Coronavirus

[Dan]

For those who think it's not too bad and the media is blowing it all out of proprtion letme tell you what I am hearing from colleagues in university Medical centers in hard hit New England. So many internal medicine residents are quarantined or sick they are pulling subspecialty residents (opthamology and dermatology) to cover the wards. A major university hospital up there has decided not to resuscitate covid patients who are full code if they show extensive multiple end organ failure as the risk to the team during resuscitation is too high and the likelihood of survival too low. This is regardless of age. Long Island ICUs are full and they are about out of ventilators already.

I have been an MD since 1987 and I have never seen doctors so nervous about anything like this before. Not the early days of AIDS, not anthrax, not Ebola. The original SARS and MERS were really bad in Asia but it didn't really hit here so I didn't experience their anxiety first hand.

Thankfully reading CT from home today.

 

[TankTop5]

For those who think it's not too bad and the media is blowing it all out of proprtion letme tell you what I am hearing from colleagues in university Medical centers in hard hit New England. So many internal medicine residents are quarantined or sick they are pulling subspecialty residents (opthamology and dermatology) to cover the wards. A major university hospital up there has decided not to resuscitate covid patients who are full code if they show extensive multiple end organ failure as the risk to the team during resuscitation is too high and the likelihood of survival too low. This is regardless of age. Long Island ICUs are full and they are about out of ventilators already.

I have been an MD since 1987 and I have never seen doctors so nervous about anything like this before. Not the early days of AIDS, not anthrax, not Ebola. The original SARS and MERS were really bad in Asia but it didn't really hit here so I didn't experience their anxiety first hand.

Thankfully reading CT from home today.

Do you think a lot of the concern from DR’s is in relation to “the curve” and having to pick who lives and who dies when equipment and medications are exhausted?

I have also heard rumors coming out of research hospitals that a large number of people may be immune but those who are not are extremely susceptible, have you heard anything similar that could be credible?


Sent from my iPhone using Tapatalk

 

[TLS Guy]

I get it when you say you're venting for the benefit of venting. But I still get the impression, by your repeated venting, that something else is on your mind.

A friend recently reminded me of a relevant quote from Issac Asimov:

There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge. – Isaac Asimov​

That quote is perfection.

I think there is another clue in Danzilla's response. He admits to worry. There is nothing productive in worry. What abolishes worry, is taking the time to research the problem and understand its essence and fundamentals. That certainly does not mean getting all your data and information from one source. Whatever side of the political spectrum you are on, you owe it to yourself and your families to cast your net for information far and wide. At this time that absolutely means not restricting yourself to US media outlets. You need to gather data and assimilate the facts on the ground from around the world. Then you are properly informed to protect yourself and family by formulating sensible and implementable plans, and judge the wisdom of the advice from individuals of any political persuasion. Then you will not worry. Worry is absolute evidence of an information deficit. Lastly at a time like this, absolutely you should not filter any hard information and data through any pre exiting political biases you have. That is a tough ask, but necessary for us all.

 

[Kvn_Walker]

Like @ryanosaur said, stay positive and kick its butt! Be well @killdozzer !

PS - I can't get anything from you can I?
View attachment 34750

Microsoft Natural Keyboard Pro.. best gaw-damn keyboard ever made!

 

[TLS Guy]

For those who think it's not too bad and the media is blowing it all out of proprtion letme tell you what I am hearing from colleagues in university Medical centers in hard hit New England. So many internal medicine residents are quarantined or sick they are pulling subspecialty residents (opthamology and dermatology) to cover the wards. A major university hospital up there has decided not to resuscitate covid patients who are full code if they show extensive multiple end organ failure as the risk to the team during resuscitation is too high and the likelihood of survival too low. This is regardless of age. Long Island ICUs are full and they are about out of ventilators already.

I have been an MD since 1987 and I have never seen doctors so nervous about anything like this before. Not the early days of AIDS, not anthrax, not Ebola. The original SARS and MERS were really bad in Asia but it didn't really hit here so I didn't experience their anxiety first hand.

Thankfully reading CT from home today.

That is not unexpected to me Dan. It is troubling none the less, particularly as we are just at the beginning of the curve. At least in New England and New York now everyone needs to be at home except for essential personnel. Public transit needs to be shut immediately. Every jurisdiction in the US needs to follow promptly.
I think your news indicates we need to engage all resources to build temporary medical facilities now, and get it done in two weeks or less. We have frittered away far too much time!

 

[Dan]

Do you think a lot of the concern from DR’s is in relation to “the curve” and having to pick who lives and who dies when equipment and medications are exhausted?

I have also heard rumors coming out of research hospitals that a large number of people may be immune but those who are not are extremely susceptible, have you heard anything similar that could be credible?


Sent from my iPhone using Tapatalk

I think the concern is for many things. They know capacity is insufficient on all levels. Insufficient ventilators, ICU beds, staff especially as they themselves become sick, anxiety over their safety and infecting their families, lack of protective gear, the backlog on tests (we are experiencing an eight day wait after a test is done to get a result) as well as the enormous amount of work to keep these people alive. The loss of income from traditional elective surgery will drive many marginal hospitals out of existence.

I have not heard a thing about immunity except a few Chinese reports of people getting reinfected after clearing their test. Health care workers on the US seem to be getting sicker than their age matched controls though the numbers are small. We can't know if people are immune if we have no idea who has the disease and the tests have been flubbed so badly we basically have no idea who does and doesn't have it. South Korea tests more people in a day than we have in total. That is a failure on the Federal level.

As for the curve I think we at the bottom end of the very steep rise now. I expect the numbers of dead and infected to rise exponentially in the next week.

 

[Dan]

That is not unexpected to me Dan. It is troubling none the less, particularly as we are just at the beginning of the curve. At least in New England and New York now everyone needs to be at home except for essential personnel. Public transit needs to be shut immediately. Every jurisdiction in the US needs to follow promptly.
I think your news indicates we need to engage all resources to build temporary medical facilities now, and get it done in two weeks or less. We have frittered away far too much time!

The only people I know of who can build that quickly is the military and by that I mean the Army. The National guard is not up to this kind of speed. It's one thing to build it, it's another thing to staff and supply it. More beds is of no help if there isn't enough protective gear, ICU nurses respiratory therapists, and docs. If they call up docs in the reserves to man them what happens to the hospitals where they are working now who need them just as much? I hate to call up retired docs like you since you're in that vulnerable age group. But the call has already gone out in New England.

 

[Mr._Clark]

Thanks man. The biggest struggle remaining now is just getting over the chest congestion and dealing with the isolation. That's been pretty rough since my wife is having a hard time managing the house and cooking by herself. Hopefully I will be cleared soon.

Gene, at the risk of prying, how are you faring?

 

[lovinthehd]

Gene, at the risk of prying, how are you faring?

Did you see his latest update video?

 

[Ponzio]

https://www.washingtonpost.com/world/europe/a-chilling-scientific-paper-helped-upend-us-and-uk-coronavirus-strategies/2020/03/17/aaa84116-6851-11ea-b199-3a9799c54512_story.html?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1

 

[Mr._Clark]

Did you see his latest update video?

Thanks, I did not see that.

 

[lovinthehd]

https://www.washingtonpost.com/world/europe/a-chilling-scientific-paper-helped-upend-us-and-uk-coronavirus-strategies/2020/03/17/aaa84116-6851-11ea-b199-3a9799c54512_story.html?utm_campaign=wp_to_your_health&utm_medium=email&utm_source=newsletter&wpisrc=nl_tyh&wpmk=1

FWIW very hard to read articles there unless you subscribe....

ps disabling Javascript in the browser did the trick, thanks to @AudioGekko

 

[Trell]

FWIW very hard to read articles there unless you subscribe....

If you clear your browser cookies you can read a couple of articles....

 

[lovinthehd]

If you clear your browser cookies you can read a couple of articles....

It's still pretty aggressive. I even undid my adblocker altogether and it quickly came back with a subscribe or GTFO response.

 

[Trell]

It's still pretty aggressive. I even undid my adblocker altogether and it quickly came back with a subscribe or GTFO response.

Perhaps they are kinder to us Europeans

 

[lovinthehd]

Perhaps they are kinder to us Europeans

Mebbe I'll try via a european vpn

ps it was disabling javascript in the brower that worked, didn't get around to trying the vpn thing, tho

 

[Matthew J Poes]

The only people I know of who can build that quickly is the military and by that I mean the Army. The National guard is not up to this kind of speed. It's one thing to build it, it's another thing to staff and supply it. More beds is of no help if there isn't enough protective gear, ICU nurses respiratory therapists, and docs. If they call up docs in the reserves to man them what happens to the hospitals where they are working now who need them just as much? I hate to call up retired docs like you since you're in that vulnerable age group. But the call has already gone out in New England.

I'm hearing much the same concern in my circles. Just not enough of anything, and even if we get more equipment, we don't have the doctors and nurses. We have had a doctor and nurse shortage for decades, this is just exacerbating the problem.

One of my fears early on was that as the hospitals became overwhelmed, the critical medical staff would get sick too. We are starting to see that. Two of the ER doctors at Rush were just diagnosed (and this is happening all over the country). A common reason for this can also be lapses in protocol when doctors get overworked and rushed, or when safety equipment gets scarce.

I'm currently working with some of the prevention teams to come up with ideas to help stem the rise, but we all feel like this is too little too late. I'm helping develop some new policies for early childhood programs and family services. A lot of what we are doing is trying to get people to start taking this all more seriously.

I had a feeling that when the President enacted the wartime powers to manufacture medical goods it might not do us any good. I have a feeling he hasn't actually implemented them yet because it might not be feasable. The vast majority of ventilators, beds, etc. are all made in China. I saw on the news that NYC has folks in China trying to procure ventilators on their own. I will be interested to see what they can do. The way manufacturing is done today, it seems hard to just switch to a different product. Car manufacturing looks nothing like ventilator manufacturing. I worry there is no way to ramp that up in a timely manner.

 

[Danzilla31]

I get it when you say you're venting for the benefit of venting. But I still get the impression, by your repeated venting, that something else is on your mind.

A friend recently reminded me of a relevant quote from Issac Asimov:

There is a cult of ignorance in the United States, and there has always been. The strain of anti-intellectualism has been a constant thread winding its way through our political and cultural life, nurtured by the false notion that democracy means that my ignorance is just as good as your knowledge. – Isaac Asimov​

Honestly it's all good to me He said what he felt he needed to say and I said what I needed to say I offered my hand and moved on it's water under the bridge to me now I'm done with it so carry on gentleman. If you want to read anything further in my reaction be my guest I don't plan to respond to it.

If we're talking serious now and I'm not venting I have some thoughts about the situation but really don't want to get into them now

But I do wish any one and everyone the best of luck with getting through however this plays out

 

[Swerd]

Enough gloomy forecasts, for at least one day. I know things can look worse as they approach through the windshield, than they look afterwards when watching through the rear view mirror. But when you have to plan ahead for life or death matters affecting large populations, one cannot afford to be a rosy-eyed optimist without very good evidence. And with a pandemic involving a novel virus, we cannot have any evidence in advance, good or bad.

Have any of you seen those computer generated graphic models that depict the outer surface of the COVID-19 virus? They show the phospholipid envelope dotted with the envelope proteins (depicted in red) floating in the lipid bilayer. I think they're pretty cool lookng. Most likely, these envelope proteins will be the biological material in vaccines that will generate neutralizing antibodies directed against them.

New images are now available. Instead of a computer prediction based on DNA sequence data, the new images are made with laboratory grown coronavirus particles, using the latest 3D ultrahigh resolution scanning electron microscope methods. As you zoom in, startling details of the envelope protein are revealed.

 

[panteragstk]

Enough gloomy forecasts, for at least one day. I know things can look worse as they approach through the windshield, than they look afterwards when watching through the rear view mirror. But when you have to plan ahead for life or death matters affecting large populations, one cannot afford to be a rosy-eyed optimist without very good evidence. And with a pandemic, we cannot have any evidence, good or bad, in advance.

Have any of you seen those computer generated graphic models that depict the outer surface of the COVID-19 virus? They show the phospholipid envelope dotted with the envelope proteins floating in the lipid bilayer. I think they're pretty cool.
View attachment 34760

New images are available. Instead of a computer prediction based on DNA sequence data, the new images are made with laboratory grown coronavirus particles, using the latest 3D ultrahigh resolution scanning electron microscope methods. As you zoom in, startling details are revealed.
View attachment 34761

Have to admit I did not see that coming. Well played.