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The Coronavirus Pandemic thread III
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Going strong Offline
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Post: #1076
RE: The Coronavirus Pandemic thread III
(03-23-2020 07:30 PM)RoastBeefCurtains4Me Wrote:  
(03-23-2020 06:52 PM)Hell_Is_Like_Newark Wrote:  
(03-23-2020 06:02 PM)fiasco360 Wrote:  Bats really are the spawn of satan.

Given how many mosquitos bats will eat in a single night, the are OK in my book.

Out of all the animals available as inspiration for pictures of demons or gross, scary aliens, bats are certainly one of the most grotesque, with some of the worst looking insects as their only competitors. They really do look evil.

That being said, I agree that I like their bug eating habits. In my back yard, the bats come out at twilight, and you can see them flittering around, jerking this way and that as they catch bugs. I'm happy to have the bugs removed, and the bats usually don't cause any bother (except that time one flew into the house).

Bats, ya gotta love em, and ya gotta hate em too!

What if bats have been given, by God, their fast virus-laden body and scary lethal face, for a reason. To be His scary instruments for decimating uncontrollable juice-sucking populations: mosquitoes and boomers.
03-23-2020 07:54 PM
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RE: The Coronavirus Pandemic thread III
I think the only way we could reopen the economy and ditch mass quarantines is to do what South Korea did: Mass testing and self quarantine for those that test positive with tracking with an app on the phone. Also temperature testing people who want to enter public events and spaces, and a widespread public spaces disinfection campaign along with a publicity campaign to encourage best practices regarding hygiene.

Of course, that probably won't happen because the USA isn't an orderly NE Asian country, so I suspect the COVID-19 pandemic will be a disaster in the USA.
(This post was last modified: 03-23-2020 08:02 PM by Easy E.)
03-23-2020 08:00 PM
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RE: The Coronavirus Pandemic thread III
I am an internal medicine doctor in NYC. I am not an intensivist, but this weekend I was asked to help in my hospitals ICU due to short staffing. The entire ICU was full of COVID patients. Supposedly 80% of infections from coronavirus are mild or asymptomatic. I can't say from personal experience, but I have no reason not to believe those numbers. The patients in the ICU are the sickest patients and the most severe cases, so what I'm going to say will not apply to most infections, but is sort of a worst case scenario of infection.

For context, since most of you are presumably not medial people, I'll explain a few terms. Hypoxia is the term for low oxygen levels in your tissues. Hypoxemia is a closely related term meaning low oxygen levels in the blood. Hypercarbia is when there is elevated levels of carbon dioxide in the blood. Endotracheal intubation is when a tube is but down your throat, between your vocal cords, and into your windpipe. This tube is connected to a breathing machine, called a ventilator.

Because each patient was critically ill, I was taking care of somewhere between 10-15 patients. My observations may be partially due to chance and small sample size, or representative of patients in general with this disease. I don't think there is any way to tell until there is more data.

Every single patient in the unit was intubated and in acute respiratory distress syndrome (ARDS). ARDS is caused by there is an injury to the lungs, which inhibits the uptake of oxygen, in spite of high amounts of oxygen being delivered. Most cases of ARDS I had seen previously were caused by pneumonia, although inhaled chemicals or toxins can also cause the condition. In a typical month, there will be maybe 2 cases of ARDS that go through the ICU, so to have the entire unit full of it is much above average. All of the other areas of the hospital that can support patients on ventilators were also full of these patients.

In severe cases of ARDS, some studies suggest that patients do better with medications that paralyze them. This helps keep patients breathing in synchrony with the ventilator, because if patients try to breath at different rates than the ventilaor, it can cause oxygen levels to drop. These medications that paralyze patients do no affect consciousness, and this is something that would obviously been very unpleasant, so heavy sedation is also given on patients who are paralyzed. Studies also show that patients who are placed in a prone position (lying on their stomach) tend to have better oxygen levels in ARDS than patients on their backs. Being proned for too long a period of time causes issues such as an increased rate of pressure ulcers and increased facial swelling, so they must be turned at least twice a day. The fact that they need so many medications and need to be turned frequently is partially why extra workers were needed and I was called in.

While many patients were on very high ventilator settings, it seemed the sickest patients and the ones (I am told) who died previously did not die of hypoxia but of heart or kidney issues. It appears some people with COVID develop myocarditis, or an infection of the heart muscle. The sickest patients, however, all seemed to be in kidney failure. Dialysis can be started to help do the kidney's job of removing toxins from the blood, but the lack of dialysis machines seems to be on of the most glaring shortages in the hospital right now.

Much has been said that older patient and patients with many comorbidities seem to be most vulnerable. However, about half of my patients were in their 30s or 40s and were otherwise relatively healthy prior to hospitalization. I'm not sure if this is because they were prioritized because there are limited beds, or if this is representative of the cases in NYC in general. When I checked today, 3 of the patients I had taken care of over the weekend had passed.

In terms of the treatments being used, at least once they reach the ICU, everyone is being covered empirically for superimposed bacterial pneumonia with antibiotics ceftriaxone and azithromycin (the regimen used for patients with "regular" pneumonia). In addition to being an antibiotic, azithromycin is sometimes used in patients with COPD exacerbations because it seems to have to anti-inflammatory effects. Patients with isolated respiratory failure and no other issues are being tried on a novel drug remdesivir, whereas those with other organ involvement are being treated with hydroxychloroquine. My understanding is that most patients not in the ICU are not being treated with remdesivir or hydroxychloroquine (although they are likely still getting antibiotics.

For now there is not a shortage of personal protective equipment, but I think they are prioritizing it for those in the ICUs taking care of the sickest patients. They number of cases we are seeing every day is still going up. At the current rate, there may be shortages soon.

Three of the patients I was taking care of passed away. Similarly to what I was told, they all had renal failure caused by COVID.

Again, as I understand it, most patients hospitalized with COVID are getting better and are going home. A few of my colleagues have been infected, but they seem to be doing OK. This is what I observed this weekend, again, not sure how typical or out of the ordinary it is compared to whats happening in other cities or at other institutions.
03-23-2020 08:21 PM
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RE: The Coronavirus Pandemic thread III
(03-23-2020 08:21 PM)Doubting Thomas Wrote:  I am an internal medicine doctor in NYC. I am not an intensivist, but this weekend I was asked to help in my hospitals ICU due to short staffing. The entire ICU was full of COVID patients. Supposedly 80% of infections from coronavirus are mild or asymptomatic. I can't say from personal experience, but I have no reason not to believe those numbers. The patients in the ICU are the sickest patients and the most severe cases, so what I'm going to say will not apply to most infections, but is sort of a worst case scenario of infection.

For context, since most of you are presumably not medial people, I'll explain a few terms. Hypoxia is the term for low oxygen levels in your tissues. Hypoxemia is a closely related term meaning low oxygen levels in the blood. Hypercarbia is when there is elevated levels of carbon dioxide in the blood. Endotracheal intubation is when a tube is but down your throat, between your vocal cords, and into your windpipe. This tube is connected to a breathing machine, called a ventilator.

Because each patient was critically ill, I was taking care of somewhere between 10-15 patients. My observations may be partially due to chance and small sample size, or representative of patients in general with this disease. I don't think there is any way to tell until there is more data.

Every single patient in the unit was intubated and in acute respiratory distress syndrome (ARDS). ARDS is caused by there is an injury to the lungs, which inhibits the uptake of oxygen, in spite of high amounts of oxygen being delivered. Most cases of ARDS I had seen previously were caused by pneumonia, although inhaled chemicals or toxins can also cause the condition. In a typical month, there will be maybe 2 cases of ARDS that go through the ICU, so to have the entire unit full of it is much above average. All of the other areas of the hospital that can support patients on ventilators were also full of these patients.

In severe cases of ARDS, some studies suggest that patients do better with medications that paralyze them. This helps keep patients breathing in synchrony with the ventilator, because if patients try to breath at different rates than the ventilaor, it can cause oxygen levels to drop. These medications that paralyze patients do no affect consciousness, and this is something that would obviously been very unpleasant, so heavy sedation is also given on patients who are paralyzed. Studies also show that patients who are placed in a prone position (lying on their stomach) tend to have better oxygen levels in ARDS than patients on their backs. Being proned for too long a period of time causes issues such as an increased rate of pressure ulcers and increased facial swelling, so they must be turned at least twice a day. The fact that they need so many medications and need to be turned frequently is partially why extra workers were needed and I was called in.

While many patients were on very high ventilator settings, it seemed the sickest patients and the ones (I am told) who died previously did not die of hypoxia but of heart or kidney issues. It appears some people with COVID develop myocarditis, or an infection of the heart muscle. The sickest patients, however, all seemed to be in kidney failure. Dialysis can be started to help do the kidney's job of removing toxins from the blood, but the lack of dialysis machines seems to be on of the most glaring shortages in the hospital right now.

Much has been said that older patient and patients with many comorbidities seem to be most vulnerable. However, about half of my patients were in their 30s or 40s and were otherwise relatively healthy prior to hospitalization. I'm not sure if this is because they were prioritized because there are limited beds, or if this is representative of the cases in NYC in general. When I checked today, 3 of the patients I had taken care of over the weekend had passed.

In terms of the treatments being used, at least once they reach the ICU, everyone is being covered empirically for superimposed bacterial pneumonia with antibiotics ceftriaxone and azithromycin (the regimen used for patients with "regular" pneumonia). In addition to being an antibiotic, azithromycin is sometimes used in patients with COPD exacerbations because it seems to have to anti-inflammatory effects. Patients with isolated respiratory failure and no other issues are being tried on a novel drug remdesivir, whereas those with other organ involvement are being treated with hydroxychloroquine. My understanding is that most patients not in the ICU are not being treated with remdesivir or hydroxychloroquine (although they are likely still getting antibiotics.

For now there is not a shortage of personal protective equipment, but I think they are prioritizing it for those in the ICUs taking care of the sickest patients. They number of cases we are seeing every day is still going up. At the current rate, there may be shortages soon.

Three of the patients I was taking care of passed away. Similarly to what I was told, they all had renal failure caused by COVID.

Again, as I understand it, most patients hospitalized with COVID are getting better and are going home. A few of my colleagues have been infected, but they seem to be doing OK. This is what I observed this weekend, again, not sure how typical or out of the ordinary it is compared to whats happening in other cities or at other institutions.

Thanks for the detailed first hand report, and for fighting this on the front lines. It's a real privilege to have RVF members who are able to offer this kind of information.

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03-23-2020 08:39 PM
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Post: #1080
RE: The Coronavirus Pandemic thread III
We can get the economy going again if we:

1. Mandate people wear masks in public, large fine if not (thought this for awhile Cernovich and others are starting to promote).

2. Get antibody test for immunity working.

Don't even need to do death rate extrapolations anymore if we have these two things.

Chloroquine and antibody blood transfusion would just be nice bonuses.
(This post was last modified: 03-23-2020 08:42 PM by Travesty.)
03-23-2020 08:41 PM
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Post: #1081
RE: The Coronavirus Pandemic thread III
(03-23-2020 08:21 PM)Doubting Thomas Wrote:  Every single patient in the unit was intubated and in acute respiratory distress syndrome (ARDS). ARDS is caused by there is an injury to the lungs, which inhibits the uptake of oxygen, in spite of high amounts of oxygen being delivered. Most cases of ARDS I had seen previously were caused by pneumonia, although inhaled chemicals or toxins can also cause the condition. In a typical month, there will be maybe 2 cases of ARDS that go through the ICU, so to have the entire unit full of it is much above average. All of the other areas of the hospital that can support patients on ventilators were also full of these patients.

In severe cases of ARDS, some studies suggest that patients do better with medications that paralyze them. This helps keep patients breathing in synchrony with the ventilator, because if patients try to breath at different rates than the ventilaor, it can cause oxygen levels to drop. These medications that paralyze patients do no affect consciousness, and this is something that would obviously been very unpleasant, so heavy sedation is also given on patients who are paralyzed. Studies also show that patients who are placed in a prone position (lying on their stomach) tend to have better oxygen levels in ARDS than patients on their backs. Being proned for too long a period of time causes issues such as an increased rate of pressure ulcers and increased facial swelling, so they must be turned at least twice a day. The fact that they need so many medications and need to be turned frequently is partially why extra workers were needed and I was called in.

Someone may have posted this video previously, but for anyone looking for more information on how the coronavirus kills, this video describes in great detail the process for treating ARDS that Doubting Thomas discussed. It is well worth a watch.



(This post was last modified: 03-23-2020 08:45 PM by Tail Gunner.)
03-23-2020 08:44 PM
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Post: #1082
RE: The Coronavirus Pandemic thread III
(03-23-2020 08:41 PM)Travesty Wrote:  We can get the economy going again if we:

1. Mandate people wear masks in public, large fine if not (thought this for awhile Cernovich and others are starting to promote).

2. Get antibody test for immunity working.

Don't even need to do death rate extrapolations anymore if we have these two things.

Chloroquine and antibody blood transfusion would just be nice bonuses.

There's also doctors reporting 100% success rates treating hundreds of CV19 patients with the new drug combo that's being touted, that alone (if demand can be met) will greatly decrease the total deaths and take pressure off healthcare infrastructure.
(This post was last modified: 03-23-2020 08:45 PM by aeroektar.)
03-23-2020 08:44 PM
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RE: The Coronavirus Pandemic thread III
(03-23-2020 08:21 PM)Doubting Thomas Wrote:  I am an internal medicine doctor in NYC. I am not an intensivist, but this weekend I was asked to help in my hospitals ICU due to short staffing. The entire ICU was full of COVID patients. Supposedly 80% of infections from coronavirus are mild or asymptomatic. I can't say from personal experience, but I have no reason not to believe those numbers. The patients in the ICU are the sickest patients and the most severe cases, so what I'm going to say will not apply to most infections, but is sort of a worst case scenario of infection.

For context, since most of you are presumably not medial people, I'll explain a few terms. Hypoxia is the term for low oxygen levels in your tissues. Hypoxemia is a closely related term meaning low oxygen levels in the blood. Hypercarbia is when there is elevated levels of carbon dioxide in the blood. Endotracheal intubation is when a tube is but down your throat, between your vocal cords, and into your windpipe. This tube is connected to a breathing machine, called a ventilator.

Because each patient was critically ill, I was taking care of somewhere between 10-15 patients. My observations may be partially due to chance and small sample size, or representative of patients in general with this disease. I don't think there is any way to tell until there is more data.

Every single patient in the unit was intubated and in acute respiratory distress syndrome (ARDS). ARDS is caused by there is an injury to the lungs, which inhibits the uptake of oxygen, in spite of high amounts of oxygen being delivered. Most cases of ARDS I had seen previously were caused by pneumonia, although inhaled chemicals or toxins can also cause the condition. In a typical month, there will be maybe 2 cases of ARDS that go through the ICU, so to have the entire unit full of it is much above average. All of the other areas of the hospital that can support patients on ventilators were also full of these patients.

In severe cases of ARDS, some studies suggest that patients do better with medications that paralyze them. This helps keep patients breathing in synchrony with the ventilator, because if patients try to breath at different rates than the ventilaor, it can cause oxygen levels to drop. These medications that paralyze patients do no affect consciousness, and this is something that would obviously been very unpleasant, so heavy sedation is also given on patients who are paralyzed. Studies also show that patients who are placed in a prone position (lying on their stomach) tend to have better oxygen levels in ARDS than patients on their backs. Being proned for too long a period of time causes issues such as an increased rate of pressure ulcers and increased facial swelling, so they must be turned at least twice a day. The fact that they need so many medications and need to be turned frequently is partially why extra workers were needed and I was called in.

While many patients were on very high ventilator settings, it seemed the sickest patients and the ones (I am told) who died previously did not die of hypoxia but of heart or kidney issues. It appears some people with COVID develop myocarditis, or an infection of the heart muscle. The sickest patients, however, all seemed to be in kidney failure. Dialysis can be started to help do the kidney's job of removing toxins from the blood, but the lack of dialysis machines seems to be on of the most glaring shortages in the hospital right now.

Much has been said that older patient and patients with many comorbidities seem to be most vulnerable. However, about half of my patients were in their 30s or 40s and were otherwise relatively healthy prior to hospitalization. I'm not sure if this is because they were prioritized because there are limited beds, or if this is representative of the cases in NYC in general. When I checked today, 3 of the patients I had taken care of over the weekend had passed.

In terms of the treatments being used, at least once they reach the ICU, everyone is being covered empirically for superimposed bacterial pneumonia with antibiotics ceftriaxone and azithromycin (the regimen used for patients with "regular" pneumonia). In addition to being an antibiotic, azithromycin is sometimes used in patients with COPD exacerbations because it seems to have to anti-inflammatory effects. Patients with isolated respiratory failure and no other issues are being tried on a novel drug remdesivir, whereas those with other organ involvement are being treated with hydroxychloroquine. My understanding is that most patients not in the ICU are not being treated with remdesivir or hydroxychloroquine (although they are likely still getting antibiotics.

For now there is not a shortage of personal protective equipment, but I think they are prioritizing it for those in the ICUs taking care of the sickest patients. They number of cases we are seeing every day is still going up. At the current rate, there may be shortages soon.

Three of the patients I was taking care of passed away. Similarly to what I was told, they all had renal failure caused by COVID.

Again, as I understand it, most patients hospitalized with COVID are getting better and are going home. A few of my colleagues have been infected, but they seem to be doing OK. This is what I observed this weekend, again, not sure how typical or out of the ordinary it is compared to whats happening in other cities or at other institutions.

Any ideas on why most people that get COVID-19 only get symptoms comparable to a mild chest cold and yet others have to be sent to the hospital?

That is what is so strange about this disease. The outcomes vary so much.

I also think that is why there are so many conspiracies about COVID-19.

The outcomes seem odd to the normal, everyday person.
(This post was last modified: 03-23-2020 08:49 PM by Easy E.)
03-23-2020 08:47 PM
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Post: #1084
RE: The Coronavirus Pandemic thread III
@Doubting Thomas: Thank you for the frontline report. I'm sure the men of this board would be very interested to hear your updates with whatever little free time you have. Personally, I'd appreciate any further updates you have to share regarding hydroxychloroquine/chloroquine/remdesivir. Given that the R0 factor of this virus is so high, we must all anticipate getting it at some point, and most critically, know what instructions to give our doctors based upon what appears to be most therapeutically efficacious.

A number of friends and family members are overweight/have poor blood glucose levels/endocrine disorders like PCOS, metabolic syndrome etc. Based on preliminary data I've read in the Lancet and other medical journals, it seems like this virus hits hard against overweight patients or with any kind of chronic or acute inflammation, especially any pre-existing pulmonary issues.

Another question came to mind as I was typing this; As magnesium IV's are often used as a bronchodilator for patients with severe asthma attacks, do you think it would have any efficacy in COVID patients? Mg is a natural anti-inflammatory and can help not only relax bronchial muscles but also have a protective effect on the heart and cardiovascular system if it is under severe distress, or at least that is the conclusion that seemed reasonable when I read about it previously. Have you seen or could you speculate a bit on magnesium being used as a treatment option?

Lastly, have you witnessed any use of intravenous Vitamin C, another option that I've seen suggested in patients in both The Netherlands and in South Korea?

As our knowledge of COVID is rapidly evolving, we deeply appreciate any first-hand reports, as with so many lives on the line, sometimes that's one of the best sources of information if one of us gets struck acutely ill and can't wait for further research to manifest itself. We all need to know what our treatment options are before we get to the E.R.

Thank you once again for your service.

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03-23-2020 08:56 PM
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Post: #1085
RE: The Coronavirus Pandemic thread III
We hit 77 in Hawaii. That does not include tge numbers from this weekend's mass testing.

Aloha!
03-23-2020 09:23 PM
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Post: #1086
RE: The Coronavirus Pandemic thread III
@aeroektar

Hydroxychloroquine may or may not be effective, but the patients of mine who died over the weekend were on it, so it's not a magic bullet

@Easy E

Not sure why there are such different presentations, but this is true about most diseases. There are influenza patients who develop ARDS and wind up receiving similar treatment to what the COVID patients I described are getting now, but it's much rarer for influenza than it seems to be for COVID. Sometimes there are different gene variations of the receptors that the virus uses to get into cells, or sometimes genetic variations in the immune system can make certain people more susceptible.

@ John Michael Kane

Asthma affects the lungs at the levels of the bronchioles, which are the tiny branches of the windpipe. In asthma, spasm of the smooth muscle in the bronchioles causes them to constrict and air to get trapped in the lungs. Magnesium can relax these smooth muscles and help increase airflow. In ARDS, the damage is at the level of the alveoli, which is at the end of the branching where gas exchange takes place. Fluid and inflammation accumulates in the alveoli in ARDS, which can cause the alveoli to collapse and prevents gas exchange in spite of high levels of oxygen supplementation. Because of this different mechanism, I don't expect magnesium would be of much help. For cardiac patients or other medical patients, magnesium is usually only given if patients are deficient on lab testing.

Some medications that reduce inflammation such as steroids and NSAIDs (like ibuprofen) have anecdotal evidence against their use for COVID. But again, there is lots that still needs to be learned about this disease.

I know Vitamin C is popular on this forum, but as far as I'm aware there is little in terms of studies that shows benefit at preventing colds or other infections, and it is not being routinely used at my hospital.
03-23-2020 09:24 PM
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Post: #1087
RE: The Coronavirus Pandemic thread III
Great news about immunity, at least in monkey model.

https://www.youtube.com/watch?v=q4P91VrfPGw
03-23-2020 09:57 PM
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RE: The Coronavirus Pandemic thread III
8 days until we attempt to "restart " the economy, dooming anyone over 60 with complications. They have already ceased graduate teaching as well as clinical teaching. Residents and Fellowships only. My program is now over and no medicine training for me until August plus they cancelled my Step 3 exam indefinitely. This sucks but my friends in the ER tell me it is following the Italian model with a lot older and comorbidities patients. A few stressed out MHPs have had some serious symptoms.

No I hear a bunch of New York/New Jersey people are coming here to deal with quarantine- might as well be warm right? We are totally going to quarantine them right? Not.

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(This post was last modified: 03-23-2020 10:12 PM by Atlanta Man.)
03-23-2020 10:05 PM
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RE: The Coronavirus Pandemic thread III
(03-23-2020 09:24 PM)Doubting Thomas Wrote:  In ARDS, the damage is at the level of the alveoli, which is at the end of the branching where gas exchange takes place. Fluid and inflammation accumulates in the alveoli in ARDS, which can cause the alveoli to collapse and prevents gas exchange in spite of high levels of oxygen supplementation. Because of this different mechanism, I don't expect magnesium would be of much help. For cardiac patients or other medical patients, magnesium is usually only given if patients are deficient on lab testing.

Do you think there is any possibility of the claim that 5G antennas have an effect on oxygen molecules, interfering with the binding to hemoglobin in the lungs? does your hospital have any 5g antennas near by?

Same question to Atlantaman
(This post was last modified: 03-23-2020 10:10 PM by Stats.)
03-23-2020 10:09 PM
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RE: The Coronavirus Pandemic thread III
So in 8 days we open all the clubs and bars and invite vacationers? Please explain the "restart" of the economy, I cannot fathom how it happens in Miami....

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03-23-2020 10:11 PM
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Post: #1091
RE: The Coronavirus Pandemic thread III
(03-22-2020 09:37 PM)Dusty Wrote:  
(03-22-2020 11:04 AM)Dusty Wrote:  
(03-21-2020 03:45 PM)Dusty Wrote:  COVID-19 US deaths:

3/18 150, +38% from prior day
3/19 207, +38% from prior day
3/20 256, +24% from prior day

The daily death growth rate slowed yesterday. Let’s hope that’s a new trend. Only one data point though.

Huge difference between 38% daily growth, versus 24%.

The three day rolling average daily death growth rate is 33%. You take that out 30 days, and you have 1.4 million deaths. Let’s keep an eye on that and hope it decelerates.

Update

COVID-19 US deaths (Worldometer):

3/19 207, +38% from prior day
3/20 256, +24% from prior day
3/21 302, +18% from prior day

3 day rolling average daily growth rate: 27%. At that rate, the number of deaths doubles every three days.

Today’s numbers are in on Worldometer. Not a good day.

COVID-19 US deaths (Worldometer):

3/20 256, +24% from prior day
3/21 302, +18% from prior day
3/22 419, +39% from prior day

3 day rolling average daily growth rate: 27%. At that rate, the number of deaths doubles every three days.

COVID-19 US deaths (Worldometer):

3/21 302, +18% from prior day
3/22 413, +37% from prior day
3/23 553, +34% from prior day

3 day rolling average daily growth rate: 30%. At that rate, the number of deaths more than doubles every three days. If this growth rate were to continue, we’d reach one million COVID-19 deaths in the next 29 days.
(This post was last modified: 03-23-2020 10:14 PM by Dusty.)
03-23-2020 10:13 PM
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rainy Offline
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Post: #1092
RE: The Coronavirus Pandemic thread III
How trusted is the Worldometer?

They have the US down for under 300 recoveries.

Spain has 11K fewer cases and 3,300 recoveries.

If the site is largely true, what's happening in the US is positive compared to Italy.

Italy has about 64K cases and 6K deaths.

US has 46K cases and 579 deaths. Again leads to the recovery rate being completely unreported.

China should never be used as a source again.

And here in NY while I don't doubt the numbers and NYC should be quarantined, it appears to me many other places as severely under testing. No way CA only has 2,100 cases while Trump sends navy vessels to use as floating hospitals.
(This post was last modified: 03-23-2020 10:29 PM by rainy.)
03-23-2020 10:24 PM
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Post: #1093
RE: The Coronavirus Pandemic thread III
03-23-2020 10:32 PM
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Post: #1094
RE: The Coronavirus Pandemic thread III
(03-23-2020 08:21 PM)Doubting Thomas Wrote:  Much has been said that older patient and patients with many comorbidities seem to be most vulnerable. However, about half of my patients were in their 30s or 40s and were otherwise relatively healthy prior to hospitalization. I'm not sure if this is because they were prioritized because there are limited beds, or if this is representative of the cases in NYC in general. When I checked today, 3 of the patients I had taken care of over the weekend had passed.

In terms of the treatments being used, at least once they reach the ICU, everyone is being covered empirically for superimposed bacterial pneumonia with antibiotics ceftriaxone and azithromycin (the regimen used for patients with "regular" pneumonia). In addition to being an antibiotic, azithromycin is sometimes used in patients with COPD exacerbations because it seems to have to anti-inflammatory effects. Patients with isolated respiratory failure and no other issues are being tried on a novel drug remdesivir, whereas those with other organ involvement are being treated with hydroxychloroquine. My understanding is that most patients not in the ICU are not being treated with remdesivir or hydroxychloroquine (although they are likely still getting antibiotics.

Hey mate, there's so much disinformation out there that it would be good to have someone who is the thick of it to wake up my mates in the health service here by providing hard data. They rang me this morning because they want to me to come out of retirement - I had to tell them I'm still two more days in quarantine and doubt my particularly specialization helps in matters of low-level social anxiety and stress, but they're desperate - and I had a long talk with them about the situation. They're expecting no younger patients and think there's no real serious threat because hydroxycholoroaquine will help.

You couldn't be a lifesaver and play whistleblower for us, could you? It'd be really useful to see the treatment files for these younger people who died if you'd can to 'leak' them, including what dosages of the drug were given and how regularly. I doubt there's any serious threat to your job at a time like this, and it would only be going internally through the health service anyway. See what you can do in your downtime.

Godspeed.
03-23-2020 10:49 PM
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Post: #1095
RE: The Coronavirus Pandemic thread III
(03-23-2020 10:09 PM)Stats Wrote:  
(03-23-2020 09:24 PM)Doubting Thomas Wrote:  In ARDS, the damage is at the level of the alveoli, which is at the end of the branching where gas exchange takes place. Fluid and inflammation accumulates in the alveoli in ARDS, which can cause the alveoli to collapse and prevents gas exchange in spite of high levels of oxygen supplementation. Because of this different mechanism, I don't expect magnesium would be of much help. For cardiac patients or other medical patients, magnesium is usually only given if patients are deficient on lab testing.

Do you think there is any possibility of the claim that 5G antennas have an effect on oxygen molecules, interfering with the binding to hemoglobin in the lungs? does your hospital have any 5g antennas near by?

Same question to Atlantaman
Germany is a 5G 3rd or 4th world country and rapidly catching up to Italy regarding infections, forget about your tinfoil hat and get mask.

Brought to you by Carl's Jr.
03-23-2020 11:00 PM
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Post: #1096
RE: The Coronavirus Pandemic thread III
Registered Nurse/FNP-S here. Have worked on a COVID-19 holding unit in NYC at a major hospital, and will continue to do so, for the foreseeable future.

Everything thomas stated, is 100% what I've seen. Most people do go home. The very sick is usually the elderly, though we do have people in there 30-40s. The most sick of them, end up in renal failure.

Most of the deaths are due to cytokinesis storm, from what the physicians have explained to me. This is when the immune system goes overboard.

I've seen 20 year olds requiring intubation, though this appears to be VERY rare, at this time.

The doctors are "compassionately" prescribing hydroxycholorquine and azithromycin. I do not know how well it is working, it is too soon to tell.

I am receiving anecdotal reports from doctors, nurses, and pharmacists from neighboring hospitals that it is, in fact, working moderately well to treat COVID-19.

Quick post, this is all I have for now.

Edit: if anyone can give me tips or ideas on how to boost my immunity, it would be much appreciated. I am slightly terrified.
(This post was last modified: 03-23-2020 11:22 PM by Sol-lek.)
03-23-2020 11:10 PM
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Post: #1097
RE: The Coronavirus Pandemic thread III
(03-23-2020 11:10 PM)Sol-lek Wrote:  Edit: if anyone can give me tips or ideas on how to boost my immunity, it would be much appreciated. I am slightly terrified.

daily vitamin c, vitamin d, zink, sunshine, fresh air, exercise, healthy diet, at least 8h sleep in total darkness.
ppe that has airtight seal over eyes,nose, mouth, and covered ears
(This post was last modified: 03-23-2020 11:43 PM by Stats.)
03-23-2020 11:41 PM
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Post: #1098
RE: The Coronavirus Pandemic thread III
(03-23-2020 11:10 PM)Sol-lek Wrote:  Registered Nurse/FNP-S here.

Edit: if anyone can give me tips or ideas on how to boost my immunity, it would be much appreciated. I am slightly terrified.

You're the medical health professional....what are you asking us for?
03-23-2020 11:44 PM
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Post: #1099
RE: The Coronavirus Pandemic thread III
Priests in India face charges for breaking COVID-19 restrictions on mass gatherings

Quote:MUMBAI, India - A Catholic priest in India has been arrested after breaking coronavirus restrictions by organizing a prayer meeting in the state of Kerala.

Father P. Pauly was taken into custody on Monday by Kerat police after an early morning prayer session at the Kudapuzha Nithyasahaya Matha Church at Chalakudy, near Kochi.

“It was for violating the guidelines that is in place. He will be given bail,” an official told Daijiworld.

The police are also planning to register cases against 100 people who attended the morning prayers.

On March 19, two other priests were charged after celebrating public Mass after religious services were suspended due to the COVID-19 pandemic.

“We had taken all precaution before conducting the Mass, which was part of the church’s feast. We had cancelled the celebrations and was conducting the Mass,” Father Thomas Pattamkulam told the New Indian Express.

The priests could face six months in jail and a monetary fine for violating the restrictions.

Coronavirus: Are Indians not taking the lockdown seriously? 'Stop dancing on the streets,' say tweets

[Image: Indians-perform-Garba-dance_1710679b6f2_large.jpg]

Quote:India was under a 'curfew' yesterday to prevent the spread of Coronavirus, but, videos of people taking to the streets and dancing during the ‘Janata (public) curfew’ on Sunday emerged on Twitter. Many Indian tweets are outraged.

The videos show people gathering and celebrating in huge groups, banging on plates, clapping their hands, and dancing in rallies. So, what about social distancing? That was the whole point of the curfew, many tweeps have said.


During a speech on Thursday night, Indian prime minister, Narendra Modi, called for a self-imposed lockdown to be observed on Sunday from 7am to 9pm. He also asked the nation’s public to “clap their hands” at 5pm as part of efforts to display their support for healthcare workers amid the coronavirus outbreak.

However, there were those who seemed to have misinterpreted Modi’s proposal and chose to socialise instead.

Several clips have emerged of people holding rallies and performing ‘garba’ (Gujarati dance form) during the lockdown.


Social media users shared the videos and urged these people to take social distancing seriously and slammed those who did not respect the curfew guidelines.

Tweep @HukkeriGanesh posted a video of a group of people dancing on the streets with a large crowd of spectators: “Oh My God! Do we want to stop or to ignite it more... When'll we understand the seriousness in such pandemic attack of Corona? #Social_Distancing Was the objective behind today's #JanataCurfew and you are playing Garba? It's time to get serious not to celebrate guys... grow up!”


User @Raghuchilukoori tweeted a clip of a rally with people seen wearing masks and beating drums, and wrote: “Can there be anything more frustrating than watching this for a healthcare worker?”


Twitter user @Forumkeralam1 posted a similar video of a group of people: “Victory celebrations... The intent of the whole act has gone for a complete toss.”


Tweep @PradeepraoBJP shared a clip apparently from his locality of a gathering of people beating drums and clapping: “My villagers voluntarily participated in the #JanataCurfew. As well as Gudipally villagers also thanked the people who are giving their service during dangerous coronavirus is spreading all over the India and they all prayed for their good health.”


Modi, @narendramodi, took to Twitter to point out that people are still not taking the lockdown seriously in the country: “Many people are still not taking the lockdown seriously. Please save yourself, save your family, follow the instructions seriously. I request the state governments to get the rules and laws followed.”

The World Health Organization has urged the public to practice social distancing. They have asked people to leave at least three feet, or one metre, between themselves and anyone who is coughing or sneezing.
(This post was last modified: 03-23-2020 11:53 PM by WalterBlack.)
03-23-2020 11:47 PM
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Post: #1100
RE: The Coronavirus Pandemic thread III
(03-23-2020 11:41 PM)Stats Wrote:  
(03-23-2020 11:10 PM)Sol-lek Wrote:  Edit: if anyone can give me tips or ideas on how to boost my immunity, it would be much appreciated. I am slightly terrified.

daily vitamin c, vitamin d, zink, sunshine, fresh air, exercise, healthy diet, at least 8h sleep in total darkness.
ppe that has airtight seal over eyes,nose, mouth, and covered ears

I've been dosing 2000 mg of vitamin C, and have zinc tablets on the way. Combined with relative youth, I'm hoping this is enough. Crazy thing is, I have friends that have tested positive, with very minimal symptoms. I've had this odd dry cough for about 2 weeks now, but that's really about it.

Thankfully, my hospital has been ok with rationing out the N95 masks. They insist we use one per shift, but that still doesn't sit right with me.
03-23-2020 11:53 PM
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