, but Taiwan, Hong Kong and South Korea all did well too. 

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By the time we started seeing nursing home cases in the southern part of the state (mid- to late-March), area nursing homes, acute rehab facilities, and long term acute care hospitals (LTACs) were refusing to take patients back from unless they had documentation of two negative COVID tests while in house.  Each facility had their own policy, and while the state government can issue a blanket ruling or executive order stating basically what the facilities near us were saying, it wasn't necessary as our area facilities were just saying no.  So the claim in that article "Gov. Phil Murphy of New Jersey issued...orders in late March requiring nursing homes to accept COVID-19 patients being discharged from hospitals. The orders barred the homes from even asking if the patients had the virus, lest they be discriminated against" is patently false, as our local facilities were REQUIRING attestation from physicians and documentation from laboratories that patients coming to them or coming back to them were COVID (-) x 2.  I had my last experience with this two weeks ago, when my colleague was finally able to discharge a patient who had been in our care for 33 days, including 16 days after leaving the ICU extubated because he continued to have positive nasopharyngeal swabs.  Also, OUR facility policy stated that once a patient tested positive, we could not re-test that patient for at least 72 hours regardless of their clinical condition or improvement, so there's that.

Don't get me wrong, I completely understand what's happening here, and hospitals just can't dump people back to facilities, especially when those facilities aren't prepared for them (just as hospitals weren't). 

What's the downside of hospitals keeping those patients?  For the hospital, even with the best documentation and the best case scenarios, our Medicare reimbursement stops somewhere around day 17-18, so those last 10, 20, 30 days are literally on the house.  And in a situation where hospitals are growing more and more dependent on NOT INPATIENT revenue streams, and during a pandemic where those revenue streams are coming to a halt, what does that lead to?  That leads to the significant workforce reductions and furloughs that we're seeing around the state in healthcare, even as those revenue streams are re-established.  It's a lose/lose situation.  We weren't prepared for anything like this at the state level, just as we weren't prepared at the Federal level, and we certainly weren't prepared at the level of a healthcare industry. 

All that said, today our count of inpatient COVID cases dropped below 60 for the first time since April 9.  That makes today a good day.

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44 minutes ago, Rainshadow5.8 said:

Yeah there is a 9/11 type commission coming with this (and the testing snafu).  Two of the biggest never agains that have to come out of this.  They should have used the field hospitals.

Javits center and the boat were hardly used and the Christian hospital in central park which endured attacks from the LGBT community.. Cuomo was asking for 30,000 to 40,000 ventilators really? Why put them in nursing homes? Not to mention the boat that was sent to California that wasn't used. Ok I have probably pissed everyone off.

We are coming out of this and my mother always said not to throw stones if you live in a glass house.So

Stay well.

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1 hour ago, Harbourton said:

Javits center and the boat were hardly used and the Christian hospital in central park which endured attacks from the LGBT community.. Cuomo was asking for 30,000 to 40,000 ventilators really? Why put them in nursing homes? Not to mention the boat that was sent to California that wasn't used. Ok I have probably pissed everyone off.

We are coming out of this and my mother always said not to throw stones if you live in a glass house.So

Stay well.

Vulnerable population, people working in multiple facilities, problematical procedures, there aren't many states that come out looking good on this map other than Alaska.  BTW NY % is not right, they are only counting people who die at LTC facilities, not in hospitals who were residing in LTC facilities.

4.JPG.926f3cf2c31fb0737db9832baff18d6b.JPG

 

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Third day in a row in which Brazil has topped the U.S.

The U.S. didn't make it easy for them today, nearly 500,000 test dump day or more than half of the total tests that Brazil has done since day 1.  We are watching a bullet train speeding toward a non-existent bridge.

3.JPG.45a8aa6ff514801146a104cdca4959fa.JPG

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3 hours ago, Harbourton said:

Javits center and the boat were hardly used and the Christian hospital in central park which endured attacks from the LGBT community.. Cuomo was asking for 30,000 to 40,000 ventilators really? Why put them in nursing homes? Not to mention the boat that was sent to California that wasn't used. Ok I have probably pissed everyone off.

We are coming out of this and my mother always said not to throw stones if you live in a glass house.So

Stay well.

No need to apologized we have continued to move the goal posts of what was needed to open up....1st not enough ventilators....then overwhelming the ERs now we need a vaccine....the good news is we will never go down this path again as while there will of course will be another variant of a virus we have never seen before...maybe a covid22...and despite folks that will again push to shut down the economy and move 20% plus of all US workers to unemployment....cooler heads will prevail. We are as prepared as is possible for the next pandemic. While our government leadership (neither Republican or Democratic - this is not a political issue as both left and right political leaders have failed all of us) for the last 100 years no administration was ever truly prepared (that includes Bush, Obama and Trump)....we finally have enough ventilators to stop the ERs from being overwhelmed. Now there is no way of course to have a test for a virus that has not yet reared it's ugly head....we at least will be ready to handle any potential ER rush.....this is the best thing coming out of this mess!

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On a personal note. I had my first cataract surgery on March 9. Very happy with results. Cataract surgery on other eye cancelled cause of Covid restrictions. As some of you know, NJ Gov. allowed elective surgery effective May 26 with restrictions. I have no problems with restrictions so that I can be safe and health care workers can be safe. One of the requirements is that patients have Covid test within 96 hours of surgery and then self quarantine until surgery. 

Left eye cataract surgery on June 1st. 

The good news is that my test is negative. My housemate and I have been sheltering in place except for grocery shopping, pharmacy, medical services since March 17th. And  we wear masks in public and wash our hands, disinfect, etc. 

Will be glad to have left eye cataract operated on. 
 

Tyler

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23 hours ago, rramblings said:

On a personal note. I had my first cataract surgery on March 9. Very happy with results. Cataract surgery on other eye cancelled cause of Covid restrictions. As some of you know, NJ Gov. allowed elective surgery effective May 26 with restrictions. I have no problems with restrictions so that I can be safe and health care workers can be safe. One of the requirements is that patients have Covid test within 96 hours of surgery and then self quarantine until surgery. 

Left eye cataract surgery on June 1st. 

The good news is that my test is negative. My housemate and I have been sheltering in place except for grocery shopping, pharmacy, medical services since March 17th. And  we wear masks in public and wash our hands, disinfect, etc. 

Will be glad to have left eye cataract operated on. 
 

Tyler

best of luck! 

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