Coronavirus thread

[1911nerd]

ICU distribution:

Attachment 50498

https://khn.org/news/as-coronavirus-...h-no-icu-beds/

Some of those counties in ID, MT, and SD that I know well don't have a hospital at all. And some that do have a BIA hospital .
One county in particular, that had ~2,500 residents at the last census and ~1,200 in 2017 expects 100 COVID-19 cases by May. Knowing the ranchers there, they are at high risk (old, comorbidities), stubborn, hard working, and shearing/lambing/calving season is coming so they have to overcome their natural tendency to practice "social distancing" and work together. I'm afraid it may wipe most of a county off the map this Spring.

[TAZ]

The Koreans and Chinese use temperature checks as the least invasive way of screening people before they enter public spaces.

That's fine so long as the patient isn't in the 2 weeks +/- of symptomatic behavior. Unless things have changed as to the behavior, I was under the impression that this bug could be all over you like white on rice for up to 2 weeks and you're feeling like a champ without any indication that you're sick and infecting those around you. Hence the lockdowns and such.

[Borderland]

We just got locked down here in WA. Gov said shut it all down. This is going to cripple our economy. Not saying it doesn't need to be done, just saying it's a hammer blow to people that need to work for a paycheck. I just hope there's some relief in the pipeline because if there isn't the weeks and months ahead are going to be very interesting. I'm damn happy I'm on the dole, have everything paid for and not depending on a pay check anymore. My good friend who is still employed at the agency where I worked says furloughs are coming.

[YVK]

Curious question for you virologists, immunologists and other medical types with knowledge on cooties…

Does it matter how exposed to a virus like COVID-19 a person is in regards to how severe their symptoms may end up being?

I don't know if there is an answer. There is a data for other coronavirus infections where viral load was shown to correlate with the severity. The viral load is measured in serum tho, so it is a function of both initial viral insult and how fast it propagates and replicates. I presume that the latter varies from person to person.


So, we've been about 10 days into a more available testing, still with under-testing and bias towards severe case testing, and we're already at over half of the Chinese case volume and 2/3 of the Italians. This allows to start making some early comparisons not on the basis of the Imperial College computers but on our current numbers. Our case fatality rate is about 1.2%, vs 4% for China and nearly 10% for Italy, numbers taken from Johns Hopkins map. Further intrinsic trend for case fatality rate would depend on number of newly diagnosed to number of newly dead. Since everyone agrees that most people are asymptomatic or minimally sick, we should expect the former number exceed the latter and case fatality rate go even lower. That would be good.
Potential issues with this:
1. We have not diagnosed all dead correctly before tests became available, and may still be misdiagnosing them.
2. We might start seeing 600-800 / day mortality numbers, either due to non-salvageable cases or system overload.
3. Lower case fatality rate but larger population affected will still result in huge number of lives lost. It still has 10 times higher case fatality rate than flu. Assuming the same community spread and capture as of flu, the loss of life can be pretty staggering even with a relatively low case fatality rate.
4. Bet 50 P-F.com dollars that Trump lifts some of the federal restrictions by April Fool's day.

[Totem Polar]

May as well add a ray of light from the land of Yale. Somebody has to play the pollyanna on TV...


https://www.nhregister.com/coronavir...photo-19189174

The novel coronavirus news is scary, we get it.

Headlines continuously read distressing news regarding the virus so we can all take advanced safety measures to protect not just ourselves, but also those around us.

Yet, there's a handful of worldwide news doling out glimmers of hope in the midst of frightening times, and that's important too.

So, we've rounded up all the good news about the virus worth catching up on.

[45dotACP]

So now that my unit has fully converted into a COVID unit I have observed some stuff as a nurse.

1. It's way faster and way nastier that the flu. It progresses to ARDS fast. I've had patients talking to me on admit, and intubated two days later.

2. Age is maybe a factor, but most of the patients I've been given have been anywhere from 40 years old to 85. And this is critically ill people. Not just the normal cases.

3. Fevers have been refractory to almost everything I throw at them. Tyelenol to straight up ice water blankets. Still high temps.

4. Intubation is preferred to BiPap or HFNC due to droplets being aerosolized.

We filled a 36 bed unit to capacity in two days. Correction. A 36 bed Critical Care unit. We're re-using N95s but the support of the community has been incredible. Local restaurants have donated food, tattoo shops and hardware stores are bringing in masks.

People might surprise you with how great they are..

But one more thing.

We've just completed a project to set the rooms up to accept two patients to a room. That goes live tomorrow. Recently a few hospitals have closed and legislation is being fast tracked to open them. The IL-ANA is also apparently aware of a few bills that are meant to get nursing school seniors to practice pending license.

This is going to get worse in a hurry, but hey, I live for this high stress shit.

Please stay home friends.

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[the Schwartz]

Of those in this age bracket—

2. Age is maybe a factor, but most of the patients I've been given have been anywhere from 40 years old to 85. And this is critically ill people. Not just the normal cases.

—how many present (percentage-wise in your opinion) with 3 or more significant co-morbidities?

[45dotACP]

Of those in this age bracket—



—how many present (percentage-wise in your opinion) with 3 or more significant co-morbidities?

Sorry, misread so I had to edit...


Most of them if they were older. The younger patients had one or two.

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[YVK]

Sorry, misread so I had to edit...


Most of them if they were older. The younger patients had one or two.

Just out of curiosity, how many of them are overweight across all ages?

[45dotACP]

Just out of curiosity, how many of them are overweight?

Both of the patients under 50 had what I'd say was a normal BMI. But the majority of them were probably clinically overweight, but around Southside Chicago that's the majority of patients in the ICU anyways...what with a Portillos on ever corner here

Small sample size and all, but the 40 year old was an acute chest, so his one comorbidity was pretty bad, and his ongoing vasocclusive crisis jumped his Creatinine to 8 so being thrown into AKI probably wasn't doing him any good either.

The other young guy had asthma. And hypertension.

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