Coronavirus

[Verdinut]

Then how can pneumonia get started, create sepsis, and organ failures follow? I have no clue but if pneumonia can get a beached in a person for sepsis to destroy organs then I would think fighting that pneumonia right up front when people have fever would help a lot?

Don't you know that not all pneumonias are of bacterial origin?

 

[TLS Guy]

I understand but pneumonia is already treated with anti bacterial meds and it seems that covid19 brings on pneumonia that causes sepsis to set in an organ failures so why not treat the pneumonia?

This is where it gets hard for the public to understand. I will do my best to explain.

Firstly the causes of pneumonia are diverse. Pneumonia just means inflammation of the lungs causing a reaction in the lung that causes the microscopic air sacks to fill up with inflammatory fluid.

Now the causes can be bacteria, viruses, mycoplasma, and insults such as inhaling smoke from a fire or things like chlorine gas exposure.

Now a common misconception is that vaccine for pneumonia will prevent you getting pneumonia. It won't. It will stop you getting pneumonia from a highly infectious gram positive coccus called strep pneumoniae. It won't protect you from any other cause.

Now the next thing I have to explain is the difference between sepsis and septicemia. Septicemia means you have organisms in your blood stream. Often this set off the cytokine storm of ARDS and multi system organ failure, but it may not. Other things can set off this reaction as I have explained before. The best way to prevent sepsis is prompt treatment and resolution of the underlying cause. The problem with the pneumonia caused by Covid 19 is that we have no reliable treatment for the underlying cause. So the cytokine storm has to run its course, as and after, your immune system takes care of the Covid 19 infection. So more likely than not it is how quickly your immune system knocks out the Covid 19 virus and probably a genetic propensity to cytokine storm that will determine whether you will get ARDS and stop there, or go on to multi system organ failure.

Now when you have someone in the ICU intubated and invasive vascular access in the great vessels. just about 100% of cases get secondary bacterial pneumonias and other infections which require antibiotic treatment, even though they were not the primary cause. However they sure light it up again, which makes ICU care so tedious, and why we tend to live with these patients for weeks. None of these cases are ever easy. There are no easy cases in this scenario.

Lastly the hdrochloroquine and Azithromycin in this context are not being used for their anti plasmodial and antibiotic properties respectively in this case of possible use against this virus.

That is the best I can do to explain a very complex subject and never thought we would have to delve this deeply into care in an ICU.

If you are more confused than ever after this, I'm sorry.

 

[mtrycrafts]

...
If you are more confused than ever after this, I'm sorry.

Many thanks.

 

[mtrycrafts]

Don't you know that not all pneumonias are of bacterial origin?

Ah, no. Not my forte.

 

[mtrycrafts]

...
If you look, you can find that South and Central America, and Mexico, are doing virtually nothing to prepare for or contain the virus. So why aren't we seeing decimation there? Why isn't Mexico City littered with bodies in the street?
...

Is this a real question or something behind it?
Perhaps they are preparing but doesn't make the news here?
And, most likely, their time will come as well.

 

[highfigh]

I don't understand your answer to my question as to why secondary infections by bacteria is of no concern with respect to Covid-19.

I know I'm not an expert either, very far from it, really, which many posts in this excellent thread confirms. What I've been told over the decades, though, is that antibiotics is ineffective against viral infections but that antibiotics could be given when having secondary bacterial infection. Thus my post after reading your other post in response to @mtrycrafts as Azithromycin is an antibiotic.

Am I misremembering and just have a mild case of the Dunning-Kruger syndrome?

One possible reason is that using one antibiotic on the pneumonia may help it, but not do anything to stop COVID-19 and it may even make it mutate to be more resistant. Then, they would have to wait before trying another antibiotic because using the same one may put the patient at further risk. This is what I was told when I asked why I was prescribed Zithromax for my second sinus infection when Amoxicillan for the first.

 

[highfigh]

Mexico Is Frighteningly Unprepared for the Coronavirus

The country is only now waking up to the threat—and the government continues to downplay it.

www.google.com

Plus, countries like Mexico don't have the same - already inadequate - testing capacity that more affluent countries. They may have a much worse problem - they just don't know it yet.

The Mexican government clearly can't be bothered to give a rat's ass about the vast majority of the population, so they don't report it. Plus, with the borders closed, they can't pawn their people off on the US. If they did care, they would stop the cartels, educate the people and get their crap in order.

 

[highfigh]

I have a question for those who know much more than I do about medicine- I have been taking Amoxicillin with a booster for an infected toe for a little over a week and recently, have been having mild cold symptoms. I didn't work for most of this week and a few of the people where I work have had colds, but nothing major and have shown none of the COVID symptoms, although one guy's sister came back from Italy a few weeks ago and he has been banned form the premises.

Is it likely/possible that my antibiotic is working to moderate my symptoms in the event that I have contracted COVID, or am I on the wrong track? I have had a slight cough and runny nose, but none of the weakness, fever, pain, etc- to be honest, I feel great. Also, what is the effect of anything that has been effective on transmission? Has it stopped that in patients who have been ID'd as carriers, or does it do nothing?

 

[panteragstk]

The Mexican government clearly can't be bothered to give a rat's ass about the vast majority of the population, so they don't report it. Plus, with the borders closed, they can't pawn their people off on the US. If they did care, they would stop the cartels, educate the people and get their crap in order.

In an attempt to clarify without derailing this conversation. Mexico has a MASSIVE corruption problem. One of the reasons you don't see them stop the cartels is that their government is bought off by them...or has members in the government.

They currently don't have many cases, but this would be very bad if it got to Mexico City.

 

[TLS Guy]

I have a question for those who know much more than I do about medicine- I have been taking Amoxicillin with a booster for an infected toe for a little over a week and recently, have been having mild cold symptoms. I didn't work for most of this week and a few of the people where I work have had colds, but nothing major and have shown none of the COVID symptoms, although one guy's sister came back from Italy a few weeks ago and he has been banned form the premises.

Is it likely/possible that my antibiotic is working to moderate my symptoms in the event that I have contracted COVID, or am I on the wrong track? I have had a slight cough and runny nose, but none of the weakness, fever, pain, etc- to be honest, I feel great. Also, what is the effect of anything that has been effective on transmission? Has it stopped that in patients who have been ID'd as carriers, or does it do nothing?

First of all with that history you have to assume you have Covid 19 until proved otherwise. It is actually very likely. Amoxicillin will have no impact on this what so ever.

You and your family need to self isolate totally immediately. That means right now. No argument about this.

 

[TLS Guy]

One possible reason is that using one antibiotic on the pneumonia may help it, but not do anything to stop COVID-19 and it may even make it mutate to be more resistant. Then, they would have to wait before trying another antibiotic because using the same one may put the patient at further risk. This is what I was told when I asked why I was prescribed Zithromax for my second sinus infection when Amoxicillan for the first.

First of all sinusitis is not something reliably diagnosed by history and clinical exam. A CT is required. Antibiotics have very little part to play in the treatment if sinusitis. Most primary care doctors have not woken up to that. To diagnose sinusitis reliably takes a CT scan, and careful attention to the drainage pathways. The correct treatment of sinusitis is now largely via endoscopic surgery. Most people clinically diagnosed with sinusitis don't have it. It requires a CT scan.

 

[JerryLove]

First of all sinusitis is not something reliably diagnosed by history and clinical exam. A CT is required. Antibiotics have very little part to play in the treatment if sinusitis. Most primary care doctors have not woken up to that. To diagnose sinusitis reliably takes a CT scan, and careful attention to the drainage pathways. The correct treatment of sinusitis is now largely via endoscopic surgery. Most people clinically diagnosed with sinusitis don't have it. It requires a CT scan.

Doesn't "sinusitis" just literally mean "inflamed sinuses"? So, like, any disease or condition or iriritant that inflames your sinus give you sinusitis?

Or are you stating that sinusitis is a specific bacteria or virus?

 

[Verdinut]

In an attempt to clarify without derailing this conversation. Mexico has a MASSIVE corruption problem. One of the reasons you don't see them stop the cartels is that their government is bought off by them...or has members in the government.

They currently don't have many cases, but this would be very bad if it got to Mexico City.

They already have many cases of Corona beer !

 

[panteragstk]

They already have many cases of Corona beer !

That they do. What weird is that Corona is technically an american lager.

Way back when I used to go to Mexico we'd go to the pay at the door all you can drink bars they'd bring in Coronitas by the case (small 8oz) and people would drink them so fast you'd pretty much get beer then go to the back of the line to get more because they were so small.

It got crazy when all the morons started amazing bottles in the ground at the end of the night. That's when it was time to leave.

Ah memories...sort of

 

[Timforhifi]

I said something super funny that either wasn’t funny enough to everybody or no one understands. Probably just went over your heads, guys need to get out more! .............. Wait I take that last part back, stay inside!

I believe this will pass, just stay strong. Get busy doing something that’s not news related. I spent probably 8 hours today talking with my kids about anything. Made me realize I’m pretty lucky to have such amazing, strong, resourceful and smart kids
Not sure if I talked to them that much in the last month as I did today. Made me take a step back, I’ll be strong for them because they need me to right now. I’m not going to constantly worry or talk about everything I read or see in the news. It’s not helping family morale and I can carry this burden of worry for them. Look at the positives and get to know the ones you love the most.

One last thing, 35-45 weeks from now this next generation will be known as the new baby boomers. So much time with the spouse will ....... you know

 

[TLS Guy]

Doesn't "sinusitis" just literally mean "inflamed sinuses"? So, like, any disease or condition or iriritant that inflames your sinus give you sinusitis?

Or are you stating that sinusitis is a specific bacteria or virus?

There are two issues.

First the causation is lack of drainage. You can not cure any pus filled walled off infections with antibiotics. What I mean is that it is like trying to cure an abscess with antibiotics. You can't, you have to drain it.

The second issue is that sinusitis is very much a mixed infection of bacteria, and especially anaerobic bacteria and a collection of fungi. So you are dealing with a plethora of organisms that would require a toxic mix of a huge variety of different classes of antimicrobial and anti fungal drugs. So in any event you would need some of the abnormal fluid loculated in the affected sinus to culture and get antibiotic sensitivities. So you might as well just go ahead and drain it. If you drain and open up any closed infection, you don't actually need antibiotics. Nature will do the rest.

So the principle of treatment is drainage, and in the case of sinusitis creating drainage pathways, so the problem is much less likely to recur.

Here is a normal sinus CT

Here is a CT of sinusitis.

Note that the left maxillary sinus is opaque and the right one has an air fluid level. That is very stinky fluid that should be drained. That patient requires endoscopic surgery.

Apologies to Dan for infringing on his territory.

We should get back on topic, this is a Coronavirus thread and not a sinusitis thread.

 

[JerryLove]

There are two issues.

I need to take your post to my ENT after this pandemic ends. I've been fighting for surgery for pathway issues for, well, a long time.

I'm not saying I have the infections involved. I'm saying they've wanted me to keep using (mostly ineffective) nasinex and netti pots and feel me using that for the rest of my life is better than simply intervening surgically.

But I digress.... Coronavirus...

 

[gene]

First of all sinusitis is not something reliably diagnosed by history and clinical exam. A CT is required. Antibiotics have very little part to play in the treatment if sinusitis. Most primary care doctors have not woken up to that. To diagnose sinusitis reliably takes a CT scan, and careful attention to the drainage pathways. The correct treatment of sinusitis is now largely via endoscopic surgery. Most people clinically diagnosed with sinusitis don't have it. It requires a CT scan.

I've had 2 major sinus surgeries for chronic sinusitis (deviated septum, removal of pollops, etc) and several in-office procedures by my ENT where they've burned tissue to make adjustments (very painful). My last procedure arguably made me worse to the point where I get extreme sinus pressure if I go upside down. I am wondering if my sinusitis is causing me to hold on to COVID-19 longer or if it's because I have RA. I'm going on 3 weeks this Monday being positive for COVID-19, despite I'm feeling 90% better.

Usually when I get an infection, my ENT does drain it like you say. He also cultures it to see if it's bacterial and if I will need an antibiotic. Problem now is I can't go out of the house to see him. So I've been flushing like crazy and using my steroidal nose sprays and nebulizer in hopes to keep this at bay. Anyways, good topic to discuss here.

 

[killdozzer]

Honestly, if things keep progressing like this, I'll stoop so low and bid farewell to my dignity only to start creating 2020 memes.

My town was hit by 5.93 earthquake this morning at 6:30 AM. So this is what happened; my country went into a first quarantine as the number of sick started to rise. And then the weather went bad and temperature dropped considerably. After the springlike 18-20C (65F) this morning it started to snow just like the corona likes.

Then the earthquake chased all the old and sick out in the snow from their beds at 6:30.

Naturally, people panicking forgot about quarantine and were all together in front of our buildings in large groups of hundreds.

Not only that, but a lot of houses and old monuments were damaged and one young child of 15 was badly hurt from debris falling on him.

Well played, destiny, well played.

 

[killdozzer]

Some footage here: