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"138 suspected Covid cases in hospitals"-what's the threshold for "suspected cases&qu

  • 16-07-2020 7:00pm
    #1
    Registered Users Posts: 7,819 ✭✭✭ _Whimsical_


    RTE reported yesterday that there are currently 138 patients in hospital in the country with suspected Covid alongside 13 confirmed cases.

    Does anyone know what the threshold of suspicion is for a case to considered "suspected Covid"?

    I know a few Drs and nurses who have worked with Covid patients and who've said that once it reaches a point of requiring hospitalisation it is quite distinct in terms of clinical symptoms and trajectory. They've mentioned having patients who test negative but who very obviously have Covid. That fits with there being a reported upto 30% false negative rate with the current test.

    138 false negatives would be a bit astounding though surely? Who are these 138 patients and how likely are they to have Covid?

    https://www.rte.ie/news/coronavirus/2020/0715/1153327-ireland-coronavirus-covid19/


Comments

  • Registered Users Posts: 11,535 ✭✭✭✭ ACitizenErased


    Anyone in a hospital is a suspected case. Ridiculous journalism. It comes out in the HSE report daily.
    https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/covid-19-daily-operations-update-2000-15-july-2020.pdf


  • Registered Users Posts: 7,819 ✭✭✭ _Whimsical_


    Anyone in a hospital is a suspected case. Ridiculous journalism. It comes out in the HSE report daily.
    https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/covid-19-daily-operations-update-2000-15-july-2020.pdf

    There must be symptoms of clinical significance to be considered suspected surely? There has to be some threshold for determining likelihood? Otherwise everyone arriving in hospital would be a suspected case of everything?

    There are currently 6 suspected cases in ICU for example.


  • Registered Users Posts: 11,535 ✭✭✭✭ ACitizenErased


    There must be symptoms of clinical significance to be considered suspected surely? There has to be some threshold for determining likelihood? Otherwise everyone arriving in hospital would be a suspected case of everything?

    There are currently 6 suspected cases in ICU for example.
    Nope. Everyone's tested and counted as suspected. If you go for a trip to A&E you will be tested, if you have an operation you will be tested etc.


  • Registered Users Posts: 497 ✭✭ Kerry25x


    Anyone in a hospital is a suspected case.

    That's not the case. Everyone admitted is tested for the virus whether they are suspected or unsuspected but a suspected case is treated as a positive and put in to full isolation and cared for by staff dressed in full PPE.

    Some patients are diagnosed using clinical judgement through chest x-rays, blood work etc despite a negative swab result.


  • Registered Users Posts: 11,535 ✭✭✭✭ ACitizenErased


    Kerry25x wrote: »
    That's not the case. Everyone admitted is tested for the virus whether they are suspected or unsuspected but a suspected case is treated as a positive and put in to full isolation and cared for by staff dressed in full PPE.

    Some patients are diagnosed using clinical judgement through chest x-rays, blood work etc despite a negative swab result.
    Everyone tested is treated as suspected on the HSE report. It's been like that since the beginning. I'm talking about the report, not actual hospital procedure.


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  • Registered Users Posts: 905 ✭✭✭ coastwatch


    Everyone tested is treated as suspected on the HSE report. It's been like that since the beginning. I'm talking about the report, not actual hospital procedure.

    That would explain it.
    The HSE report always seems to have high numbers of daily "suspected cases" that never become confirmed cases over the following days.


  • Registered Users Posts: 72,121 ✭✭✭✭ Atlantic Dawn


    Surely in a hospital you need the results back in under 24 hours?


  • Registered Users Posts: 9,918 ✭✭✭ Tom Mann Centuria


    Anyone in a hospital is a suspected case. Ridiculous journalism. It comes out in the HSE report daily.
    https://www.hse.ie/eng/services/news/newsfeatures/covid19-updates/covid-19-daily-operations-update-2000-15-july-2020.pdf

    No, I don't think you're correct. iPMS, the HSE antique computer system used in hospitals has an alert system included. You are correct that you get tested if you're being admitted or having a procedure. But on none of those patients are they flagged as "suspected" in that alert system unless they are symptomatic or a clinicians suspect it. In fact people are admitted to general wards before the swab results come back.

    Maybe you, like me, also work in a HSE hospital, or HSE establishment, and maybe you know something I don't, but I honestly think you're completely wrong. On a single ward yesterday we swabbed 11 new admissions, and this isn't a regional hospital or a Dublin hospital. So if you're even conservatively working the figures, we'd probably have 50 patients being swabbed yesterday in the hospital where I work, which in your theory makes them suspected. Times that by the number of hospitals in Ireland, you've got a shed load more than 150 "suspected" cases.


    Edit: to be fair to the good folk in ED, they usually swab the patients prior to transfer, don't want to take the credit for their work. So we had 11 swabbed patients admitted would be more accurate.


    Oh yeah, I almost forgot, we also swab everyone going back to long-term care facilities (like a nursing home) or anyone who's getting carers coming into their house with a HSE home care package.


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