COVID-19 (f/k/a "the Coronavirus")

[Hards Alumni]

Dudes, The local ICUs are starting to get patients. I'm a primary care provider in Milwaukee.  It is only a matter of time before the state has our first of many deaths.  I've been testing multiple patients a day and we were told today by our organization/the state to stop.  We send our tests to the state lab and they can only handle 400 tests a day. They can't keep up.  The state says the infection is already widespread and there is no point in testing mild illness or outpatients. Right now we're only going to test inpatients and critically ill patients.  It seems if you are celebrity you can get a test too.

We are grossly under prepared for this as a country as we don't have adequate testing and there is lack of protective equipment. I'm supposed to wear an N 95 respirator mask but I don't have one.  I'm wearing a standard poorly fitted mask that doesn't offer great protection.  I have to wear the same damn gown every day for the same patients. Protocol is to change protective equipment after each patient but we just don't have the resources.  It's madness.

Don't let anyone tell you this isn't real. And it's definitely not just the flu. The flu doesn't kill 20% of patients hospitalized with it.  The flu doesn't permanently destroy your lungs like this. Stay safe my friends

Bolded for emphasis.  Stay safe.

[Galway Eagle]

My moms Medispa got shut down by Arizona board of plastic surgery today. They said if something goes wrong they don't want to back up hospitals and don't want non essential treatments taking up medical supplies. Mom and sister considering being volunteer nurses if Phoenix Scottsdale gets hit hard.

[Hards Alumni]

My moms Medispa got shut down by Arizona board of plastic surgery today. They said if something goes wrong they don't want to back up hospitals and don't want non essential treatments taking up medical supplies. Mom and sister considering being volunteer nurses if Phoenix Scottsdale gets hit hard.

Respect.  We need people like them.

[Hards Alumni]

WHO: ibuprofen bad for coronavirus

https://www.yahoo.com/news/avoid-taking-ibuprofen-covid-19-symptoms-202007508.html

I can't emphasize enough how terrible this is.  The first thing people reach for when they feel bad is ibuprofen.  This means you don't take it unless you are sure you are not positive for Covid19.

[Bo Ryan's Massage Therapist]

Asthmatics should also not use nebulizer machines/just inhalers.  Nebulizers can aerosolize the virus.

For the granola crowd who takes Elderberry syrup in an attempt to prevent illness. STOP. There is concern Elderberry also makes the illness worse by releasing a cytokine response.

[Hards Alumni]

Asthmatics should also not use nebulizer machines/just inhalers.  Nebulizers can aerosolize the virus.

For the granola crowd who takes Elderberry syrup in an attempt to prevent illness. STOP. There is concern Elderberry also makes the illness worse by releasing a cytokine response.

Thanks for the info, my wife had been taking it.  Kiboshed.

[GooooMarquette]

Asthmatics should also not use nebulizer machines/just inhalers.  Nebulizers can aerosolize the virus.

For the granola crowd who takes Elderberry syrup in an attempt to prevent illness. STOP. There is concern Elderberry also makes the illness worse by releasing a cytokine response.

Hope the CDC gets info like this out quickly. And the ibuprofen thing is enormous - CDC must get word out ASAP for people to use acetaminophen.

Scary.

[Bo Ryan's Massage Therapist]

Thanks for the info, my wife had been taking it.  Kiboshed.

I should clarify. I'm on a Facebook group for physicians sharing info regarding COVID-19. This includes Italian docs. You can take Elderberry but the second you feel sick you should stop due to concern over a cytokine storm that can make it worse.  I can't find concrete info on this but I'd be cautious.

The ibuprofen thing is concerning. Acetaminophen is fine. 

There is helpful info on cutting edge treatments being tried that I can share if anyone's loved ones become infected.

[Coleman]

Gotta admit, I'm curious to see if everyone singing Fauci's praises and extolling his credibility will accept his claim that the problems with testing were not the President's or CDC's fault.
Hell, CNN called him "Trump's Coronavirus truth teller."

He's towing the company line in public so he doesn't get canned. I'm fine with it. We need him in the job.

[Galway Eagle]

Asthmatics should also not use nebulizer machines/just inhalers.  Nebulizers can aerosolize the virus.

For the granola crowd who takes Elderberry syrup in an attempt to prevent illness. STOP. There is concern Elderberry also makes the illness worse by releasing a cytokine response.

Just started using a nebulizer because of painting and drywalling around the house. Should I stop and stick to garlic and fish oil?

[Eldon]

The illness runs for about two weeks. And lethargy sets in towards the end.

We personally know of at least two dozen confirmed cases here in Seattle and many more where the symptoms mirrored ours.

What is interesting is that they altered the criteria here because not everyone had all of the symptoms, especially shortness of breath.

We need to be mindful of its impact on those populations which are at mortal risk. This is why we voluntarily self-quarantine. But for the vast majority of people it will be a rather uncomfortable cold.

Tom Hanks:

"Good News: One week after testing positive, in self-isolation, the symptoms are much the same. No fever but the blahs," Hanks wrote on social media Tuesday. "Folding the laundry and doing the dishes leads to a nap on the couch."

https://www.yahoo.com/entertainment/tom-hanks-coronavirus-health-update-isolation-no-fever-232623665.html

_________________________________

I wonder if this is the result of:
a) the body still attacking the remnants of the virus
or
b) long-lasting, possibly-permanent, damage

[rocket surgeon]

Well, made it to Az, my SWA 1:40 pm flight had maybe 30-35 people.  Basically everyone had their own row

On another note, has anyone heard of using the plasma antibodies from a recovered patient?  I heard that one recovered patient can provide enough plasma antibodies for 2 sick people.  Now, the big question will be at what point/stage of an illness is the plasma effective?  If the patient is on a ventilator?  Could it work as a "vaccine"or preventative? 

[forgetful]

As far as I'm aware, there still isn't a good explanation for why children don't seem to have the same response to COVID-19. I wonder part of it is due to children being more likely to have recently had an active infection by the coronavirus NL63, that causes croup in children.

NL63 uses the same biochemical mode of entry as COVID-19, and hence could possibly generate a similar signal to the immune system and antibody production.

If so, infection with NL63, which produces little or no symptoms in adults, could function as a pseudo-vaccine to at least lead to weaker infections and more mild symptoms.

Just throwing crap against the wall.

[GooooMarquette]

Yikes! A whopping 1,400 new cases in the past day, with 300 new cases reported just in the past two hours. It was 4,600 last night, and over 6,000 now.

And that's without enough tests to test everyone with symptoms.

[skianth16]

I disagree. I would not be surprised if we see 6 figure deaths. No one is taking it seriously yet. Beaches in Florida are still packed. This is going to get ugly fast.

You think we'll see 6 figure deaths globally or in the US? I haven't seen anything that would make me believe 100,000 deaths globally would be within the realm of possibility. And if you're talking about the US.... well, let's just say we'll have to agree to disagree.

[GooooMarquette]

A little slice of good news: Here in Rochester, Mayo developed the capacity to run about 500 tests/day. Then T-Wolves player Karl-Anthony Towns made a donation that will soon enable us to double that capacity. Very cool move.

[Benny B]

https://www.yahoo.com/huffpost/penguins-aquarium-coronavirus-chicago-223212522.html

Don't know if this is cool, or if covid-19 is a conspiracy orchestrated by penguins. 

[Hards Alumni]

Well, made it to Az, my SWA 1:40 pm flight had maybe 30-35 people.  Basically everyone had their own row

On another note, has anyone heard of using the plasma antibodies from a recovered patient?  I heard that one recovered patient can provide enough plasma antibodies for 2 sick people.  Now, the big question will be at what point/stage of an illness is the plasma effective?  If the patient is on a ventilator?  Could it work as a "vaccine"or preventative?

Yes China did that.

[Hards Alumni]

You think we'll see 6 figure deaths globally or in the US? I haven't seen anything that would make me believe 100,000 deaths globally would be within the realm of possibility. And if you're talking about the US.... well, let's just say we'll have to agree to disagree.

This is only a tweet thread summarizing the report which you find in the original tweet.

https://twitter.com/jeremycyoung/status/1239975682643357696?s=19

Save as PDF  My Authors

We can now read the Imperial College report on COVID-19 that led to the extreme measures we've seen in the US this week. Read it; it's terrifying. I'll offer a summary in this thread; please correct me if I've gotten it wrong.
imperial.ac.uk/media/imperial... 

The Imperial College team plugged infection and death rates from China/Korea/Italy into epidemic modeling software and ran a simulation: what happens if the US does absolutely nothing -- if we treat COVID-19 like the flu, go about our business, and let the virus take its course? 

Here's what would happen: 80% of Americans would get the disease. 0.9% of them would die. Between 4 and 8 percent of all Americans over the age of 70 would die. 2.2 million Americans would die from the virus itself. 

It gets worse. People with severe COVID-19 need to be put on ventilators. 50% of those on ventilators still die, but the other 50% live. But in an unmitigated epidemic, the need for ventilators would be 30 times the number available in the US. Nearly 100% of these patients die. 

So the actual death toll from the virus would be closer to 4 million Americans -- in a span of 3 months. 8-15% of all Americans over 70 would die. 

How many is 4 million people? It's more Americans than have died all at once from anything, ever. It's the population of Los Angeles. It's 4 times the number of Americans who died in the Civil War...on both sides combined. It's two-thirds as many people as died in the Holocaust. 

Americans make up 4.4% of the world's population. If we extrapolate these numbers to the rest of the world (warning: MOE is high here), this gives us 90 million deaths globally from COVID-19, in 3-6 months. 15 Holocausts. 1.5 times as many people as died in all of World War II. 

Now, of course countries won't stand by and do nothing. So the Imperial College team ran the numbers again, this time assuming a "mitigation" strategy: all symptomatic cases in the US in isolation. Families of those cases quarantined. All Americans over 70 social distancing. 

This mitigation strategy is what you've seen a lot of people talking about when they say we should "flatten the curve": try to slow the spread of the disease to the people most likely to die from it, to avoid overwhelming hospitals. 

And it does flatten the curve -- but not nearly enough. The death rate from the disease is cut in half, but it still kills 1.1 million Americans all by itself. The peak need for ventilators falls by two-thirds, but it still exceeds the number of ventilators in the US by 8 times. 

That leaves the actual death toll in the US at right around 2 million deaths. The population of Houston. Two Civil Wars. One-third of the Holocaust. Globally, 45 million people die: 7.5 Holocausts, 3/4 of World War II. That's what happens if we rely on mitigation & common sense. 

Finally, the Imperial College team ran the numbers again, assuming a "suppression" strategy: isolate symptomatic cases, quarantine their family members, social distancing for the whole population, all public gatherings/most workplaces shut down, schools and universities close. 

Suppression works! The death rate in the US peaks 3 weeks from now at a few thousand deaths, then goes down. We hit but don't exceed the number of available ventilators. The nightmarish death tolls from the rest of the study disappear. 

But here's the catch: if we EVER relax suppression before a vaccine is administered to the entire population, COVID-19 comes right back and kills millions of Americans in a few months, the same as before. 

After the 1st suppression period ends in July, we could probably lift restrictions for a month, followed by 2 more months of suppression, in a repeating pattern without triggering an outbreak or overwhelming the ventilator supply. Staggering breaks by city could do a bit better. 

But we simply cannot EVER allow the virus to spread throughout the entire population in the way other viruses do, because it is just too deadly. If lots of people we know end up getting COVID-19, it means millions of Americans are dying. It simply can't be allowed to happen. 

How quickly will a vaccine be here? Last week three separate research teams announced they had developed vaccines. Yesterday, one of them (with FDA approval) injected its vaccine into a live person, without waiting for animal testing. That's an extreme measure, but necessary. 

Now, though, they have to monitor the test subject for 14 months to make sure the vaccine is safe. This part can't be rushed: if you're going to inoculate all humans, you have to make absolutely sure the vaccine itself won't kill them. It probably won't, but you have to be sure. 

Assuming the vaccine is safe and effective, it will still take several months to produce enough to inoculate the global population. For this reason, the Imperial College team estimated it will be about 18 months until the vaccine is available. 

During those 18 months, things are going to be very difficult and very scary. Our economy and society will be disrupted in profound ways. And if suppression actually works, it will feel like we're doing all this for nothing, because infection and death rates will remain low. 

It's easy to get people to come together in common sacrifice in the middle of a war. It's very hard to get them to do so in a pandemic that looks invisible precisely because suppression methods are working. But that's exactly what we're going to have to do. /end

[Dr. Blackheart]

Tom Hanks:

"Good News: One week after testing positive, in self-isolation, the symptoms are much the same. No fever but the blahs," Hanks wrote on social media Tuesday. "Folding the laundry and doing the dishes leads to a nap on the couch."

https://www.yahoo.com/entertainment/tom-hanks-coronavirus-health-update-isolation-no-fever-232623665.html

_________________________________

I wonder if this is the result of:
a) the body still attacking the remnants of the virus
or
b) long-lasting, possibly-permanent, damage

Just to note, Tom Hanks is a diabetic

[Dr. Blackheart]

Well, made it to Az, my SWA 1:40 pm flight had maybe 30-35 people.  Basically everyone had their own row

On another note, has anyone heard of using the plasma antibodies from a recovered patient?  I heard that one recovered patient can provide enough plasma antibodies for 2 sick people.  Now, the big question will be at what point/stage of an illness is the plasma effective?  If the patient is on a ventilator?  Could it work as a "vaccine"or preventative?

I posted this the other day.

https://www.usatoday.com/story/news/health/2020/03/15/coronavirus-treatment-could-coming-doctors-say-still-no-vaccine/5052788002/

[Dr. Blackheart]

Yikes! A whopping 1,400 new cases in the past day, with 300 new cases reported just in the past two hours. It was 4,600 last night, and over 6,000 now.

And that's without enough tests to test everyone with symptoms.

Just quick numbers from the hot spots like Boston, SF, Seattle, but this national 30% increase is half or less where intervention has occurred. Not official as it is very fluid, and testing availability will bias numbers, but the rate is slowing where public action has occurred like China and SK. A long ways to go but an early sign. That said, as this expands to new areas, these same actions need to be deployed.

[rocket surgeon]

I posted this the other day.

https://www.usatoday.com/story/news/health/2020/03/15/coronavirus-treatment-could-coming-doctors-say-still-no-vaccine/5052788002/

Thanks doc, I tried going back and scanning as many posts as I could To catch up, looking for it so didn't mean to be redundant

[rocky_warrior]

So remember when CDC said they were delivering enough tests for 75k patients 1.5 weeks ago?  And remember that they said millions more were coming online?  So why have only 27k been tested between both the CDC and public labs?

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/testing-in-us.html

As mentioned above, health care providers are still unable to get the tests they want.  They are being told to only test the high risk, and already hospitalized.  Internally *they* are wondering if it's a conspiracy to keep the numbers down.

For the record, I mostly think it's still just poor execution.  But wouldn't' be surprised if the current admin wants to keep the numbers low (since they said as much)

[🏀]

How much longer are you fellow WFH people going to utilize daycare?

I feel like my wife and I can still be productive WFH, but without the kids. If we keep the kids home, there's a massive drop off coming. She's busier than I am at this point, but that could level off as well.

Flipside is daycare and spreading germs. You have six families dropping kids off every day, that's not really distancing.