the Coronavirus outbreak thread

[12Relojes]

Originally Posted by uscmatt99

This is the most hopeful news yet. There will be a lot of people who survive this disease who would be able to help those who are struggling. This can be tested and scaled rapidly as opposed to novel meds or a vaccine, it's easy to test a donor, and (hopefully) easy to match to recipients. I look forward to the results of ongoing trials!

Comments as a doctor.

1. If an infectious disease doctor or virologist refutes what I say, listen to them, not me.
2. Think of this as "borrowing" antibodies. You take blood from an exposed patient who now has antibodies but has cleared the virus. The idea being to augment your own antibody count.
3. It doesn't provide long lasting help. The antibodies you "borrow" don't help you make antibodies. Only exposure to the virus makes you make your own antibodies.
4. How you make a vaccine is by splitting the virus into pieces and taking a piece of it to see if it triggers an immune response, but not disease. This doesn't do that.
5. It therefore has no role in mass protection, it would only have a role in the treatment of the ill.
6. A vigorous immune response isn't always what we want. Our immune system can overshoot the mark, and frequently does. Think of asthma, anaphylaxis and just plain seasonal allergies where our immune system triggers an inappropriately aggressive response. These challenges are common in ICU medicine and one would be appropriately concerned that extra antibodies could just as easily make things worse.
7. We are better at identifying viruses than ever in the history of man. We are really good at identifying receptors that may provide a key to the structure of a vaccine. The rate-limiting step remains human testing. That's why they say 18 months at the earliest, bc everything is theory until you give it to human beings and see how they react and we don't know how to rush the human body.

[Moggo]

Originally Posted by Johny

Hi

Our local chemist is only allowing two people in the shop at a time. Waiting outside the shop everyone else is spaced/spread out and maintaining social distancing. This makes it look like a big long/giant queue.

Good point Johny, that could also explain the large queues outside

I know our chemist has stopped taking prescription requests right now as they have 1000, so need to try another chemist.


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[tadbart]

Originally Posted by joeychitwood

Better than an orthopedic surgeon! Radiologists are going to have to do their own clinical correlations now.

Those ortho guys intubate with a hammer, not a laryngoscope!

I think humor is gonna go a long way toward preserving morale, and maybe humanity.

This is going to suck, for a lot of people, for a long time. My SIL is a dental hygienist- out of work now. The only people I know who are doing really well right now are in groceries or hospital medicine.

[77T]

I posted the info below in a Formula One thread. It may seem off-topic here, but I offer it in the spirit of a coronavirus coping mechanism.

Just a small respite for those needing a 90 minute diversion from this topic. It’s motorsports related but also Sim related, too.
——————————————————-

On a different note, and just a sidebar to F1, IMSA has concocted an online Sebring race today using iRacing and YouTube live, or Twitch. Not the 12-hour race, but a 90 minute race by some of the same drivers who would have been racing in the cars.

I thought some here might like to know.
It is this afternoon at 2:30, EDT (US TZ).

The race will be streamed live on iRacing’s Twitch channel and the iRacing eSports Network on YouTube. The commentary team will include the voice of IMSA Radio’s John Hindhaugh.


https://www.imsa.com/news/2020/03/18...persaturday/#/



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[uscmatt99]

Originally Posted by joeychitwood

Better than an orthopedic surgeon! Radiologists are going to have to do their own clinical correlations now.

Haha my colleagues and I have sent this around (I'm a rad). The corollary is that I can guarantee the ET tube enters the mouth. Where it ends up, I have no idea, until the X-ray

[Bryant Park]

Originally Posted by uscmatt99

Haha my colleagues and I have sent this around (I'm a rad). The corollary is that I can guarantee the ET tube enters the mouth. Where it ends up, I have no idea, until the X-ray

I still trust you more than my proctologist if in need of incubation

[uscmatt99]

Originally Posted by 12Relojes

Comments as a doctor.

1. If an infectious disease doctor or virologist refutes what I say, listen to them, not me.
2. Think of this as "borrowing" antibodies. You take blood from an exposed patient who now has antibodies but has cleared the virus. The idea being to augment your own antibody count.
3. It doesn't provide long lasting help. The antibodies you "borrow" don't help you make antibodies. Only exposure to the virus makes you make your own antibodies.
4. How you make a vaccine is by splitting the virus into pieces and taking a piece of it to see if it triggers an immune response, but not disease. This doesn't do that.
5. It therefore has no role in mass protection, it would only have a role in the treatment of the ill.
6. A vigorous immune response isn't always what we want. Our immune system can overshoot the mark, and frequently does. Think of asthma, anaphylaxis and just plain seasonal allergies where our immune system triggers an inappropriately aggressive response. These challenges are common in ICU medicine and one would be appropriately concerned that extra antibodies could just as easily make things worse.
7. We are better at identifying viruses than ever in the history of man. We are really good at identifying receptors that may provide a key to the structure of a vaccine. The rate-limiting step remains human testing. That's why they say 18 months at the earliest, bc everything is theory until you give it to human beings and see how they react and we don't know how to rush the human body.

All excellent points. As a radiologist I only help to diagnose, I don't treat (yet!). It seems to me that this therapy could serve as a temporizing measure until a vaccine or better pharmaceutical agent is available. Theoretically if administered early on in the course of disease, it could decrease the overall viral load for patients and avert a cytokine storm and subsequent ARDS. Who knows, maybe it could be administered as a protective agent for frontline healthcare workers. Will certainly be easier to come by some plasma than PPE based on what I'm seeing in my neck of the woods. We will have to use all the tools in the toolkit for this one, and acquiring plasma is a definitely a much easier task than creating more beds, ventilators, and providers to staff them.

[statsman]

Thoughts-

1. These extreme measures of social distancing will last weeks, not months. At the rate of growth in cases, in six weeks the curve will either have flattened or we will all have been exposed.

2. The delay in testing in the US really cloaked the situation in NYC (and to a lesser extent- Seattle and SF). A “one policy for all” really doesn’t make sense for the US. Thought- a shortage of masks means that, in the US, only medical personnel and patients get the masks. Our Asian friends say that, without masks, we are really losing effectiveness. Would it make sense to make sure mask production was diverted to NYC, Seattle and SF so that all citizens there can have them? And a similar approach to other resources?

3. Step 1 for getting out of a hole is “stop digging”. We (the world) needs a very frank conversation about nations’ stats, before reopening travel. For example- I don’t believe Russia’s stats that show no cases contracted in Russia. I suspect they (at least major cities) are in a situation like NYC two weeks ago- they have no idea how many cases they have. The WHO is dependent upon local government and is no help. Similarly, as great as the news out of China and Iran is that their case numbers are dropping, I would like to see some skeptical scrutiny of the data (I have no problem trusting S. Korea numbers).

[uscmatt99]

Originally Posted by Bryant Park

I still trust you more than my proctologist if in need of incubation

John. Best of luck to you and your family through this crisis. I've been reading some of your other posts. This will soon hit home for all of us in the US and abroad on TRF if it hasn't already.

[Sergiomomesso]

Here in Quebec (province of Canada) our government had close every public building including school since last Friday, way before any place in the world while we had around 10 confirmed cases. I think these early closing, plus social distancing will help our province to flatten the curve. Only here in Quebec we are capable of 6000 test a day at the moment wich is pretty good for a 9 millions people province. USA didnt take it enough seriously, I wish you all the best to any of you in these historic times.

[RWH]

Originally Posted by Sergiomomesso

Here in Quebec (province of Canada) our government had close every public building including school since last Friday, way before any place in the world while we had around 10 confirmed cases. I think these early closing, plus social distancing will help our province to flatten the curve. Only here in Quebec we are capable of 6000 test a day at the moment wich is pretty good for a 9 millions people province. USA didnt take it enough seriously, I wish you all the best to any of you in these historic times.

It's good to hear you guys are doing well up north. Unfortunately too many in the USA just passed it off as just a bad flu or media hype landing us where we are now.

Stay healthy and safe

[TswaneNguni]

Had to go to the supermarket quickly ....

Armed with an N95 and hand liquor ..

1) When I wear a face mask ,people keep their social distance more.
2) If you ad a few coughs ..they get the f... outta there !

A face mask works !!

[Sergiomomesso]

Originally Posted by TswaneNguni

Had to go to the supermarket quickly ....

Armed with an N95 and hand liquor ..

1) When I wear a face mask ,people keep their social distance more.
2) If you ad a few coughs ..they get the f... outta there !

A face mask works !!

hahaha yeah, you are very ON POINT ! a little cough and a mask haha, stay safe, and respect the social distance and go out only if you really need to!

[904VT]

Originally Posted by TswaneNguni

Had to go to the supermarket quickly ....

Armed with an N95 and hand liquor ..

1) When I wear a face mask ,people keep their social distance more.
2) If you ad a few coughs ..they get the f... outta there !

A face mask works !!

Include sealed googles for your eyes too if you need a N95 mask due to being a higher risk.

[Duey]

If you want to see a clown show just look at Hawaii. The news there just says "It didn't come from here they got it from somewhere else and brought it here"

International & Domestic flights still coming in -
Hotels still open -
People still all over the beaches - They put same yellow police tape up on Waikiki beach for people to duck under to get to the beach.

It's just sad

[jatco]

Originally Posted by RWH

It's good to hear you guys are doing well up north. Unfortunately too many in the USA just passed it off as just a bad flu or media hype landing us where we are now.

Stay healthy and safe

..Yeah...Its Catastrophic...

[mountainjogger]

Originally Posted by uscmatt99

This is the most hopeful news yet. There will be a lot of people who survive this disease who would be able to help those who are struggling. This can be tested and scaled rapidly as opposed to novel meds or a vaccine, it's easy to test a donor, and (hopefully) easy to match to recipients. I look forward to the results of ongoing trials!

Yes. Does look hopeful. Numbers are limited (1 recovered person to help 2 others). But it is a tool.

Stay safe.

[Patton250]

Originally Posted by Bryant Park

I still trust you more than my proctologist if in need of incubation

Amen!!!

[mgsooner]

Very sobering read describing what a respiratory therapist in New Orleans is seeing.

https://www.propublica.org/article/a...young-patients

[Star Ferry]

Originally Posted by jatco

. Quote redacted..

At this point, finger pointing doesn't help anyone. Imagine if doctors, instead of treating the sick, put their effort into deciding who to blame.

[BigBlue1]

Originally Posted by Star Ferry

At this point, finger pointing doesn't help anyone. Imagine if doctors, instead of treating the sick, put their effort into deciding who to blame.

That political statement by Jatco should be removed. It is these comments that lead to threads being closed. It’s been reported. Lets get thru this as a whole and then let the finger pointing happen. At this point causing arise isn’t helping. We could go on and on and bring politics into the mix, but giving the severity of the grave situation I think it’s best to refrain.

[Star Ferry]

Originally Posted by BigBlue1

That political statement should be removed. It is these comments that lead to threads being closed. It’s been reported.

Ok. I redacted my quote

[Sergiomomesso]

Originally Posted by mgsooner

Very sobering read describing what a respiratory therapist in New Orleans is seeing.

https://www.propublica.org/article/a...young-patients

Frightening articles but really true. Everybody should read that, thanks for posting it here.

[77T]

A little patience may go a long way. Thomas has some time to edit.

Let’s don’t jump hard - it’s the rancor that can also close a thread.


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[djgallo]

Originally Posted by jatco

..Yeah. [BS edited] ..

Most of us here want to keep this thread going in these trying times....bringing political crap into it is against the rules and not respectful to the rest of us.

[jankymutt]

It's refreshing to see most people on here taking this seriously. I an an ER doc in central Massachusetts. We are seeing really sick presumptively positive covid patients this week, but luckily haven't been overwhelmed by a large volume of patients.

Unfortunately, we are quickly running out of PPE and our hospital apparently has no plan B. We are receiving donations from local contractors and other companies that have PPE but are not working right now (pavers, roofers, etc.)

This is an article by another ER physician I work with everyday. Please support your local emergency departments and first responders!

https://www.telegram.com/news/202003...iers-need-help

[Brew]

Originally Posted by Bryant Park

I still trust you more than my proctologist if in need of incubation

I can only imagine what a proctologist incubates . . . .

[statsman]

I saw an article in the WSJ today (subscription required) that said that NYC hospitals are close to being overwhelmed. This is why “ride it out” is a poor strategy, and we’re trying social distancing. The article also mentioned how surprised medical care
Providers were by the number of young people having severe reactions.

[fmc000]

Originally Posted by Moggo

What’s it like in your region of Italy?

Stay safe


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I live in Lombardy, where we had the first Italian cases and where most of the deaths are. For some strange reason in the Como province where I live we had few cases but in Brescia and especially Bergamo they were hit pretty bad. They had to use some Army trucks to ship dead bodies because the local crematory ovens were not able to keep up with the number of deaths.

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[Uggi]

Anyone following the potty conspiracy theories out there? This one believes that CV is a manufactured conspiracy by governments wanting to victimise old people:
https://youtu.be/xbEHEzEEHJ8