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


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

While your entire rant is off base and ridiculous, as a PA in MI I'll respond to this.  In the state of MI it is clearly stated that self-prescribing is unethical and there is significant precedence. 

I'm ordering zpacks for myself.  Online from china.  Zpacks improve everything.  And if it doesn't help in the first go round, try it again.  Maybe I'll just use both barrels and order Levaquin too. 

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I am officially bored with protestors and frustrated as all hell with conspiracy theorists about this whole pandemic being a plot to take away rights.

When did freedom become FreeDUMB?

I am debunking crap daily from folks - everything from famotidine to that damn hydrochloroquine and people wanting to stop their ACE/ARBs because of something on the news. Now remdsivir,which I think holds promise, as long as the WH stays out of it and we can get enough.

Maybe this is job security in medicine - not sure anymore.

Just worn out with stupidity.

 

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A friend called me last night.  Reported a co worker had tested positive COVID 3 times.  Was told by her company she could not return to work until she was negative.  WTH is with that?    I have been reading listening to podcast to try to keep current.  Has anybody heard of testing (nasal swab) until negative???

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The PCR is positive if you have active viral replication, by nasal swab. 

Folks have to test negative twice - at least 24 hrs apart to be considered negative. At least in our hospital. 

Meaning, the person you reference is still making virus in all likelihood. 

However, the antibody testing is not reliable and we do not know if you can get refinfected, reactivated or remain contagious even after a negative PCR. One test showed viral shed 6 weeks after positive test and then even with negative test.

We don't know enough and this virus keeps giving us new and ugly symptoms, new and ugly sequalae and will be around for a very long time. 

So, anyone positive is better off away from people. Sad but true.

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A friend called me last night.  Reported a co worker had tested positive COVID 3 times.  Was told by her company she could not return to work until she was negative.  WTH is with that?    I have been reading listening to podcast to try to keep current.  Has anybody heard of testing (nasal swab) until negative???
Our state DOH updated guidance has 2 strategies.
1) sx based-- stay home from work 10 days after sx first appeared and no sx for at least 3 days.
2) resolution of fever + reduced sx like cough + two consecutive negative PCRs.

Option 2 has a little asterisk that says there have been reports of prolonged RNA detection without correlation to viral culture and that PCR RNA detection does not necessarily mean that infectious virus is present..

Clear as mud and twice as interesting.
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On 5/11/2020 at 4:23 PM, Reality Check 2 said:

The PCR is positive if you have active viral replication, by nasal swab. 

Folks have to test negative twice - at least 24 hrs apart to be considered negative. At least in our hospital. 

Meaning, the person you reference is still making virus in all likelihood. 

However, the antibody testing is not reliable and we do not know if you can get refinfected, reactivated or remain contagious even after a negative PCR. One test showed viral shed 6 weeks after positive test and then even with negative test.

We don't know enough and this virus keeps giving us new and ugly symptoms, new and ugly sequalae and will be around for a very long time. 

So, anyone positive is better off away from people. Sad but true.

well that would all be true if we knew enough about the nasal swab testing to be sure it is not a false positive due to "old pieces" of the virus hanging out

 

 

I am starting to be dismayed that we are putting so much faith in unproven tests - they are ALL under emegency approval, none of them had gone through traditional approval process they just "certify" that they work..... they are all crap in my opinion.....

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1 hour ago, ventana said:

well that would all be true if we knew enough about the nasal swab testing to be sure it is not a false positive due to "old pieces" of the virus hanging out

 

 

I am starting to be dismayed that we are putting so much faith in unproven tests - they are ALL under emegency approval, none of them had gone through traditional approval process they just "certify" that they work..... they are all crap in my opinion.....

 

And get ready...Healthy adults are now officially being "re-infected" with similar and in one case more severe symptoms then the first go around with the disease.  This is going to be a marathon not a sprint.  $182k deaths in the US with conservative estimates of over 300k dead by December.......

Anyone still think it's just another flu?  I love to go back and read some of the early posts when I started this thread.  Denial, not just a river in Egypt. 

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On 8/29/2020 at 9:58 PM, Cideous said:

 

And get ready...Healthy adults are now officially being "re-infected" with similar and in one case more severe symptoms then the first go around with the disease.  This is going to be a marathon not a sprint.  $182k deaths in the US with conservative estimates of over 300k dead by December.......

Anyone still think it's just another flu?  I love to go back and read some of the early posts when I started this thread.  Denial, not just a river in Egypt. 

Bruh, how many times in this very thread are you going to stick your tongue out and say "I was right and you were wrong".. What is it you're looking for?

You were right, tons of people died, what a huge victory for you.

By the way, it's only denial if we were still denying the seriousness of covid.  Early on, it was simply optimism, something I am POSITIVE you lack.

 

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I did have an older gentleman tell me he treats his arthritis in his knee with a few spritzes of WD-40.. [emoji1751]
I actually had one octogenarian pt tell me this very same thing a few years ago! No joke! [emoji23]

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 https://www.ibtimes.com/cdc-finds-only-6-coronavirus-deaths-are-solely-covid-19-3037136

 

 

https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

 

 

 

While I am NOT denying the fatality of this disease (9000+ deaths are still a lot) but in typically well (no comorbidities, under 65 etc) pts recover pretty well. And this would seem that the data may have been skewed by listing COVID as cause of death though the more probable cause of death was an underlying disease.

 

Anecdotally, a distant family member of mine died in May of lung cancer (she was already in hospice for several months) but she tested positive for SARS-COV2 while in a facility but was afebrile. She had SOB and cough at baseline but she was in end stage lung cancer with bad disease. COVID was listed as her primary cause of death on the DC.

 

Same side of the family: 9 people tested positive for SARS-COV2 and were ill ranging from 2 days to a week (multi generational ppl from age 25-68 with comorbidities like HTN, HLD, DM, and obesity, also asthma and active smokers) all recovered with no lingering effects. Incidentally, the grandmother died of heart failure at age 93 a week before. Negative for SARS-COV2.

 

I have 4 pts who have recovered from COVID (I just returned to work July 14th so I have limited COVID pt experience). 2 are HIV +over 65 and have COPD, HTN, obesity, African American (which I only bring up b/c it was said people of color fair worse with COVID by some data sources). One went to ICU and got remdesivir and Decadron and recovered after a month. The other convalesced at home in quarantine and recovered in 3 weeks with only supportive care. Both are doing well today. My other 2 were in early 30s and were only sick with mild flu like sxs for a few days and have fully recovered as well with only supportive care if that...

 

So... My anecdotal data aside, I think while this disease is certainly deadly to some demographic (comorbidities age etc), I think I'm leaning back on my initial opinion (I did at one point think we were headed for the apocalypse thanks to this thread and the news [emoji23]) that it is, for the majority of people, SURVIVABLE. The current CDC data seems to support this.

 

I will add a caveat that as flu season approaches we may be heading into a resurgence and possibly more deaths given influenza and pneumonia were listed as the main comorbidities with COVID deaths by the CDC...

 

Edited to add about IgG data from my pts: all post testing showed a negative IgG but the Diasorin IgG (supposedly more sensitive and specific) were all positive. Does this convey immunity? We shall see. [emoji2369]

 

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40 minutes ago, Joelseff said:

https://www.ibtimes.com/cdc-finds-only-6-coronavirus-deaths-are-solely-covid-19-3037136

 

 

https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm

 

 

 

While I am NOT denying the fatality of this disease (9000+ deaths are still a lot) but in typically well (no comorbidities, under 65 etc) pts recover pretty well. And this would seem that the data may have been skewed by listing COVID as cause of death though the more probable cause of death was an underlying disease.

--------------

So... My anecdotal data aside, I think while this disease is certainly deadly to some demographic (comorbidities age etc), I think I'm leaning back on my initial opinion (I did at one point think we were headed for the apocalypse thanks to this thread and the news emoji23.png) that it is, for the majority of people, SURVIVABLE. The current CDC data seems to support this.

 

I will add a caveat that as flu season approaches we may be heading into a resurgence and possibly more deaths given influenza and pneumonia were listed as the main comorbidities with COVID deaths by the CDC...

So if I am to understand you correctly, the presence of an underlying comorbidity should prevent a cause of death being identified due to a separate disease process?

Do you have an explanation for the excess deaths these past 6 months?

https://public.tableau.com/views/COVID_excess_mort_withcauses_08262020/WeeklyExcessDeaths?:embed=y&:jsdebug=y&:toolbar=n&:tabs=n&:display_count=n&:origin=viz_share_link

To address your other statements...

How many people in the U.S. are lacking the comorbidities that increase mortality in COVID? How many individuals 18 - 65 are "otherwise healthy"?

Care to cite your source for influenza and pneumonia being the main comorbidities in death per CDC? They don't appear to be on the following list:

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

I simply cannot understand the need of certain segments of society to downplay this disease.  Come hang out and watch some people die with me, maybe you'll change your mind. <--Hyperbole acknowledged.

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So if I am to understand you correctly, the presence of an underlying comorbidity should prevent a cause of death being identified due to a separate disease process? Do you have an explanation for the excess deaths these past 6 months?

https://public.tableau.com/views/COVID_excess_mort_withcauses_08262020/WeeklyExcessDeaths?:embed=y&:jsdebug=y&:toolbar=n&:tabs=n&:display_count=n&:origin=viz_share_link

To address your other statements...

How many people in the U.S. are lacking the comorbidities that increase mortality in COVID? How many individuals 18 - 65 are "otherwise healthy"?

Care to cite your source for influenza and pneumonia being the main comorbidities in death per CDC? They don't appear to be on the following list:

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html

I simply cannot understand the need of certain segments of society to downplay this disease.  Come hang out and watch some people die with me, maybe you'll change your mind.

 

Hey MediMike,

 

I have no agenda... And will admit I may be reading the data wrong. So I'm glad you chimed in. Perhaps I need to examine the data better. I did see the excess death data but admittedly haven't thoroughly reviewed the weighted data.

 

The influenza and pneumonia were listed in one of the articles I read citing the CDC as "top" comorbidities. Perhaps a my use of "main" is also inappropriate.

 

http://nbc25news.com/news/local/cdc-94-of-covid-19-deaths-had-underlying-medical-conditions

 

Again, I have no agenda just trying to make sense of the recent CDC info about the isolated COVID only causes of death...

 

Now that you bring up some good points which I did not take into account I'll look into it more.

 

I by no means am a COVID specialist. Just trying to make heads or tails of the influx of data coming in.

 

A question for you (and I am truly curious as my COVID experience is very limited to 4 pts) how many young people with no comorbidities have you seen die of it?

 

(I'm not republican by the way and definitely not supportive of unscientific data but perhaps quite rusty in reading statistics [emoji23])

 

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6 minutes ago, Joelseff said:

 

 

 

 

 

Hey MediMike,

 

I have no agenda... And will admit I may be reading the data wrong. So I'm glad you chimed in. Perhaps I need to examine the data better. I did see the excess death data but admittedly haven't thoroughly reviewed the weighted data.

 

The influenza and pneumonia were listed in one of the articles I read citing the CDC as "top" comorbidities. Perhaps a my use of "main" is also inappropriate.

 

http://nbc25news.com/news/local/cdc-94-of-covid-19-deaths-had-underlying-medical-conditions

 

Again, I have no agenda just trying to make sense of the recent CDC info about the isolated COVID only causes of death...

 

Now that you bring up some good points which I did not take into account I'll look into it more.

 

I by no means am a COVID specialist. Just trying to make heads or tails of the influx of data coming in.

 

(I'm not republican by the way and definitely not supportive of unscientific data but perhaps quite rusty in reading statistics emoji23.png)

 

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Hey Joel!

Sorry, I wasn't trying to portray you as one political party or the other and likely came across harsher than I intended, was a "wake up 'n post" moment, have since had my coffee and would like to apologise 😁

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Hey Joel! Sorry, I wasn't trying to portray you as one political party or the other and likely came across harsher than I intended, was a "wake up 'n post" moment, have since had my coffee and would like to apologise [emoji16]

 

Lol no worries. [emoji1688] My post was a wake up and post too since I just read the article last night [emoji23] . But I did edit my post to ask (seriously without trying to incite an argument) have you seen young pts with no comorbidities die from COVID? My experience is very limited. And I am genuinely asking out of curiosity. 

My advice and stance is still social distancing, masks, hand washing if youre at risk then stay home etc...

 

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I'm not positive or negative when it comes to public health.  I am driven by data and the ability to extrapolate that data in a logical predictive nature.  What I "hope" will happen does not factor in.  Our dear leader "hoped" it would just "go away like a miracle", and yet here we are.

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33 minutes ago, Joelseff said:

Lol no worries. emoji1688.png My post was a wake up and post too since I just read the article last night emoji23.png . But I did edit my post to ask (seriously without trying to incite an argument) have you seen young pts with no comorbidities die from COVID? My experience is very limited. And I am genuinely asking out of curiosity. 

My advice and stance is still social distancing, masks, hand washing if youre at risk then stay home etc...

 

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I personally have not had individuals without comorbidities end up in the unit. Just about all of them have either HTN, DM or a touch of the fluff. But they are still dying in their 40s and 50s.

I have seen younger folks included in other cohort studies who have died.

Anecdotally a coworker of my wife is late 30s has mild asthma and was intubated for 7 days, in hospital for another 2 weeks, couldn't return to work for close to 3 months.

We are seeing long hospital courses and a poor functional return for those folks who do recover, regardless of age.

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On 8/29/2020 at 6:58 PM, Cideous said:

 

And get ready...Healthy adults are now officially being "re-infected" with similar and in one case more severe symptoms then the first go around with the disease.  This is going to be a marathon not a sprint.  $182k deaths in the US with conservative estimates of over 300k dead by December.......

Anyone still think it's just another flu?  I love to go back and read some of the early posts when I started this thread.  Denial, not just a river in Egypt. 

Let's hope it's not 1.5 million deaths like someone else proposed in an earlier post. I do hope the continued health measures will help mitigate the numbers affected because the economic effects of such efforts are already starting to set in, sadly. 

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