What do I need to know about coronavirus?

[cyanide12345678]

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Mortality will not be ONE number. There is no one case fatality rate. For the Spanish Flu, there were 10 fold differences in death within locales of the same state.

So there is going to be a range.

Here in America I think it's going to be like 0.3-0.6% and maybe higher in certain locales (like NYC, maybe there it will be 1.5%).

I don't think we will be Italy because
- we are much less dense
- it did come a little bit later
- we are younger
- we have more capacity
- we probably have better supplies

All of those things will add up

Better supplies???? Reusing hospital gowns, masks right now -_- how bad was Italy lol?

 

[thegenius]

A NYT article from today says..:

State officials have projected that the number of coronavirus cases in New York will peak in early May.

That’s crazy...and they are getting a deluge now? In late March?

 

[thegenius]

Better supplies???? Reusing hospital gowns, masks right now -_- how bad was Italy lol?

Italy was bad. They were asking doctors to work without gloves in some cases. At least one of them died. I doubt there will be doctors or nurses not wearing gloves here. I sure won’t. Especially not for something where we can’t treat. I would rather not work than work without PPE.

 

[cyanide12345678]

I ruffled a lot of feathers today and woke up admin at 3 am and yelled at our infection control person and made her call admin.

We have a hospital employee, her requests to be off were repeatedly denied by admin and her supervisor. She's coughing all over my ER while "cleaning" the rooms as her job. Coughing all over the halls. Her family member who resides in the same household was yesterday placed in the icu with bilateral pneumonias and lab findings concerning for covid. They told her she didn't have a fever so she comes in to work. She's taking around the clock ibuprofen and tynelol -_-

Yelled at a lot of people and told admin this is absurd and i sent the employee home. I called her supervisor and told her she's not coming back. Yelled at the infection control person as well and ripped her apart -_-

So pissed

 

[TheTruckGuy]

Question on MDM: A 30 year old complains of runny nose, some post nasal drip, and sore throat, as well as a bit of fatigue, sporadic cough, and subjective "warm armpits" about 8 days after a return from Thailand. Temperature 99.2, otherwise normal vitals and unremarkable exam. Currently residing in an area with no active cases of COVID.

Would you test or not at this point?

Same patient, placed on home isolation after initial visit, 4 days later reports feeling much better, sore throat is gone, still with some runny nose, but sudafed helps with that. Cough is also gone since starting sudafed. Just a little more tired than usual, but not as much fatigue as 2-3 days prior.

What's your level of clinical suspicion for COVID?



Tough call in my mind, especially with that recent trip to Thailand and all these anecdotal reports of URI symptom being the only symptoms of COVID. But if I'm operating under the assumption that the median incubation period is 5 days, and that a true 100.4 fever is one of the most common symptoms, along with cough, I'm leaning towards a standard viral URI with a possible allergic rhinitis component. I think duration of COVID is close to 2 weeks, and if symptoms are improving on day 4, that's a little more fitting with a viral URI as well.

Ended up not testing, and advised to remain in self-isolation until 48 hours post any symptoms.

Thoughts?

 

[Birdstrike]

Question on MDM: A 30 year old complains of runny nose, some post nasal drip, and sore throat, as well as a bit of fatigue, sporadic cough, and subjective "warm armpits" about 8 days after a return from Thailand. Temperature 99.2, otherwise normal vitals and unremarkable exam. Currently residing in an area with no active cases of COVID.

Would you test or not at this point?

Same patient, placed on home isolation after initial visit, 4 days later reports feeling much better, sore throat is gone, still with some runny nose, but sudafed helps with that. Cough is also gone since starting sudafed. Just a little more tired than usual, but not as much fatigue as 2-3 days prior.

What's your level of clinical suspicion for COVID?



Tough call in my mind, especially with that recent trip to Thailand and all these anecdotal reports of URI symptom being the only symptoms of COVID. But if I'm operating under the assumption that the median incubation period is 5 days, and that a true 100.4 fever is one of the most common symptoms, along with cough, I'm leaning towards a standard viral URI with a possible allergic rhinitis component. I think duration of COVID is close to 2 weeks, and if symptoms are improving on day 4, that's a little more fitting with a viral URI as well.

Ended up not testing, and advised to remain in self-isolation until 48 hours post any symptoms.

Thoughts?

COVID suspicion: Moderate. The only thing testing would potentially change is, if you truly do feel your area has "no active cases of COVID," and I'm not sure there are many such places left, then testing might serve an epidemiologic purpose in notifying the community that they do have COVID (if not, they will soon) and to take social distancing orders seriously.

 

[Birdstrike]

Do I suck because these names mean ZERO to me? Taleb may have changed the course of your life, but that doesn't even ring a bell for me, much less invoke a memory.

I've never heard of them either. Who are they?

 

[TheTruckGuy]

COVID suspicion: Moderate. The only thing testing would potentially change is, if you truly do feel your area has "no active cases of COVID," and I'm not sure there are many such places left, then testing might serve an epidemiologic purpose in notifying the community that they do have COVID (if not, they will soon) and to take social distancing orders seriously.

Yeah, I should've said "no known active cases." But that's true, and with reported sensitivity as low as the mid 60's for an NP swab, a negative test could give the individual a false sense of security and they may take fewer precautions.

That recent trip to Thailand is what concerns me the most that this could be more than a viral URI. Although they really haven't had that many cases (but I'm unsure how many people they're testing, as their proximity to China and their influx of Chinese tourists makes me think their numbers should be higher). I think I'm sticking with my recommendation to come off self-isolation after 48 hours of no symptoms, with the assumption that it's a viral URI, but with an additional abundance of caution.

Thanks for the feedback

 

[Birdstrike]

We have fewer smokers and a younger population,

These factors are everything and can't be minimized. That, and our massive advantage in ICU beds per capita, 3 times Italy, 10 times China.

but plenty of air pollution

Prove the link between air pollution and COVID-19 deaths. India, Myanmar, South Africa, Ukraine are at the top of pollution, but nowhere near the top for COVID. Italy, Spain, Germany and France are at the top for COVID, but all over the map as far as pollution. I mean, it makes sense that there would be a link (pollution > bad lungs > worse covid) but is there one, beyond simply a surrogate marker for the highest density populations? I don’t know.

We may have more ICU beds, but aren't they always full?

I've heard we average 80% full, but it's hard to find a hard number on this because it's constantly changing minute to minute, day to day. Either way, most places don't build ICU beds with the goal of sitting them empty while waiting for stuff that happens once every 50 years. They build them to meet capacity with a (hopefully) a little wiggle room. Either way, we have the most ICU beds per capita, way more than Italy.

 

[cyanide12345678]

Either way, we have the most ICU beds per capita, way more than Italy. We're not Italy.

Yet there's never a damn bed for hours when I'm doing a transfer to these bigger hospitals, even before covid -_-

 

[Birdstrike]

There may be mildly encouraging signs that the curve is flattening in Washington State, already, per Univ of Wash Virology Dept.

 

[Birdstrike]

Yet there's never a damn bed for hours when I'm doing a transfer to these bigger hospitals, even before covid -_-

I know, right? You can't get a bed to save your life, then all of a sudden they bust out 1,000 bed Navy hospital ships, and it's like, "What are you worried about, we have the most ICU beds in the world, you toothless rubes." Tf

 

[Perrotfish]

These factors are everything and can't be minimized. That, and our massive advantage in ICU beds per capita, 3 times Italy, 10 times China.

Keeping in mind that its only an advantage if we appropriately triage our ICUs during the crisis. The way we got 3x as many ICU beds as Italy was by putting people on in ICUs that other nations' systems would put on comfort care at home. If we KEEP putting those people in ICUs then the ICUs stay full and its not an advantage.

 

[Perrotfish]

HSV and EBV are other diseases that are known to have asymptomatic viral shedding contribute to spread. People touch their faces, pick their noses, share utensils, put their tongue down someone’s throat (or up someone’s...you get the picture) - it’s the gift that keeps on giving all year long.

I suspect that IL-6 and TNF play a big role in the pathogenesis of COVID lung injury and IL-6 may be a therapeutic target. Adult lungs don’t like spikes in IL-6 and some data coming out of China suggests that levels correlate with illness severity. This might explain why neonates and infants has mild disease since they seem to have baseline high levels of IL-6:TNF

You're not the only one to think this. Sarilumab enters clinical trial for COVID-19, spotlighting 'key role' for IL-6

 

[Birdstrike]

Keeping in mind that its only an advantage if we appropriately triage our ICUs during the crisis. The way we got 3x as many ICU beds as Italy was by putting people on in ICUs that other nations' systems would put on comfort care at home. If we KEEP putting those people in ICUs then the ICUs stay full and its not an advantage.

That is absolutely correct. In other words, we have a much greater capacity than we're being lead to believe on a day to day basis, because that capacity is being misutilized and squandered, way too often. You are correct. Good point.

 

[cyanide12345678]

Italy was bad. They were asking doctors to work without gloves in some cases. At least one of them died. I doubt there will be doctors or nurses not wearing gloves here. I sure won’t. Especially not for something where we can’t treat. I would rather not work than work without PPE.

But will you work with a bandana or a scarf? The cdc says go ahead 😉

 

[Birdstrike]

Germany is playing the world for fools. They have 20,000 cases, but 60 deaths and 2 people listed as having serious illness currently! What a crock of crap. It's now patently obvious that if you have so much as pre-hypertension, the Germans will chalk up your death or your ICU admit to that and not to Corona. Utterly ridiculous.

They’re clearly cheating. They should forced to relinquish their winner’s medal, hang their heads in shame and be banned from the pandemolymoics for 4 years.

 

[Perrotfish]

Italy was bad. They were asking doctors to work without gloves in some cases. At least one of them died. I doubt there will be doctors or nurses not wearing gloves here. I sure won’t. Especially not for something where we can’t treat. I would rather not work than work without PPE.

The point of disposable gloves it to protect the patient and you. If you want to protect just you then can't you just wear the same pair of rubber kitchen gloves each day and and wash them like you would wash your hands?

 

[Birdstrike]

I am predicting a CFR of about 0.3-0.5% and total number of deaths to be akin to a normal flu season (25-50K)

People were beating the sh * t out of me on here for saying basically this 10 days ago.

 

[Birdstrike]

Interesting compilation and analysis of  COVID-19 data and trends. Some I agree with, some I don't. But I think there might be some positives to pick out of this

https://link.medium.com/qq37F0mi14

 

[namethatsmell]

I ruffled a lot of feathers today and woke up admin at 3 am and yelled at our infection control person and made her call admin.

We have a hospital employee, her requests to be off were repeatedly denied by admin and her supervisor. She's coughing all over my ER while "cleaning" the rooms as her job. Coughing all over the halls. Her family member who resides in the same household was yesterday placed in the icu with bilateral pneumonias and lab findings concerning for covid. They told her she didn't have a fever so she comes in to work. She's taking around the clock ibuprofen and tynelol -_-

Yelled at a lot of people and told admin this is absurd and i sent the employee home. I called her supervisor and told her she's not coming back. Yelled at the infection control person as well and ripped her apart -_-

So pissed

Good for you. If I was there I'd have bought you a beer. We need more of this.

Your value (and the value of your hospital custodial staff) to humanity is about 908349824.3% higher than hospital administrators right now. The sky is not falling but if we don't appropriately respond in every meaningful way we can right now than needless deaths and further economic damage will follow. For better or worse, nobody has a better idea of the realities that are playing out right now than us. We owe it to society (and ourselves) to be vocal and help coach people to make rational decisions.

Two days ago I went off on a hospital admin trying to preach to a group of us about how certain changes we were considering in patient flow could jeopardize the hospital facility fee and that we needed to slow our roll. I'm not proud of myself for telling him to f*ck off publicly as I think these conversations are better done discreetly. But now is not the time to be discreet. The admin tucked tail and our proposed changes to flow are appropriately proceeding.

In the coming days administrators will only further highlight their lack of value unless they: get us more PPE/resources, make things easier/safer for us to do our work and treat patients, and work on the front lines with us when appropriate. In my mind, the days of them simply cracking the whip to make us work harder/faster without regard for our own well-being are at an end.

 

[turkeyjerky]

People were beating the sh * t out of me on here for saying basically this 10 days ago.

The problem with that assumption is math. If you have 100 million cases, a CFR of 0.3% is 300,000.

Italy was bad. They were asking doctors to work without gloves in some cases. At least one of them died. I doubt there will be doctors or nurses not wearing gloves here. I sure won’t. Especially not for something where we can’t treat. I would rather not work than work without PPE.

We'll need to relax our standards. Same PPE for multiple patients.

I'm not proud of myself for telling him to f*ck off publicly as I think these conversations are better done discreetly. But now is not the time to be discreet. The admin tucked tail and our proposed changes to flow are appropriately proceeding.

In the coming days administrators will only further highlight their lack of value unless they: get us more PPE/resources, make things easier/safer for us to do our work and treat patients, and work on the front lines with us when appropriate. In my mind, the days of them simply cracking the whip to make us work harder/faster without regard for our own well-being are at an end.

You might not be, but I am. People getting in the way need to be castigated, publicly and loudly.

Regarding the optimal testing strategy, this is from an interview with an epidemiologist:

Now that we've missed the opportunity for early testing, is it too late for testing to make a difference?

Absolutely not. Tests would make a measurable difference. We should be doing a stochastic process random probability sample of the country to find out where the hell the virus really is. Because we don't know. Maybe Mississippi is reporting no cases because it's not looking. How would they know? Zimbabwe reports zero cases because they don't have testing capability, not because they don't have the virus. We need something that looks like a home pregnancy test, that you can do at home.

 

[ShockIndex]

People were beating the sh * t out of me on here for saying basically this 10 days ago.

Nah. People were just politely disagreeing with you. It was pretty civil without any name calling. Think of it as your internet friends conducting an “online intervention” before you could go all COVID Truther on us.

 

[TooMuchResearch]

Our group has moved ahead with changes without hospital system support because they move too slowly. We've started no touch MSEs from far enough away that exposure should be minimal.

They are slowly trying to support our demand for telehealth and tents. Our group is trying to obtain bulk order PPE as we don't think our hospital systems will be able to keep up, and we're willing to pay more than they are.

Good for you. If I was there I'd have bought you a beer. We need more of this.

Your value (and the value of your hospital custodial staff) to humanity is about 908349824.3% higher than hospital administrators right now. The sky is not falling but if we don't appropriately respond in every meaningful way we can right now than needless deaths and further economic damage will follow. For better or worse, nobody has a better idea of the realities that are playing out right now than us. We owe it to society (and ourselves) to be vocal and help coach people to make rational decisions.

Two days ago I went off on a hospital admin trying to preach to a group of us about how certain changes we were considering in patient flow could jeopardize the hospital facility fee and that we needed to slow our roll. I'm not proud of myself for telling him to f*ck off publicly as I think these conversations are better done discreetly. But now is not the time to be discreet. The admin tucked tail and our proposed changes to flow are appropriately proceeding.

In the coming days administrators will only further highlight their lack of value unless they: get us more PPE/resources, make things easier/safer for us to do our work and treat patients, and work on the front lines with us when appropriate. In my mind, the days of them simply cracking the whip to make us work harder/faster without regard for our own well-being are at an end.

 

[IMGASMD]

If you have positive exposure and now symptomatic, what is your plan?

 

[gutonc]

I think cancer would as well.

As would (presumably) bleomycin exposure from his nard cancer.

 

[TwoHighways]

As would (presumably) bleomycin exposure from his nard cancer.

This is something I’m curious about. Early on, you’d probably want a good/normal immune response to mitigate viral replication (which may have been lacking in someone that developed cancer to begin with, or just got unlucky and immune cells weren’t able to pick up the cancer prior to it being too late), but clearly when you’re at the cytokine storm level, would there not be benefit in something that attenuates the inflammatory response?

 

[TooMuchResearch]

Current plan is call occupational health and get instructions. Unfortunately instructions are currently "stay home, we don't have the ability to test." That plan stops working soon as we're going to run out of doctors.

If you have positive exposure and now symptomatic, what is your plan?

 

[gutonc]

This is something I’m curious about. Early on, you’d probably want a good/normal immune response to mitigate viral replication (which may have been lacking in someone that developed cancer to begin with, or just got unlucky and immune cells weren’t able to pick up the cancer prior to it being too late), but clearly when you’re at the cytokine storm level, would there not be benefit in something that attenuates the inflammatory response?

I was actually commenting on the risk of pulmonary toxicity to high O2 concentrations (like on a vent) in people with prior bleomycin exposure.

Can't really comment on your other point (which is a good one). In addition to being a cancer doc working my regular FT gig (although spending half of it on phone calls instead of in person visits, seeing only patients who "need" continued cancer directed treatment and new high risk cancers), I'm also one of those useless administrators everyone here likes to rail about, spending all the rest of my time trying to manage this pandemic at the health system level.

 

[Birdstrike]

Nah. People were just politely disagreeing with you. It was pretty civil without any name calling. Think of it as your internet friends conducting an “online intervention” before you could go all COVID Truther on us.

10 days ago

Birdstrike: ”It’s a serious thing. But we’ll get through this better than predicted. Those worst case predictions are BS. And we’re not Italy.”

Intervention happens:

Internet friends: “No way! You’re insane! We’re not doing enough. Experts say 2.2 million Americans are gonna die! Our hospital systems will collapse. We’re Italy in 10 days!”

Birdstrike: “You’re right 2.2 million of us are gonna die. Let’s do more.”

Internet friends: “That’s right. Let do more!”

(10 days later after everyone “doing more.”)

Birdstrike: “Looks like you guys we’re right. Doing more has kept us from not ‘becoming Italy’ in 10 days and we’ve apparently saved 2.2 million - 250 American lives. Good job everyone. We’re on track for the best response, best success, and most lives saved ever.”

Internet friends: “Wrong, everything was done wrong. We’re gonna get through this better than expected. But not because we responded and did more, you idiot. It’s because we’re not Italy. And those predictions were BS.

Man, I love SDN.

 

[Birdstrike]

The problem with that assumption is math. If you have 100 million cases, a CFR of 0.3% is 300,000.

The problem with simple equations is that they rarely are accurate when exposed to real life and feedback mechanisms.

 

[thegenius]

Question on MDM: A 30 year old complains of runny nose, some post nasal drip, and sore throat, as well as a bit of fatigue, sporadic cough, and subjective "warm armpits" about 8 days after a return from Thailand. Temperature 99.2, otherwise normal vitals and unremarkable exam. Currently residing in an area with no active cases of COVID.

Would you test or not at this point?

Same patient, placed on home isolation after initial visit, 4 days later reports feeling much better, sore throat is gone, still with some runny nose, but sudafed helps with that. Cough is also gone since starting sudafed. Just a little more tired than usual, but not as much fatigue as 2-3 days prior.

What's your level of clinical suspicion for COVID?



Tough call in my mind, especially with that recent trip to Thailand and all these anecdotal reports of URI symptom being the only symptoms of COVID. But if I'm operating under the assumption that the median incubation period is 5 days, and that a true 100.4 fever is one of the most common symptoms, along with cough, I'm leaning towards a standard viral URI with a possible allergic rhinitis component. I think duration of COVID is close to 2 weeks, and if symptoms are improving on day 4, that's a little more fitting with a viral URI as well.

Ended up not testing, and advised to remain in self-isolation until 48 hours post any symptoms.

Thoughts?

I would test but he wouldn’t be high priority if we had rationed test kits. Otherwise if we had an unending supply then I would test. Of course i would.

We have a virus that is exponentially growing in our population as we speak. Why would we think there is a much higher chance he has adenovirus or rhinovirus?

 

[dadaddadaBATMAN]

The problem with simple equations is that they rarely are accurate when exposed to real life and feedback mechanisms.

10 days ago

Birdstrike: ”It’s a serious thing. But we’ll get through this better than predicted. Those worst case predictions are BS. And we’re not Italy.”

Intervention happens:

Internet friends: “No way! You’re insane! We’re not doing enough. Experts say 2.2 million Americans are gonna die! Our hospital systems will collapse. We’re Italy in 10 days!”

Birdstrike: “You’re right 2.2 million of us are gonna die. Let’s do more.”

Internet friends: “That’s right. Let do more!”

(10 days later after everyone “doing more.”)

Birdstrike: “Looks like you guys we’re right. Doing more has kept us from not ‘becoming Italy’ in 10 days and we’ve apparently saved 2.2 million - 250 American lives. Good job everyone. We’re on track for the best response, best success, and most lives saved ever.”

Internet friends: “Wrong, everything was done wrong. We’re gonna get through this better than expected. But not because we responded and did more, you idiot. It’s because we’re not Italy. And those predictions were BS.

Man, I love SDN.

the predictions might or might not have been bs. We will never know, and I for one am grateful for that.

without going into depth on my (irrelevant) political views, though there have been many things that have not impressed me in this administration, the response to this virus has not been one of them.

the initial delayed response was understandable, and I’m not sure I agree with those who think a different administration would have done better. Many of the problems (not accepting who test) seem to be at the level of the cdc. Downplaying the virus was stupid, but any politician in power would have done the same. Removing the pandemic response team was obviously very bad optics, but considering he was essentially elected to undo what Obama did I get it.

the things I don’t like have been the steady and continuous proposals to decrease public funding of research (nih, cdc) and the reduced funding of public heath infrastructure.

however, a rapid and appropriate 180 has taken place, and hopefully the somewhat crazy measures we’re taking now will accomplish the desired result. If not, we are probably f*cked anyway

 

[thegenius]

People were beating the sh * t out of me on here for saying basically this 10 days ago.

You are too smart Birdstrike. It took me exponentially longer to arrive to the same conclusion as you. Hell what do I know. One of these days, or years, I would like to hang out with ya at a BBQ, drink some beer and listen to the Dead.

 

[Birdstrike]

the predictions might or might not have been bs. We will never know, and I for one am grateful for that.

Will will be able to know if the predictions were correct or not. When this has burned itself out, you simply compare the final death counts, to the predicted counts (1.6 million Americans dead, predicted by Obama's CDC Dir Tom Frieden or 2.2 million Americans predicted by the U.K. group). If these numbers are serious enough to prompt us to action, then their serious enough with which to gauge the success of those actions.

hopefully the somewhat crazy measures we’re taking now will accomplish the desired result.

Agree 100%

 

[Birdstrike]

One of these days, or years, I would like to hang out with ya at a BBQ, drink some beer and listen to the Dead.

Amen, bro. Likewise. Anytime.

And by the way, I don't know sh * t.

 

[thegenius]

The problem with that assumption is math. If you have 100 million cases, a CFR of 0.3% is 300,000.

The key to keeping the infectivity rate down is ensuring our top 20 cities stay on lockdown / quarantine for a few months. If we can control this in the big cities we have a chance to keep that 100,000,000 down by a factor of 10. We can deal with 10,000,000 cases except in the rarest of cases. E.g. I wouldn’t be surprised if NYC has a higher CFR like 1.5% as compared to the nation due to the population density.

 

[GeneralVeers]

I'll say that just for the record I was with Birdstrike all along (please consider me for a cabinet appointment!).

 

[Birdstrike]

I'll say that just for the record I was with Birdstrike all along (please consider me for a cabinet appointment!).

As I assume my post as Ruthless Dictator in Chief of SDN EM, I appoint you as Chief Consigliere, and hereby grant you Ultimate Power.

 

[dadaddadaBATMAN]

Will will be able to know if the predictions were correct or not. When this has burned itself out, you simply compare the final death counts, to the predicted counts (1.6 million Americans dead, predicted by Obama's CDC Dir Tom Frieden or 2.2 million Americans predicted by the U.K. group). If these numbers are serious enough to prompt us to action, then their serious enough with which to gauge the success of those actions.

Agree 100%

If predicted models were a perfect method then trump wouldn’t currently occupy the White House. Again, we will never know what would have or could have happened. Good on them for doing the right thing and being conservative though

 

[wareagle726]

Plaquenil and azithro combo seems to have a substantial effect on viral load in very early trial. I'll post a link when I can find it. May not actually work but at the rate we are investigating this michelob-virus(true patient quote) I am optimistic.

 

[TooMuchResearch]

BTW, the Powers That Be are attempting to push balance billing legislation through with the COVID-19 emergency spending bill.

the predictions might or might not have been bs. We will never know, and I for one am grateful for that.

without going into depth on my (irrelevant) political views, though there have been many things that have not impressed me in this administration, the response to this virus has not been one of them.

the initial delayed response was understandable, and I’m not sure I agree with those who think a different administration would have done better. Many of the problems (not accepting who test) seem to be at the level of the cdc. Downplaying the virus was stupid, but any politician in power would have done the same. Removing the pandemic response team was obviously very bad optics, but considering he was essentially elected to undo what Obama did I get it.

the things I don’t like have been the steady and continuous proposals to decrease public funding of research (nih, cdc) and the reduced funding of public heath infrastructure.

however, a rapid and appropriate 180 has taken place, and hopefully the somewhat crazy measures we’re taking now will accomplish the desired result. If not, we are probably f*cked anyway

 

[alpinism]

What level care are they getting admitted to?

The overwhelming majority are regular admits with a handful of ICU admits per shift.

Its basically all elderly patents with flu like symptoms who require supplemental oxygen.

 

[Birdstrike]

FDA grants emergency approval for point of care COVID-19 test; results in 45 minutes FDA grants 'emergency use' coronavirus test that can deliver results in 45 minutes

 

[Birdstrike]

this michelob-virus(true patient quote)

We had a patient come in yesterday saying, "I gotst da carnivorous! I gotst da carnivorous!"

 

[zurned]

FDA grants emergency approval for point of care COVID-19 test; results in 45 minutes FDA grants 'emergency use' coronavirus test that can deliver results in 45 minutes

Best news of the week

 

[sensejae]

For public health policy, I understand that in the U.S., CDC has recommended against asymptomatic people wearing masks due to supply shortage, and also for the fact that it is imperfect compared to say well-fitted n95.

While there is no significant data per se, there are countries like Korea and Japan that have culture of their citizens wearing masks, even prior to this pandemic. These countries have not been pursuing aggressive lockdown like China, and yet their data has been encouraging. Japan hasn't even been pursuing testing aggressively like Korea.

The supply shortage of masks is assumed due to the need to use disposable mask daily. But what if each American can wear one mask? Surely, with news that China is producing 100 million masks daily and with different companies increasing production, this can be done. When done along with social distancing, especially if every American were to wear one in public, one would think that it may at least help in preventing asymptomatic patients from coughing to other patients, along with preventing people from touching their faces. Also, culturally, when everyone wears a mask in public, it signifies that everyone is committed.

For instance, what if each citizen owned two cotton masks and one surgeon mask that can fit inside a cotton mask? The cotton masks can be washed with soap and rotated between use. We are talking about putting in 1 trillion dollars to give universal income and making thousands of new ventilators. Giving one mask to 300 million American would be much more affordable solution that may help flatten the curve.

Not trying to go against CDC or anything. Just was wondering if this idea made sense to other posters. There are a lot of states like Montana that are still relatively early in infection, and any public health measure, such as this, may help, especially knowing that the fight against coronavirus may take months. You can't go on lockdown forever.

All Korean customers wearing masks in the store today.

 

[alpinism]

How's your PPE @alpinism ? Are you scared? Overwhelmed? Or doing OK?

So our volumes have actually gone down overall with less regular patients.

Definitely running low on N95 masks and we're only being given one per shift.

 

[deleted65604]

There may be mildly encouraging signs that the curve is flattening in Washington State, already, per Univ of Wash Virology Dept.

I have a friend working in Washington. Their curve is flattened because tests are taking over 7 days to come back.

 

[Birdstrike]

Holy shaeet, Italy

Almost 1,000 dying per day (793 today, 627 day before) now. Case fatality rate (CFR) near 10%! Tf. They're not going to have anyone over 80, left.

CFR:

Italy - 9.0% !!!!
Iran - 7.5%
Spain - 5.4%
U.K. - 4.6%
China - 4.0%
France - 3.9%
S. Korea - 1.2%
USA - 1.2%