Coronavirus thread

[farscott]

According to BBC News, there aren't going to be any travel restrictions. They also appear to be closing "large meeting points", but I don't know if that means they'll be actively preventing large gatherings too.

Interesting.

[theJanitor]

Serious Q for our docs/healthcare professionals:

Do people with asthma need to be cautious in evaluating their symptoms if they believe they may have covid-19?

My wife has fairly bad asthma and I worry that could be a complicating factor - I want to be able to evaluate her carefully should she come down with symptoms. I definitely don't want to add to healthcare system overload if avoidable. However, judging that quite a few folks in Italy have gone if after 5-7 days of persistent symptoms and immediately been placed on vents, I do not want to wait too long.

I realize I'm asking for advice about something we have minimal understanding of. So - broad stroke as necessary and tell me what you would do if you had an asthmatic individual with a persistent cough and shortness of breath that presented other symptoms of covid-19 - to the hospital we go when shortness of breath shows up? Give it a few hours? A day? Two days?

This applies to my 43yo wife, as well

[0ddl0t]

It's nice to know that you heap all these people into the same category without knowing one whit about the life they lead, moral values, military/community service, philanthropic contributions, etc. Spoken like a true statist...

LOL I'm about the farthest thing from a statist.

1. Less than the half a million deaths projected to be caused by this virus
2. The death of these half-a-million people (not to mention the hospitalization of millions of others) will be a far greater and more durable drag on our economy than what we are experiencing right now.

I would wager against you if we used years of productive live expectancy lost as the system of measurement.

Please cite your sources. If you're referring to risk factors for all cause mortality in US, those numbers are not relevant.

The CDC data. At least 20 of the 25 deaths had diabetes, heart disease, hypertension, or obesity. All but one qualified for AARP (and the 40 year-old had underlying health issues). 19 were in a nursing home (fun fact: the average life expectancy of those admitted into a nursing home is less than 6 months).

Here is some actual data. Feb 7 2020 - case report of 138 patients in China sick enough to require hospitalization.



Note that over half of the patients who required hospitalization did not have any comorbidites. Over 25% who required ICU level care had no underlying comorbidities.

You're talking hospitalizations, I'm talking death.

I am sad to see you and a few other younger (and very soon to be older) folks on this and other forums celebrating the possible death of your parents and grandparents who brought you into this world, loved, cared for and looked after you, seeing that you were clothed, educated and looking after your welfare for decades. All for a small monthly payroll deduction. I guess we should have reinforced your moral values a little more.The Waffen SS approves!

Butthurtboomer

Not celebrating, but putting into perspective. But if you think "looking after" my generation included saddling us with $130 trillion in unfunded social welfare program liabilities, to say nothing of climate change, I sincerely thank you.

[JHC]

@Nephrology

A couple interesting reads. This one from a German "study" seems to reveal some of the characteristics that makes covid-19 so infectious.

http://www.cidrap.umn.edu/news-persp...vid-19-viruses


This one another grisly report from Italy in the trenches.

https://threadreaderapp.com/thread/1...077697538.html

[Aisin Gioro]

Welcome to Site Supporter status, @Aisin Gioro. I sincerely appreciate your contributions here.

Much appreciated, though I certainly don't deserve such status! I get 10,000 times more from this site than I could ever contribute, and you all have my very great thanks.

[ccmdfd]

Serious Q for our docs/healthcare professionals:

Do people with asthma need to be cautious in evaluating their symptoms if they believe they may have covid-19?

My wife has fairly bad asthma and I worry that could be a complicating factor - I want to be able to evaluate her carefully should she come down with symptoms. I definitely don't want to add to healthcare system overload if avoidable. However, judging that quite a few folks in Italy have gone if after 5-7 days of persistent symptoms and immediately been placed on vents, I do not want to wait too long.

I realize I'm asking for advice about something we have minimal understanding of. So - broad stroke as necessary and tell me what you would do if you had an asthmatic individual with a persistent cough and shortness of breath that presented other symptoms of covid-19 - to the hospital we go when shortness of breath shows up? Give it a few hours? A day? Two days?

If you have asthma, you do not want to wait at all if you were to start developing symptoms. That's one of the worst things that you can do.

I've seen patients who have very mild, almost didn't even know they had asthma go from being fine to on a ventilator in the Intensive Care Unit in less than 24 hours with a viral infection, or other infection.

Does she have a local pulmonologist?

At the first sign of trouble I would be calling their office. We've been knowing about this virus for some time and all office should be, and emphasis is on should, making plans for how to handle patients in this situation in order to minimize their exposure but get them on appropriate treatment as soon as possible.

Of course I say that with our office not having done anything yet.

Best of luck to you and her

[RevolverRob]

If you have asthma, you do not want to wait at all if you were to start developing symptoms. That's one of the worst things that you can do.

I've seen patients who have very mild, almost didn't even know they had asthma go from being fine to on a ventilator in the Intensive Care Unit in less than 24 hours with a viral infection, or other infection.

Does she have a local pulmonologist?

At the first sign of trouble I would be calling their office. We've been knowing about this virus for some time and all office should be, and emphasis is on should, making plans for how to handle patients in this situation in order to minimize their exposure but get them on appropriate treatment as soon as possible.

Of course I say that with our office not having done anything yet.

Best of luck to you and her

I do not believe she has a local pulmonologist - but I will talk with her about it.

She is very stubborn and seems to be treating this like “any other virus”. However, I think my genuine concern about it, is starting to impress upon her, that this is not just any cold or flu. I will apply some pressure to her about making sure her ducks are in a row. If not for this, than in general.

PS: Thank you for the straight forward and prompt response. I will put a plan of action in place.

[blues]

Much appreciated, though I certainly don't deserve such status! I get 10,000 times more from this site than I could ever contribute, and you all have my very great thanks.

That is not even close to true...and thank you for your contributions here.

[Aisin Gioro]

Sensitivity on the kits from Kogenebiotech, Seegene, and Solgent, the three main producers in Korea at this time, have all been externally evaluated at 95% or better, which is in line with what other nations have been getting on their test kits. While I'm sure the volume of testing is going to have an impact on quality control in both collection and processing, it does seem that the PPV is pretty high. I have a message in to someone in Korea with high-level (Blue House) access to information, so I'm trying to see if they know about NPV, which I haven't seen yet, along with some other questions.

I hate to quote myself, but it seemed like the best way to follow up on this.

According to my Korean contact, NPV is around 93-94% at this point. That is, about 93.5% of negatives are "true negative". On paper, it's actually even higher, but real-world collection opens that number up a little bit. Early in the outbreak, there was a window where it was as low as about 85% (my contact hinted it might have actually been as low as high 70-something %), but it was quickly determined that this was due to poor collection practices. For most test kits, it was easier to get a false negative, especially early in the latency period, if the sample wasn't collected via nasopharyngeal swab (NPS) but rather with a throat swab, or if the NPS wasn't used correctly. Since nobody really likes to have a tiny mop "gently inserted" ("Maybe it's not so gentle"...) through their nose to the back of their throat, and it requires better technique to perform well, NPS had some limitations in the big roll-out. Throat swabbing was relied on more extensively in the early phases and the NPS collections were less consistent in application. Both are still in common use and frequently both are used on the same person, but NPS samples are preferred, with the throat swabs more as a back-up.

[RoyGBiv]

This one another grisly report from Italy in the trenches.

https://threadreaderapp.com/thread/1...077697538.html

Horrible...

5/ Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.