The Official CORONAVIRUS oh *&^! thread. Time to start stocking up on food?

[MediMike]

Yeah...kids...

[GetMeOuttaThisMess]

I'm starting to develop the attitude of can I just get my exposure done and over with as long as there's a promise of no mutation or significant complication?  I'm already self-quarantined just from the fact of hanging around the house in retirement.  I may throw my wife under the bus and volunteer her also.

[Cideous]

Trump just got done pushing hydroxychloroquine as a treatment for CV-19.

 I got the feeling watching this that he is desperately now trying to throw everything at it this week after downplaying it for months.  I hope it works, but WHO says there is no evidence that it does at this time.

[Cideous]

CDC NOW RECOMMENDS HEALTH CARE WORKERS EXPOSED TO CV-19 CONTINUE TO WORK WITH A MASK.  IF NO MASK, THEY SHOULD WEAR A "BANDANA OR A SCARF"!!!

 

I guess we just keep working until we drop and/or come home and infect our whole family.

 

What a shit show.....

Edited March 19, 2020 by Cideous

[deltawave]

1 hour ago, Cideous said:

Trump just got done pushing hydroxychloroquine as a treatment for CV-19.

 I got the feeling watching this that he is desperately now trying to throw everything at it this week after downplaying it for months.  I hope it works, but WHO says there is no evidence that it does at this time.

I know you reallllly despise the President and everything, but there is some data out there (linked below) to show it is at least worth a try, and it is the FDA who approved it....

No other leaders are doing a better job at containing or responding to this pandemic. Everyone is winging it with what options and data they have as this evolves- it is a shit show globally. Why don't we hang up the politics for a while regardless of ones political affiliations until we're out of this public health emergency?

https://www.washingtonexaminer.com/news/malaria-drug-sees-promising-signs-as-future-coronavirus-treatment

https://www.elsevier.com/__data/assets/pdf_file/0007/988648/COVID-19-Drug-Therapy_Mar-2020.pdf

https://techcrunch.com/2020/03/19/french-study-finds-anti-malarial-and-antibiotic-combo-could-reduce-covid-19-duration/

Edit: I'm not anyone's boss around here, nor am I a moderator. I just prefer to come to this PA forum and not discuss politics or hear specific political opinions on repeat. Just my opinion. Carry on.

Edited March 19, 2020 by deltawave

[Cideous]

2 hours ago, deltawave said:

 

.....No other leaders are doing a better job at containing or responding to this pandemic......

 

I think anyone who has been paying attention to South Korea vs our Administrations down played response would strongly disagree with your statement.

[cbrsmurf]

4 hours ago, Cideous said:

Trump just got done pushing hydroxychloroquine as a treatment for CV-19.

 I got the feeling watching this that he is desperately now trying to throw everything at it this week after downplaying it for months.  I hope it works, but WHO says there is no evidence that it does at this time.

In vitro, seems to work

 

in vivo good results (actually perfect results) but very poor study

[deltawave]

55 minutes ago, Cideous said:

 

I think anyone who has been paying attention to South Korea vs our Administrations down played response would strongly disagree with your statement.

Comparing any aspect (other than them having a decent economy of scale and some version of "democracy")  with regard to their response and the abilities of SK to the USA is disingenuous - we aren't the same in size, demographics, healthcare, infrastructure, etc... I'm not going to debate it with you. If you can't allow your political bias to take a backseat to reason and logic then that is on you.

Here is the direct link to the study of Hydroxychloroquine w/ Azithromycin that had a 100% cure. If you want to be upset the federal authorities are pushing that for further study/trial just because "Orange man bad" then please go right ahead. I can ignore your posts about it. It is really unbecoming and not even slightly practical to helping board members navigate this crisis, however. I think you normally have great posts and bring value to the forum. This isn't about us, so there is no need to continue the political part. If you want the last word on it go for it, but I will not participate in further political debate.

https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4xY_IlWSHnGbj/view

Edited March 19, 2020 by deltawave

[deltawave]

4 minutes ago, cbrsmurf said:

In vitro, seems to work

 

in vivo good results (actually perfect results) but very poor study

More study is needed, I agree.

 

Here is something I saw online in a few different places as a reference for healthcare providers.

 

[Cideous]

34 minutes ago, deltawave said:

Comparing any aspect (other than them having a decent economy of scale and some version of "democracy")  with regard to their response and the abilities of SK to the USA is disingenuous - we aren't the same in size, demographics, healthcare, infrastructure, etc... I'm not going to debate it with you. If you can't allow your political bias to take a backseat to reason and logic then that is on you.

Here is the direct link to the study of Hydroxychloroquine w/ Azithromycin that had a 100% cure. If you want to be upset the federal authorities are pushing that for further study/trial just because "Orange man bad" then please go right ahead. I can ignore your posts about it. It is really unbecoming and not even slightly practical to helping board members navigate this crisis, however. I think you normally have great posts and bring value to the forum. This isn't about us, so there is no need to continue the political part. If you want the last word on it go for it, but I will not participate in further political debate.

https://drive.google.com/file/d/186Bel9RqfsmEx55FDum4xY_IlWSHnGbj/view

I will leave it at that.  I value your posts here as well.  

[PickleRick]

49 minutes ago, deltawave said:

 

...study of Hydroxychloroquine w/ Azithromycin that had a 100% cure.

 

Once again, proof positive that a good old Zpak will cure just about anything.  Cleared up my chlamydia just last week.  That reminds me, I need to start hanging around a better class of people.

[polarbebe]

3 hours ago, deltawave said:

 

No other leaders are doing a better job at containing or responding to this pandemic. 

After this statement I find it more difficult to objectively take your opinion/argument seriously when lavishing such praise on our President.  

Your argument that comparing government response of South Korea (or even Taiwan) to the USA is “disingenuous” as you say.  Granted this is not a great comparison given the differences between countries as you noted.  
 

How about let’s compare India (another democracy) to the US response?  India has FOUR times the population of the US and a far less developed medical system, less infrastructure, massive slums and with a far higher poverty rate but through very early and aggressive interventions (despite close geographic distance and huge amount of commerce/travel between the countries) has so far greatly minimized the number of cases (remains to be seen if this holds but due to reasons above is at higher risk for catastrophic spread).  
 

Objectively the President has done a few things early and aggressively (shutting down travel from China) but the prior two months he spent downplaying the then epidemic (“This is their new hoax” and on, Feb. 24 (tweet): "The Coronavirus is very much under control in the USA. … Stock Market starting to look very good to me!") with FOX news relay his talking points to half the nation (misinforming the public it is less serious than the flu)... CDC with botched roll out of tests and strict guidelines of not doing community testing early on hampering mitigation efforts, Bolton disbanding pandemic team.  

No doubt this crisis would be a challenge for any administration (with multiple missteps by anyone) but to say no leader is doing a better job... I respectfully disagree.  
 

At the major metropolitan hospital system where I work in the ICU everyone gets plaquenil after discussion with ID.  

[deltawave]

27 minutes ago, polarbebe said:

Your post.

Sure. I'll retract and say some leaders are better than others. It was a rather definitive statement in an ever changing environment. The dynamics and data change day to day. As you said, managing this crisis is a challenge with missteps bound to happen by any leader. I believe we as a nation and as healthcare providers are doing the best we can be doing at this point to curb this pandemic as best as possible with the data we have now, not the data we had 2 months ago.

I stand by everything else I posted. The next few weeks will be telling and we will see if the worst predictions come to fruition.

I'll be honest, I was pretty skeptical early on as well (not because of POTUS or a tweet -I don't even have a twitter). The game has changed and adapting to reorient thought processes are vital. I don't know how this is going to go, but it isn't looking great even by conservative metrics. Eventually when this is all over everyone will have plenty of time to Monday-morning quarterback the thing from start to finish. Until then I hope we can continue to limit the loss of life and spread.

Stay safe,

DW

Edited March 19, 2020 by deltawave

[GetMeOuttaThisMess]

https://www.yahoo.com/news/coronavirus-immunity-test-090033681.html

[cbrsmurf]

5 hours ago, deltawave said:

More study is needed, I agree.

 

Here is something I saw online in a few different places as a reference for healthcare providers.

 

I think I saw this first on reddit. People there was saying there are a few errors, particularly the recommendation for corticosteroids. It is NOT recommended unless pt has something comorbid such as COPD. I forget what else. 

[EMSGuy1982]

Found this through a friend. Written by an ER doc resident. Pretty much sums up everything. 

“In one of the most vivid scenes in the HBO miniseries "Chernobyl" (among many vivid scenes), soldiers dressed in leather smocks ran out into radioactive areas to literally shovel radioactive material out of harm's way. Horrifically under-protected, they suited up anyway. In another scene, soldiers fashioned genital protection from scrap metal out of desperation while being sent to other hazardous areas.

Please don't tell me that in the richest country in the world in the 21st century, I'm supposed to work in a fictionalized Soviet-era disaster zone and fashion my own face mask out of cloth because other Americans hoard supplies for personal use and so-called leaders sit around in meetings hearing themselves talk. I ran to a bedside the other day to intubate a crashing, likely COVID, patient. Two respiratory therapists and two nurses were already at the bedside. That's 5 N95s masks, 5 gowns, 5 face shields and 10 gloves for one patient at one time. I saw probably 15-20 patients that shift, if we are going to start rationing supplies, what percentage should I wear precautions for?
Make no mistake, the CDC is loosening these guidelines because our country is not prepared. Loosening guidelines increases healthcare workers' risk but the decision is done to allow us to keep working, not to keep us safe. It is done for the public benefit - so I can continue to work no matter the personal cost to me or my family (and my healthcare family). Sending healthcare workers to the front line asking them to cover their face with a bandana is akin to sending a soldier to the front line in a t-shirt and flip flops.
I don't want talk. I don't want assurances. I want action. I want boxes of N95s piling up, donated from the people who hoarded them. I want non-clinical administrators in the hospital lining up in the ER asking if they can stock shelves to make sure that when I need to rush into a room, the drawer of PPE equipment I open isn't empty. I want them showing up in the ER asking "how can I help" instead of offering shallow "plans" conceived by someone who has spent far too long in an ivory tower and not long enough in the trenches. Maybe they should actually step foot in the trenches.
I want billion-dollar companies like 3M halting all production of any product that isn't PPE to focus on PPE manufacturing. I want a company like Amazon, with its logistics mastery (it can drop a package to your door less than 24 hours after ordering it), halting its 2-day delivery of 12 reams of toilet paper to whoever is willing to pay the most in order to help get the available PPE supply distributed fast and efficiently in a manner that gets the necessary materials to my brothers and sisters in arms who need them.
I want Proctor and Gamble, and the makers of other soaps and detergents, stepping up too. We need detergent to clean scrubs, hospital linens and gowns. We need disinfecting wipes to clean desk and computer surfaces. What about plastics manufacturers? Plastic gowns aren't some high-tech device, they are long shirts/smocks...made out of plastic. Get on it. Face shields are just clear plastic. Nitrile gloves? Yeah, they are pretty much just gloves...made from something that isn't apparently Latex. Let's go. Money talks in this country. Executive millionaires, why don't you spend a few bucks to buy back some of these masks from the hoarders, and drop them off at the nearest hospital.
I love biotechnology and research but we need to divert viral culture media for COVID testing and research. We need biotechnology manufacturing ready and able to ramp up if and when treatments or vaccines are developed. Our Botox supply isn't critical, but our antibiotic supply is. We need to be able to make more plastic ET tubes, not more silicon breast implants.
Let's see all that. Then we can all talk about how we played our part in this fight. Netflix and chill is not enough while my family, friends and colleagues are out there fighting. Our country won two world wars because the entire country mobilized. We out-produced and we out-manufactured while our soldiers out-fought the enemy. We need to do that again because make no mistake, we are at war, healthcare workers are your soldiers, and the war has just begun."

 

Spot on

[Cideous]

When the N95's run out, the new CDC recommended mask....

 

 

Edited March 20, 2020 by Cideous

[True Anomaly]

23 hours ago, GetMeOuttaThisMess said:

I'm starting to develop the attitude of can I just get my exposure done and over with as long as there's a promise of no mutation or significant complication?  I'm already self-quarantined just from the fact of hanging around the house in retirement.  I may throw my wife under the bus and volunteer her also.

Starting to?  I was there 3 weeks ago.  Just give it to me so I can deal with it and get over it.  Then I likely won’t even need PPE to see patients

(cue the study that is now showing worsening morbidity with re-infection...)

[ohiovolffemtp]

Actually P&G (ProctEr and Gamble) who has a large plant in Mehoopany, PA, which makes toilet paper, disinfecting wipes, etc. has an exemption from Pennsylvania's shutdown of all non-essential business operations and is making product as fast as possible.  

Spent 25 years of my life working for them before becoming a PA.

Many if not all of the products you mention are made on very expensive high production manufacturing lines that can only be reconfigured to make similar products.  So, it's not that easy of an "either or".

[MediMike]

3 hours ago, ohiovolffemtp said:

  Spent 25 years of my life working for them before becoming a PA.

Many if not all of the products you mention are made on very expensive high production manufacturing lines that can only be reconfigured to make similar products.  So, it's not that easy of an "either or".

Waaaaiiiitttt...are you saying that not all machines that make things can make all kinds of things? You can't just turn a garbage bag machine into an N-95 or medical gown making machine?!

Maybe there should be some life experience requirement for medical school as well.

[polarbebe]

3 hours ago, MediMike said:

Waaaaiiiitttt...are you saying that not all machines that make things can make all kinds of things? You can't just turn a garbage bag machine into an N-95 or medical gown making machine?!

Maybe there should be some life experience requirement for medical school as well.

Please lets avoid sarcasm and personal attacks during this crisis which will likely significantly impact some provider you know or family/friend during this pandemic (40% of hospitalized COVID-19 patients are 20-54 years old in the US).  
 

Preliminary data from China shows some patients with lowered lung function 1 month after acute lung injury with significant decreased exercise tolerance (unclear if this will resolve over a longer period of time).  
 

What kind of precautions having you been taking when you get home to avoid potentially transmitting it to your family?  

 

I have been taking off all my external clothes, showering immediately , wiping down surfaces after touching and quarantined myself in the bedroom of my apartment away from my family.  Also looking to sublet a studio but prices in the metro area are ridiculous.  

[ohiovolffemtp]

Personal attack or not, it's important for folks, especially in the medical field, to understand that changes in manufacturing processes can't happen quickly.  So, when a medical resident makes long posts like the one which has been quoted, people who may not know better can be influenced.  In the same way we need to caution people we encounter that just because someone says something, whether about a promising treatment, new test, or vaccine, it may not be correct or complete.  Instead it must be looked at carefully.  In the same way it's not possible to rapidly ramp up new medical knowledge and manufacture of these products, it's also not possible to rapidly ramp up production of the various medical and decon supplies currently needed.

It's useless to make statements like that resident made.  Rather, it's helpful to learn the long timelines needed to be prepared, so better plans can be made is useful.  Setting correct expectations for the public about how all facets of this pandemic and our response will progress is useful.

 

[MediMike]

When ridiculous statements go viral the general public starts losing their minds. Anger takes hold, and ridiculous demands soon follow. This leads to companies who employ hard working individuals taking a hit and becoming the "bad guys" as they won't provide the changes (which are impossible) which were demanded by the mob.

It's pretty dang irresponsible to make statements of that sort. 

[DarwinStarwin]

Can anyone help update me on self-quarantine requirements? I went to Mexico and ended up flying back early in order to ensure that I'd even make it back past the border.

Best info I can find indicates international travelers who are coming from *anywhere* at this point are advised to self quarantine for 14 days.

Then conflicting info pertaining to clinicians: work despite lack of adequate PPE unless you are symptomatic.

What's a PA to do?


Sent from my SM-G973U using Tapatalk

[Reality Check 2]

I am struggling to fathom how anyone could ask medical professionals to care for patients with no protective equipment knowing that a large percentage of medical providers, nurses and everyone medical WILL get ill and could die or end up on a vent. 

It just boggles my mind that we are so ill equipped.

At this point I can’t see any alternative other than mandatory isolation and separation.