Coronavirus thread

[Nephrology]

Updates here:

Wife is on telework and approved for telework for the next 60-days.

Lab and museum are on lock down until, at least, Mar 24.

University isn't officially locked down, yet, but we just received notice that the Spring Quarter will be further delayed for one week. And of course, it is all digital.

University-wide travel ban in effect until April 15.

The delays and closures are putting a damper on my dissertation, because I needed some specimens here to process. But hey, I'm not going to ask anyone to expose themselves to send me some dead animals. The animals are already dead, they aren't going anywhere.

But the good news is, I got the last of my samples for one diss. chapter in on Friday and the lab will run them this week. So, I'll have plenty of time to write this chapter and finish it up.

I am supposed to be working on my thesis.... but my defense isn't even supposed to be for another year?

[scw2]

This looks promising where they rigged one ventilator to support up to 4 people, Will let the experts discuss more if this looks legit. If so probably worth sharing amongst your professional contacts as well.

[RevolverRob]

I am supposed to be working on my thesis.... but my defense isn't even supposed to be for another year?

Eh, sooner it's done, easier it is for you to do other things. (<-That is advice of someone who is derelict in writing his...so ya know)

I'm supposed to be done in May (ha). More likely July. Although, at this point for me, until there is some post-doc funding, finishing is kind of a moot point. I think I've lined up a backup. But anyways, that's a tangent for another day.

But writing might be a good distraction from covid-19. I am trying to mentally distance myself to some degree, because I know that I am basically doing what I can do (social distance, effectively on self-quarantine). So, now it is try to actually do work.

I'm mostly grateful I am on fellowship funding and I do not currently have to teach right now. Trying to transfer myself to an online teaching format would be abysmal.

[Nephrology]

This looks promising where they rigged one ventilator to support up to 4 people, Will let the experts discuss more if this looks legit. If so probably worth sharing amongst your professional contacts as well.

Babcock is legit.

But writing might be a good distraction from covid-19. I am trying to mentally distance myself to some degree, because I know that I am basically doing what I can do (social distance, effectively on self-quarantine). So, now it is try to actually do work.

I am definitely spending way too much time reading/thinking about this stupid virus so you are right that it would be a productive and probably healthy distraction.

[RoyGBiv]

Right now, they're isolating themselves as if they have the virus, but without really knowing what's going on, at some point symptoms will subside (one hopes) and we're going to have to make a decision that they can travel again. How does one make that call? How does one judge when close-contact is safe again, especially with no actual testing?

First thing that comes to mind is to see if any drive through testing centers are available nearby. If they're in a hot zone, I'd expect something would be available by this week. We have one open in Dallas, and talk of several others opening closer to home "soon".

Failing that, I would call a local Dr, clinic or urgent care and establish a baseline with a local doc that would qualify them for testing (whatever that looks like) once symptoms have passed. Then go the local option for testing before RTB.

I would not fly until tested negative for active virus. Worst case, drive home if possible and make appointment with PCP, advising them of the situation before arriving.

I am not Dr. just what I would do.

[RoyGBiv]

This looks promising where they rigged one ventilator to support up to 4 people, Will let the experts discuss more if this looks legit. If so probably worth sharing amongst your professional contacts as well.

How many people did this Nurse just save? Thanks for posting. Will share.

[ccmdfd]

This looks promising where they rigged one ventilator to support up to 4 people, Will let the experts discuss more if this looks legit. If so probably worth sharing amongst your professional contacts as well.

That might, emphasis on might, be okay in a mass trauma emergency room type situation. I highly, highly doubt it could be used for medical intensive care patients with ARDS.

The limitations that she mentioned are extremely legitimate. Good luck on finding several patients that are the exact same ideal body weight, with lungs would have the exact same Airway resistance, and lungs that have the exact same elastance. Without getting into all the equations, what would end up happening is some patients would get way more air than they need which damages the lungs, and other people wouldn't get any air at all which obviously is bad.

As for cross-contamination not being a big deal since they all have the same viral infection, well that's only part of the story. One of the big killers of people with viral pneumonia is is not the viral pneumonia itself but they get a superinfection as they are recovering. Typically is with staph, but in our Hospital lately we've been seeing a lot of ugly Gram-negative bugs. The last thing you would want to do is start spreading that stuff around.

Again, if you're in the emergency room and are facing a mass casualty incident and simply don't have enough ventilators to keep people alive, I can certainly understand throwing caution to the wind and trying something like this. Just don't see it working with the current problem we're facing.

cc

[RevolverRob]

How many people did this Nurse just save? Thanks for posting. Will share.

Doctor.

I know it's a bit semantic, but she spent a long time in medical school and residency and a lot of money.

[Aisin Gioro]

Can't speak to how Italy drives admits s/p, but per this article it looks like you may have a point. Hopefully this gives us some advantage.

I do think the US has an excellent ratio of ICU beds per capita that is probably higher than most, but I would be a bit wary some of the direct comparisons in that article. The article cites papers that note the differences in definitions for ICU/CCU/TCU/IMCU beds vary quite a bit across countries, but they also seem to have selected papers that support lower numbers for at least some countries and higher numbers for the US.

For example, they say that Korea has 10.6 ICU beds/100,000 of the total national population (though the paper they have to support that actually says the 10.6 would be "the sum of IMCU beds and ICU beds", so step-downs and ICUs together). However, other Korean sources cite higher numbers, such as 17 ICU beds/100,000, not including SDUs at all, in 2009. If SDUs are included, the number is actually much higher.

The numbers for the US also seem a little equivocal. For example, the paper they cite for "34.2" (34.7 in the paper) says the US in 2009 had ~78,000 ICU beds. They select for an adult population of roughly 224,000,000, rather that a total population, so they get 34.7/100,000. The population of the US in 2009 was ~309,000,000, so that actually works out to an average of about 25/100,000 if compared in an equivalent way to the Korean numbers.

A good breakdown of this way of looking at it is here:

Is U.S. Health Care Well-Equipped for the Coronavirus?
https://www.niskanencenter.org/is-u-...e-coronavirus/

(Quick take: The answer is "better equipped than most, not as well-equipped as some". The US is in better shape to deal with it than was Italy, but not as well-equipped as Korea, which pretty much goes along with what is being seen in practice, at least as it starts to unfold in the US.)

[HCM]

Not that I promote revenge and retaliation, but we should find these fuckers and kill them in their sleep.

Drone strikes are now “social distance warfare”