Coronavirus thread

[Nephrology]

Here's a firsthand account from an ER doc in NYC. It's a professional EM podcast and is directed at EM physicians so it may not be digestible or focused enough for a global audience but it's not greek either. Worth a listen.

https://podcasts.apple.com/us/podcas...=1000469490092

[TheRoland]

Here's a firsthand account from an ER doc in NYC. It's a professional EM podcast and is directed at EM physicians so it may not be digestible or focused enough for a global audience but it's not greek either. Worth a listen.

https://podcasts.apple.com/us/podcas...=1000469490092

In the past, I've listen to this and the Canadian equivalent (EmCrit, maybe?) and found them easily digestible by anyone with a science background.

[JHC]

@YVK


https://dnyuz.com/2020/03/27/a-heart...e-coronavirus/

[Borderland]

In other news, Boris Johnson and Prince Charles have it.

https://www.spokesman.com/stories/20...positive-for-/

God save the queen.

[Mystery]

It's so scary that it feels like a nightmare.

[YVK]

@YVK


https://dnyuz.com/2020/03/27/a-heart...e-coronavirus/

Yup, we're very aware of that, and very concerned for multiple reasons. No specific treatments, as none exists for most myocarditides. Massively worse prognosis if both lungs and heart are compromised. An unneeded exposure, in a retrospect of course, of interventional and cath lab staff to COVID19 patients.

[Nephrology]

Yup, we're very aware of that, and very concerned for multiple reasons. No specific treatments, as none exists for most myocarditides. Massively worse prognosis if both lungs and heart are compromised. An unneeded exposure, in a retrospect of course, of interventional and cath lab staff to COVID19 patients.

Is myocarditis something you see ever with influenza? RSV? I think the only viral myocarditis I remember from MS1/2 was Coxsackie B.

[peterb]

9pm Friday 3/27/2020 Spain has almost matched Italy in cases per million.

[HeavyDuty]

Abbott released a presser on that speed test I mentioned a bunch of pages ago:

https://abbott.mediaroom.com/2020-03...RA-o5.facebook

[pangloss]

For the docs -

An acquaintance is a senior scientist at Abbott Molecular here, she specializes in developing oncology therapies. But, for a few weeks now she’s been talking about a huge initiative at Abbott to deliver a massive number of COVID-19 tests - yesterday she mentioned they were on track to deliver almost 1 *million* tests this week, and sustain that volume indefinitely. Something about FDA fast-tracking this. I don’t know if this was a test developed by Abbott or if they are just being asked to produce it, at one point she mentioned other peer companies were doing the same.

I haven’t heard much about this in the media, have y’all? I would think this could be a game changer.

A bunch of diagnostic companies have assays that are becoming available now. Abbott starting shipping theirs 8 or 9 days ago. It is a 96-well format and was the first platform that we got online. Our machine can analyze about 90 samples in 8.5 hours, so realistically it'll turn out 180 tests per day, a bit more if you can staff sufficiently for third shift. Even if the test kit was available in unlimited quantities, the hardware to run the tests will still be a bottle neck for a lot of places. Given what we're seeing, 180 tests per day is not a lot. Having said that, I just saw that Abbott is rolling out a point of care test. Those are for individual samples and not batched samples, but if you have enough hardware modules to run the tests, you could crank through quite a few in a day. Cepheid also has a point of care platform, and they are supposed to start shipping their kits soon. The Cepheid kits come with their own swabs!

It depends on what they mean by "kits." There process of testing for COVID19 requires a number of individual reagents of which Abbott would be well poised to develop some of. However, as @pangloss pointed out earlier, one reagent they are very short on are the actual testing swabs themselves, as one of the major manufacturers of these swabs was was based out of Italy.

So it could be helpful depending on what they're making and where they're sending it too. That is why everyone is looking for the federal government to coordinate things and why everyone is mad they are coming up short. Without some kind of centralized attack plan, it's like a soccer game with 6 year olds - everyone is mobbing the ball.

At this point, I think the federal government needs to go back to doing whatever they were doing before this mess and let the states work it out. They are clearly not competent enough to provide assistance. Federal intervention in the free market system by appropriating and re-directing resources is doing more harm than good. Last week an air force plane full of swabs flew from Italy to Tennessee. I'm in this region of the country, and we thought it reasonable to assume that there would be regional distribution of the swabs. But no, apparently they were loaded directly on to FedEx planes and flown to other parts of the country. Meanwhile the government is removing product from the normal commercial supply lines and wreaking havoc on inventory tracking. Consequently, we are effectively locked out from being able to obtain any of the appropriate swabs. I was finally able to find non-sterile swabs in stock that I think will work for nasopharyngeal sampling, but they are non-sterile. So next week I need to sterilize tens of thousands of swabs and pack them into sample collection kits. (Big advance thank you to student volunteers here! And they much prefer the term "volunteers" to "conscripts.") To the best of my knowledge, my state has received absolutely zero tangible assistance from the federal government. I assume that we'll get some money from them at some point, but that's going to be after the action is all over. It'll help pay the bills, but it won't save lives next week. Please forgive me if I'm repeating myself. I have other stories that I will tell once all of this is well behind us. For now, suffice to say that our shared mindset that no one will be there to save you when you get in a bad spot scales up pretty well. I'm extremely proud of my institution's response thus far. I'm sure we've made some mistakes, but I couldn't tell you what they are.

This thread is moving too fast for me to keep up with. I managed to get away from work in time today to go to the range this afternoon. It's been a long time since I've been this tired, but I actually shot pretty well. I'm working hard to get to 10/10 on a two inch dot from seven yards. There were three other shooters there and all of them appeared to be new shooters, which was a very good thing to see despite them not knowing how to hold a pistol. I tried to mind my own business, but it's just too hard when some one has her support hand thumb wrapped around the back of the pistol and half a hair's width below the slide.

Time to sleep!