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*** OFFICIAL *** COVID-19 CoronaVirus Thread

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1 hour ago, NotSmart said:

It's logic-based.

Kicking the can down the road a few weeks by hoping the kids will be back in school by then is emotion based.

You arent kicking the can down the road. You would be evaluating based on information that simply isnt available now.

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Posted (edited)
3 minutes ago, bradyfan said:

Will there even be an election?

I think there will be. Probably no rallies and crowds. Just candidates social distancing on front of cameras going after each other. You can always mandate vote by mail only if it's still an issue in Nov.

Edited by CurlyNight

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14 minutes ago, Craig_MiamiFL said:

Imagine soliciting business door-to-door in a neighborhood right now.

Yes, some ####### is doing it.

Was out for a walk with the family when this 65+ year old dude approaches us and tries to hand us a "census is hiring postcard". It's a bit chilly here so the dude had some snots hanging out his nose. He was out going door to door trying to find census takers. 

Eff that man. Stay the hell home. And more importantly stay away from me

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22 minutes ago, shader said:

Florida had a primary today?  Good grief the USA is clueless

Everybody is all on board with canceling schools left and right, but heaven forbid we make the people that will die most often from this thing stay home, ever. 

 

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7 minutes ago, comfortably numb said:

Need to pick up some cigars....and plan to re-up and by a cord of wood. Gonna me many firepit nights outside this spring

Get rounds and an ax. Great stress reliever. 

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56 minutes ago, timschochet said:

It shouldn’t just be retail landlords either. People are expecting the government to help out but it’s not enough. During this shutdown there should be a complete moratorium on rents, mortgages and bank loans, period. If we’re going to stop everything, then we need to stop what’s owed as well. We can pick it up when business starts again. The government should order this, but people should just do it on their own. 

If you stop the rents, have to stop the mortgages.  Just extend the mortgages by the number of months needed.

I could not go more than a few months without rents and still having to pay mortgage.  And there is still a lot of costs I have to pay for. Repairs, property taxes, property mgr, etc

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Just now, parasaurolophus said:

Get rounds and an ax. Great stress reliever. 

Very true...cant risk getting hurt and possibly needing to go to ER though 

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13 minutes ago, CurlyNight said:

I bet most vote by mail. If you look at the lines it's mostly younger folks.

I actually did vote :bag: but only after sitting in the parking lot for 15 minutes and not seeing a single person over 40. In and out in a couple minutes, maybe two other people voting at the same time.

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Have Florida have it's primary today, help kill off some dems :tinfoilhat:

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58 minutes ago, Joe Bryant said:

:confused:  Do you mean Shader? Looks like has 1 suspension in 2014. What are you talking about? 

You should ban Shader just for fun.

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This is abysmal.  Three tests at a time for over a million people:

Your Home Timeline

Joe Bruno@JoeBrunoWSOC9·2m

Health Director Gibbie Harris says Meck County is now contracting with LabCorp for COVID-19 tests. The state suggested Meck do this because of their backlog. Meck was only getting 3 tests at a time from the state

@wsoctv

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7 minutes ago, Ted Lange as your Bartender said:

Doctors in India reporting the same treatment is effective, per Bloomberg News. If doctors in 2 countries are seeing the same results, this needs to be tested in the USA ASAP.

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12 minutes ago, ren hoek said:

https://www.theverge.com/2020/3/17/21184308/coronavirus-italy-medical-company-threatens-sue-3d-print-valves-treatments

Italian 3dprinter guys printed life-saving medical parts that normally cost $11k, for about $1 apiece.  Medical device manufacturer threatens to sue for patent infringement.  

of course.  :hot:   imho, this is partly why we have such limited testing available.  the right people have got to be paid/chosen to produce the tests.  

@[icon] i didn't click on your link to the million tests that arrived in memphis.  where did they come from and who made them?  in the presser yesterday(today?) they answered questions about test kits being refused.  they said the offered tests, didn't meet standards.  

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2 hours ago, The Future Champs said:

Maybe, but there won't be anyone allowed in the stands, and that's going to suck.   Fan noise is a big part of a good game.

Seattle pumps in so much crowd noise they won't notice the difference

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31 minutes ago, parasaurolophus said:

Get rounds and an ax. Great stress reliever. 

Great workout too

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4 hours ago, gianmarco said:

I posted that 2 hours ago.  Cases in US went from 5200 to 5800 since then.

6362 and now 108 deaths. 

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Posted (edited)
On 3/16/2020 at 5:44 AM, Waingro said:

One of my buddies is an MD and has been treating Coronavirus patients for the last 72 hours. He sent out an email sharing his experience. I figure I'd share here. 

  Hide contents

Hey everyone,

 

I thought I would write this to shed some light on my own experience with Coronavirus over the last 72 hours in my ER. Currently I work in White plains and I was supposed to start a new position in their observation unit March 1st ( this is basically a urgent care) within the ER but they asked me if would volunteer for their "COVID" station and without hesitation I agreed. 

 

First of all it has been affecting all ages except people under 17 years old and the sickest patients that I have seen have been females from 20 - 40 years old with no previous medical history.

 

The contagiousness of a disease is recorded by something called an R value. Currently the R value of coronavirus is a 2 to 4 meaning its on the same wavelength as the FLU. Just because you have been in direct contact with someone or even sleep next to someone does not mean that you are going to acquire it. It is spread through something called droplet meaning that a regular mask will help but you need something called an N - 95 mask which lets smaller particles through for true protection. If you really want pure protection you need a PAPR( powered air purifying respirator) which is something that I wear when evaluating patients  

 

The virulence of the disease has been interesting to me. I have sent home multiple people with just mild cough and body aches. The persons who have been really sick have been presenting more with abdominal pain . Temperature has not really been indicative of COVID 19. Their are 2 main things I am seeing on lab values that are correlating with worse morbidity and that is lymphopenia and elevated liver functions primarily AST and alk phos. ( going back to above probably related to the abdominal pain.) 

 

The course of the disease is also very indolent until day 3 - 5  where a very small amount of patients are presenting with ARDS ( acute respiratory distress syndrome) this is a fancy word for meaning patients lungs are filling up with fluid due to something called interstitial capillary leak. We have intubated a handful of healthy young individuals due to this progression. We have not had any deaths at our hospital yet however we have needed the help of positive airway pressure these are those masks that people wear called BIPAP ( very similar to the CPAP masks that you use for sleep apnea. ) If you continue to need more airway pressure then you have to be intubated and  may require something called ECMO ( extra corporal membrane oxygenation : fancy word for a lung machine.) It basically bypasses your lungs and breathes for you. We have had only 1 case over the last weekend requiring this.

 

Overall in a 72 hour period of seeing coronavirus patients the majority of them are coming in complaining of cough / malaise ( not feeling well). Few have been healthy young adults requiring intubation.

 

The things we have found out about treating these patients is that NOT giving IV fluids is key ( this is something that goes against every principle about acute care medicine ) . Also some medications that have been helping are antivirals ( ketruda ) something we use for AIDS and also hydroxychloroquine something we use for rheumatological disease like arthritis. Steroids do not seem to help so far from what I have observed. 

 

Overall I have been asked a million questions and I made a small Q and A here :

 

Can children get it?

I have seen zero people under the age of 17 with coronavirus. I believe this is because the virus likes to attack mature lymphocytes which are not yet competent in children so they are not being affected.

 

Is the virus only affecting the elderly?

Definitely not. The sickest patients at our hospital have been young healthy women from the ages of 20 - 40

 

Is there medications to combat this?

no there are none currently that a proven effective however we are using 2 medications which may help. Chloroquine helps to block viral entry into the cells. Keytruda is something called a protease inhibitor used in HIV / AIDS patients to help stop the replication of the virus.

 

What are the most typical symptoms?

Cough and fever. There have been multiple presentations of the disease so it is hard to diagnose just by physical exam. 

 

Can you get tested for it? and should you get tested for it?

Yes you can get tested for it. I have tested over 50 people the last 3  days and the turnaround time was about 2 days however this will be prolonged with more tests being taken.  However testing does not change your overall outcome of the disease. If you are experiencing significant signs of shortness of breath we will admit you to the hospital. If you are experiencing typical flu like symptoms the smartest thing is to remain at home and try and ride it out.  

 

What is the mortality rate?

Its impossible to determine because we cannot accurately say how many people have the disease since most are walking around asymptomatic. However you can calculate the case fatality rate which is 3.4 % from multiple sources I have read 

 

Will hospitals be able to handle this?

yes. for now. My hospital has done a great job of creating negative pressure beds which helps stop the spread of the virus and they have given us the highest level of protective gear. They have moved out as many patients as possible to gear up for this upcoming week. 

 

Is there a vaccine for it?

No. Vaccines take a while for virus'

 

Is the Quarantine necessary ?

Yes for now. This helps hospitals not be overwhelmed especially if we need ventilators / ECMO machines to help those in real need.

 

How long is the quarantine?

We are mandating 2 weeks

 

I have included a great one page summary of Coronavirus that was forwarded to me from a friend who is currently working at an ICU in Seattle. Overall I believe the government did the right thing of shutting everything down so we could get a hold of this thing and understand its true potential. Only time will tell to see how this virus truly behaves over the next week. I hope this was insightful for those who have been worried. As of right now I am not that concerned about it but this may change... I have only been dealing with this disease for 72 hours. 

 

Stay safe everyone I hope this helps from my own personal experience. Feel free to share this with friends if it helps put them at ease. Also if anyone has any questions feel free to ask 

 

xxx xxxxxx MD

 

Every health care professional who is on the front lines of this thing deserve a ton of respect and applause. Stay safe everyone.  

 

That's a nice summary, but a couple things your friend probably knows, but are different in some facilities:

BiPAP is considered an aerosol generating procedure, so many hospitals are electing to minimize or eliminate its use in favor of regular mechanical ventilation to reduce spread.

The HIV drug people are trying is Kaletra, not Keytruda. The latter is a type of cancer immunotherapy that hasn't been used for C-19, TMK. And chloroquine seems to favored over hydroxychloroquine, though data isn't great for any of those meds.

AFIK, the most favorable treatment data is for Remdesivir, which is available from the manufacturer for compassionate use in critically ill patients.

Edited by Terminalxylem
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1 minute ago, fatguyinalittlecoat said:

Are any really fancy restaurants doing takeout?  

Apparently the Ruths' Chris here is doing a pretty awesome deal.

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On 3/14/2020 at 8:18 PM, bradyfan said:

Worldometer March 15 00:15 GMT Update (The day is reset after midnight GMT)

  1. China: 80,824 (+11) confirmed, 3,189 (+13) deaths
  2. Italy: 21,157 (+3,497) confirmed, 1,441 (+175) deaths
  3. Iran: 12,729 (+1,365) confirmed, 611 (+97) deaths
  4. S. Korea: 8,086 (+107) confirmed, 72 (+5) deaths
  5. Spain: 6,391 (+1,159) confirmed, 195 (+62) deaths
  6. Germany: 4,599 (+924) confirmed, 9 (+1) deaths
  7. France: 4,469 (+808) confirmed, 91 (+12) deaths
  8. USA: 2,836 (+589) confirmed, 57 (+8) deaths
  9. Switzerland: 1,375 (+236) confirmed, 13 (+2) deaths
  10. UK: 1,140 (+342) confirmed, 21 (+10) deaths
  11. Norway: 1,108 (+112) confirmed, 3 (+2) deaths
  12. Sweden: 961 (+147) confirmed, 2 (+1) deaths
  13. Netherlands: 959 (+155) confirmed, 12 (+2) deaths
  14. Denmark: 827 (+23) confirmed, 1 (+1) death
  15. Japan: 804 (+70) confirmed, 22 (+1) deaths
  16. Diamond Princess: 696 confirmed, 7 deaths
  17. Belgium: 689 (+130) confirmed, 4 (+1) deaths
  18. Austria: 655 (+151) confirmed, 1 death
  19. Quasar: 337 (+17) confirmed
  20. Australia: 248 (+49) confirmed, 3 deaths

Worldometer March 18 00:50 GMT Update (The day is reset after midnight GMT+0.)

  1. China: 80,881 (+21) confirmed, 3,226 (+13) deaths
  2. Italy: 31,506 (+3,526) confirmed, 2,503 (+345) deaths
  3. Iran: 16,169 (+1,178) confirmed, 988 (+135) deaths
  4. Spain: 11,826 (+1,884) confirmed, 533 (+191) deaths
  5. Germany: 9,367 (+2,095) confirmed, 26 (+9) deaths
  6. S. Korea: 8,320 (+84) confirmed, 81 (+6) deaths
  7. France: 7,730 (+1,097) confirmed, 175 (+27) deaths
  8. USA: 6,456 (+1,793) confirmed, 109 (+23) deaths
  9. Switzerland: 2,742 (+389) confirmed, 27 (+8) deaths
  10. UK: 1,950 (+407) confirmed, 71 (+16) deaths
  11. Netherlands: 1,705 (+292) confirmed, 43 (+19) deaths
  12. Norway: 1,470 (+122) confirmed, 3 deaths
  13. Austria: 1,332 (+314) confirmed, 4 (+1) deaths
  14. Belgium: 1,243 (+185) confirmed, 10 deaths
  15. Sweden: 1,196 (+75) confirmed, 8 (+1) deaths
  16. Denmark: 977 (+63) confirmed, 4 deaths
  17. Japan: 878 (+45) confirmed, 29 (+1) deaths
  18. Diamond Princess: 696 confirmed, 7 deaths
  19. Malaysia: 673 (+107) confirmed, 2 (+2) deaths
  20. Canada: 598 (+157) confirmed, 8 (+4) deaths
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54 minutes ago, Craig_MiamiFL said:

Imagine soliciting business door-to-door in a neighborhood right now.

Yes, some ####### is doing it.

now imagine the census was scheduled for 2020

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15 minutes ago, Grace Under Pressure said:

Doctors in India reporting the same treatment is effective, per Bloomberg News. If doctors in 2 countries are seeing the same results, this needs to be tested in the USA ASAP.

Daily Mail is pretty much garbage.

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2 minutes ago, Terminalxylem said:

That's a nice summary, but a couple things your friend probably knows, but are different in some facilities:

BiPAP is considered an aerosol generating procedure, so many hospitals are electing to minimize or eliminate its use in favor of regular mechanical ventilation to reduce spread.

The HIV drug people are trying is Kaletra, not Keytruda. The latter is a type of cancer immunotherapy that hasn't been used for C-19, TMK.

As for kids and this disease, so far it's looking like not only is it not affecting them much but that they aren't even getting the infection at all. Their rates of infection after exposure seems to be really, really low. That's a good thing.

This is bearing out in Japan as well as in China. 

Silver lining.

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Why wouldn’t college and universities just close the semester at this point?

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3 hours ago, NotSmart said:

Thanks, do you know if [sharing of ventilators] has been done anywhere for an extended period of time?

In the Vegas shooting situation (one of the 3 linked docs earlier), it was very short term and the patients were chest tubed.

To the bolded: No, I do not know. I am not an expert in the field, unfortunately, just a layman. The only events for which I've been able to find accounts of ventilator sharing have been mass casualty situations like in the aftermath of the Las Vegas shootings.

Quote

 

In the comment section, this concern caught my eye:

I have been in the field of respiratory care for over 25 years and have been down to Alabama for FEMA training. I have some very strong hesitations to anyone considering this application and will explain my concern. If at any point, there is a difference in the lung compliance of either patient hooked up to the ventilator it would alter the volume going to the patients and change how much each of them are receiving. You would be over-ventilating one and under-ventilating the other and no way of knowing since all volume returning to the ventilator is mixed. Compliance/resistance readings are also mixed. Pneumothorax, or something as simple as mucous plugging, biting, coughing, etc. This is a very dangerous concept especially in the midst of a disaster scenario when no one has the time to carefully monitor the patient.

 

The original author had similar concerns, but attempted a workable theoretical scheme (on paper) anyway. If ever attempted, it would the Hail Mary of Hail Marys ... far from a first-line attempt at treatment -- unless a major innovation of some kind is discovered.

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5 minutes ago, fatguyinalittlecoat said:

Are any really fancy restaurants doing takeout?  

I know an upscale restaurant in VA is (or will be). 

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36 minutes ago, Getzlaf15 said:

If you stop the rents, have to stop the mortgages.  Just extend the mortgages by the number of months needed.

I could not go more than a few months without rents and still having to pay mortgage.  And there is still a lot of costs I have to pay for. Repairs, property taxes, property mgr, etc

We’ve already had requests for payment moratoriums.  Input i’ve received is 3 months is pointless, start at 6 months and go from there.  This won’t be over in 3 months.  The outbreak, who knows, the financial ramifications, not even close.  

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Crap. I have what I think is allergies, but something keeps making my chest tickle and I cough. :scared: 

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2 minutes ago, gianmarco said:

As for kids and this disease, so far it's looking like not only is it not affecting them much but that they aren't even getting the infection at all. Their rates of infection after exposure seems to be really, really low. That's a good thing.

This is bearing out in Japan as well as in China. 

Silver lining.

I pray this is true

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3 minutes ago, Doug B said:

To the bolded: No, I do not know. I am not an expert in the field, unfortunately, just a layman. The only events for which I've been able to find accounts of ventilator sharing have been mass casualty situations like in the aftermath of the Las Vegas shootings.

The original author had similar concerns, but attempted a workable theoretical scheme (on paper) anyway. If ever attempted, it would the Hail Mary of Hail Marys ... far from a first-line attempt at treatment -- unless a major innovation of some kind is discovered.

I thought getting exactly the correct amount of air is important to avoid damage of lung function, no?

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3 minutes ago, gianmarco said:

As for kids and this disease, so far it's looking like not only is it not affecting them much but that they aren't even getting the infection at all. Their rates of infection after exposure seems to be really, really low. That's a good thing.

This is bearing out in Japan as well as in China. 

Silver lining.

Thank god. I’d be a lot more nervous if the age curve was reversed. Don’t get me wrong, sick and dying adults are an awful thing, but dying kids is a whole other level. 

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3 hours ago, Doug B said:
4 hours ago, culdeus said:

Wife asks what the poorer kids are going to do about provided meals as well as remote learning through computers, let alone being able to print items out or get books.

On my way out, but I can say that the public schools in this area are attending to all of this. Will post more later.

Briefly:

- Local public school cafeterias are still cooking, though the dining areas are closed. They are preparing "grab & go" breakfasts and lunches. Any child in the community can come and get a meal -- it doesn't have to be a student of the school.

- My kids' public school district has about a 50% rate of children not having internet access in their homes**. Accordingly, both online courses and paper packets have been made available. Coursework on paper can be picked up at the schools.

The system has some kinks, but that's to be expected with such a rushed implementation. Also, for now, the online coursework and the paper packets are not being graded -- they're being treated as optional assignments to keep kids engaged for the interim. No public plans yet on how the kids' final grades for this school year will be handled. Spidey sense is that kids with passing grades, or borderline kids who would pass if they passed the fourth quarter (third quarter ended last week) will be promoted to the next grade.
 

** seems high, but I think phones are not counted as home internet access.

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12 minutes ago, fatguyinalittlecoat said:

Are any really fancy restaurants doing takeout?  

Do you live in an area that has a White Castle?

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On 3/16/2020 at 5:51 AM, gianmarco said:

The other thing, so far, is that people are learning to stay home when they're sick and not come to the ER just because they don't feel good. 

It would be amazing if this "stuck" and became more of the new normal. 

Amen!

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19 minutes ago, fatguyinalittlecoat said:

Are any really fancy restaurants doing takeout?  

mine is.  not many takers.  so far.

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53 minutes ago, the moops said:

Was out for a walk with the family when this 65+ year old dude approaches us and tries to hand us a "census is hiring postcard". It's a bit chilly here so the dude had some snots hanging out his nose. He was out going door to door trying to find census takers. 

Eff that man. Stay the hell home. And more importantly stay away from me

####### disgusting. 

The stupidity of someone to go door to door right now. Don't give a #### what the reason is. 

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13 minutes ago, JbizzleMan said:

Crap. I have what I think is allergies, but something keeps making my chest tickle and I cough. :scared: 

I've had bad allergies for weeks (very early pollination here).  Get worried every day the drainage is noticable

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Just now, Slapdash said:

I've had bad allergies for weeks (very early pollination here).  Get worried every day the drainage is noticable

Yeah, I've been checking my temperature everyday. Just to make sure.

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45 minutes ago, ren hoek said:

https://www.theverge.com/2020/3/17/21184308/coronavirus-italy-medical-company-threatens-sue-3d-print-valves-treatments

Italian 3dprinter guys printed life-saving medical parts that normally cost $11k, for about $1 apiece.  Medical device manufacturer threatens to sue for patent infringement.  

(Italian judge spends 80% of the trial time playing FIFA 2020 on the X-Box in his chambers with defense counsel before rendering the decision: Get that ish outta here!)

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1 hour ago, Alex P Keaton said:

My son and I both had a variation of this in the last 2-3 weeks......he also had strep throat.   But he got meds to get rid of the strep....and then was still sick with an unexplainable illness for another 10 days....

Bizarre - my son had this exact same situation. He was treated for strep, but was still lethargic and had a cough/chest congestion that kept him out of school for two full weeks at the beginning of Feb. Doctor thought he might have the flu as well, but wasn’t worried about it enough to test for it. No one was thinking about CV at that point, but I can’t help but wonder. 

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20 minutes ago, wazoo11 said:

Why wouldn’t college and universities just close the semester at this point?

Graduation

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3 minutes ago, Doug B said:

(Italian judge spends 80% of the trial time playing FIFA 2020 on the X-Box in his chambers with defense counsel before rendering the decision: Get that ish outta here!)

Shouldn't there be some kind of eminent domaine law during situations like this? Seems reasonable.

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Another social media post I came across that is really good. From an intensive care physician in Australia.  It offers a great perspective for non-medical people.

 

“Coronavirus isn’t just like the flu, but it’s only really very dangerous to the elderly or the already unwell. Quite a lot of people in their 80s will die, but most of the rest of us will probably be okay.

“If you’re in your 70s and you get Coronavirus, you’ve got a really good chance of survival. If I’ve got a bed for you.

“If you’re in your 60s and you have a heart attack, you’ve got a really good chance of survival. If I’ve got a bed for you.

“If you’re in your 50s and need bowel cancer surgery, you’ve got a really good chance of survival. If I’ve got a bed for you.

“If you’re in your 40s and have a bad car accident, you’ve got a really good chance of survival. If I’ve got a bed for you.

“If you’re in your 30s and have terrible pre-eclampsia as a complication of pregnancy, you’ve got a really good chance of survival. If I’ve got a bed for you.

“If you’re in your 20s and have a bad reaction to a party drug, you’ve got a really good chance of survival. If I’ve got a bed for you.

“I have 7 beds equipped with life support machines. We have a plan to increase to about 25. Getting more isn’t a matter or more equipment or more money, that bit is easy. There are not enough skilled staff, even if we all work double shifts every day for six months (and we probably will).

“If 50% of my city gets infected, that’s 75,000 people. If 5% of them need life support (which is the estimate), that’s 3750 people. For 25 beds.

“And then I might not have a bed for you.

“So it’s up to you to flatten the curve. Wash your hands. Stay home."

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There's like 10-12 kids playing tackle football behind my house right now.  The parents have to be terrible people

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3 minutes ago, Ramblin Wreck said:

There's like 10-12 kids playing tackle football behind my house right now.  The parents have to be terrible people

No kidding.

Football ?!!!

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