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Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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1 hour ago, atomheartbevo said:

Dr Brix saying the increases will be massive over the next 4-5 days, because the tests are going to be processed much quicker.  Curve will be normal next week.    They are prioritizing counties with 50+ cases for now.  

Awkward question about why NBA stars and celebs getting tested.  Awkward answer.  

"What is money talks, bullshit walks? Alex."

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19 minutes ago, VABuckeye said:

Today is day 9 of their lockdown. 

 

China started the Wuhan lockdown on Jan 23rd.  Feb 3rd was about the last day they showed the cases double 4 days later (~max observed unconstrained doubling rate).  Starting about Feb 4th the doubling rate shifts to about 6-7 days and the curve really got flat by Feb 11th.   So 12 days to appx double the doubling time and 19 days to flatten the rate of new cases.

So yes hopefully we see the case double rate double (ie spread half as fast) in Italy 3 days from now and in 10 days flatten out all together.  That will still leave many thousands on life support going forward.

 

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7 minutes ago, UDontKnow said:

Well that depends, are you wearing pants or cargo shorts?

Cargos, dude -- I'm a man over the age of 40, it's required.

7 minutes ago, The Dog said:

Well if you have undiagnosed coronary heart disease then you need to worry. That's always a possibility for those of us with HBP. 

So you can worry again. ;)

 

 

Well, got that scanned pretty recently, came up all clear.  So, one less thing to worry about.  Which is good.  Because my "list of shit I gotta worry about" these days is longer than long cat posts.

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3 minutes ago, Pato del Muerto said:

My layperson thinking is that with a bug that attacks and compromises your respiratory system, making your heart work harder to move more blood to get enough oxygen to your cells, starting with high blood pressure is a bad idea. 
I’d be hesitant to go off meds without solid evidence that you are actually lowering risk. Glad it’s not a decision I need to make. 

What you say makes sense, but also I think the virus directly attacks (or can attack) the heart cells, causing inflammation.

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6 minutes ago, atomheartbevo said:

Wife was on a walk with our son, and walked by the nearby Randall’s.   She saw what is probably the same guy I saw before going in  - he had gloves and an N95 mask on, but was in shorts, a t-shirt, and no glasses.   For the surly doctors, he seems kind of unprotected, yes?

Depends. Was he wearing a condom? 

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16 minutes ago, Brisketexan said:

Also, not thrilled to see the italian death correlation to high blood pressure.  I wonder if that's UNTREATED HBP, or just having it as an underlying condition in general?  I have mild HBP (losing a few pounds would help in that regard -- may be using this situation as the opportunity to do just that with diet and exercise), but not off the charts high.  And as treated, it's perfectly normal.  So, would be interested in seeing the data on that.

Nevermind the concerns about ACE inhibitors and ARBs (Losartan, which I am on).  Of course, there's some data out there that ARBs actually might be an effective anti-viral treatment (they had some effect on West Nile cases)....so, it seems we still don't know a lot, and there remains conflicting info.  Sigh.

Since the first reports came out of Wuhan about a possible link to HBP, I've been regular searching the web for more data.   No where on the web is there any data if it's untreated high blood pressure or high blood pressure that is under control.  @The Dog dad my have anecdotal evidence, and I hope he's right, but the reports from the Hot zones that link to HBP aren't specific.  Many Meta-analysis on the web speculate that they are making the classification based on the medication the patients are taking.

As for the link between Covid-19 and ACE inhibitors / ARBs, both of which I take for HBP, this is the most comprehensive analysis on the web:

http://www.nephjc.com/news/covidace2

 It's written at a college level but basically explains that we don't know, but science is leaning against ACEi and ARBs being bad in the face of Covid-19.

  

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16 minutes ago, LABEVO said:

You can blame China for the environmental conditions that create these viruses but not telling us soon enough really wasn't on them...We had plenty of time to act....

It's both...failure by our nation to act in addition to the Chinese being dishonest. They ordered labs to stop testing and censured physicians who tried to report the condition. The Chinese knew about this in November. Even if was late November, that is over a month before they finally uploaded the referenced genetic sequence. My friend, you are either part of the Chinese communist party, misguided, or both.

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DFW will be blowing up soon. 
 
I work in Denton but live elsewhere, so I basically just drive to the hospital and back home every day. Driving out for lunch since the cafeteria is closing, and it seems like just about everything is still open and a lot of people are out and about, so that's nice.
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7 minutes ago, UDontKnow said:

It's both...failure by our nation to act in addition to the Chinese being dishonest. They ordered labs to stop testing and censured physicians who tried to report the condition. The Chinese knew about this in November. Even if was late November, that is over a month before they finally uploaded the referenced genetic sequence. My friend, you are either part of the Chinese communist party, misguided, or both.

I agree that China hid the extent but that did not stop us from preparing as we had plenty of time. Their dishonesty did not cause our failure. If we had info in Nov/Dec, we still would have not prepared....

VCs in the bay were making noise in Jan and were panned by the press for freaking out.

Edited by LABEVO
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That's not the point. WHO kits were rejected by America and they should not have been because it was crucial to the screen and quarantine process. If this was because WHO had been wrong in the past about a totally different disease (HIV/AIDS) which affected her view of the WHO, then Birx dun fucked up. It wasn't like we had our own kits and had a head start on studying the disease.
https://www.snopes.com/fact-check/us-coronavirus-test/

I keep hearing people say we rejected tests.
That's false.

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Wacky lawyer files class-action lawsuit against China in Dallas federal court. Seeking $20 trillion in damages.

https://www.dallasnews.com/news/public-health/2020/03/18/dallas-federal-lawsuit-accuses-chinese-government-of-creating-coronavirus-as-biological-weapon/?fbclid=IwAR2JJxb8eVtb9KlbSg2p-WrKh5PodnP0_zGnTGtzJpyxtAsVzISim2QOk64

Quote

Some Americans are focused on testing. Medical professionals are working on a coronavirus vaccine. And lawmakers are hashing out an economic aid package.

Lawyer Larry Klayman and his Freedom Watch nonprofit want China to pay -- for creating the COVID-19 virus as “an illegal biological weapon” in an “illegal and internationally outlawed bioweapons facility.”

The Florida man filed a class-action federal lawsuit Tuesday in Dallas against the People’s Republic for creating “massive damage.” The lawsuit seeks “an award in excess of $20 trillion U.S. Dollars.” The effort, however, is not expected to be successful in court.

Coronavirus, which President Donald Trump calls “the Chinese virus,” has spread to the U.S. and worldwide, infecting thousands. The economic damage is expected to be significant.

Klayman filed the lawsuit on behalf of himself, Freedom Watch and Buzz Photos, a McKinney business that specializes in high school sports photography. He said he expects many more people to receive class status and be added to the lawsuit as plaintiffs.

 

Buzz Photos lost about $50,000 over the weekend and had to lay off employees due to the public health crisis, the lawsuit said. The business has shut down and “stands on the verge of bankruptcy,” it said.

“Since biological weapons have been outlawed since at least 1925, including by China's membership in treaties, these illegal weapons constitute and are in effect terrorist-related weapons of mass destruction of population centers,” the lawsuit said.

Klayman, often described as a right-wing activist, said in a news release that his lawsuit is not political but was filed “to have a jury award damages to the victims of China’s release” of the virus.

Critics have called Klayman a nutty conspiracy theorist. He has made headlines by suing U.S. presidents, world leaders and foreign governments. The Southern Poverty Law Center described him as a “pathologically litigious attorney and professional gadfly notorious for suing everyone from Iran’s Supreme Leader to his own mother.”

“COVID-19 was designed by China to be a very ‘effective’ and catastrophic biological warfare weapon to kill mass populations,” Klayman’s lawsuit said.

The defendants in the suit are listed as: the People's Republic of China; the People's Liberation Army, the official military of China; the Wuhan Institute of Virology; Shi Zhengli, the institute’s director; and Major General Chen Wei, of China’s Liberation Army.

Researchers believe the virus originated in a “wet market,” or live animal market, in Wuhan, China.

But the 24-page lawsuit alleges that China created the virus “as a biological weapon in violation of China's agreements under international treaties,” and that it recklessly allowed “its release from the Wuhan Institute of Virology into the city of Wuhan, China, in Hubei Province.”

The Chinese government failed to prevent the Institute's employees from becoming infected and “carrying it into the surrounding community and proliferation into the United States,” the lawsuit says.

The lawsuit’s first claim is listed as “aiding and abetting the risk of death or serious bodily injuries to United States citizens and members of the class and subclasses.”

 

Providing material support to terrorists is the second claim.

The third claim, of six total, is conspiring to cause injury and death to Americans.

“Although it appears that the COVID-19 virus was released at an unplanned, unexpected time, it was prepared and stockpiled as a biological weapon to be used against China’s perceived enemies, including but not limited to the people of the United States.”

 

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well, this is interesting

CP24: Ontario doctor rigs up solution to double ventilator capacity in rural hospital

Quote

In basic terms, the rig involves pairing patients of similar size and lung capacity, and running two hoses from one ventilator running at double power.

 

Quote

Gauthier says the idea has been studied in theory and tried once before, for people injured in a mass shooting in Las Vegas.

Full Text:

Spoiler

 

OTTAWA -- A doctor in Ontario has improvised a way to double his small hospital's ventilator capacity in preparation for a possible COVID-19 outbreak.

Anesthetist Dr. Alain Gauthier, who has a PhD in respiratory mechanics and works in Perth, west of Ottawa, spotted the idea in a YouTube video.

In basic terms, the rig involves pairing patients of similar size and lung capacity, and running two hoses from one ventilator running at double power.

He worries the high-risk population his hospital serves may be in greater need of ventilators than his hospital can provide.

Gauthier says the idea has been studied in theory and tried once before, for people injured in a mass shooting in Las Vegas.

He says his crafty work reflects similar efforts across the country as doctors try to get ready for the worst case scenario, if COVID-19 becomes widespread.

This report by The Canadian Press was first published March 18, 2020.

 

 

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2 minutes ago, MissingInAction said:

I wonder how it goes with functional alcoholism... 

not great.  Common knowledge is that a typical sign of alcohol withdrawal is acute transient hypertension, even of a withdrawal severity not requiring formal medical detox.  Safe to say that anyone going to the ER with possible covid acute respiratory distress should be sure to notify triage about alcohol use.  If by chance you're admitted and get intubated, that's important history you may not be able to communicate after you're tubed.  

Just glancing at mechanical ventilation sedation protocols on the web, looks like propofol is most used, or midazolam if propofol is poorly tolerated.  Midazolam (Versed) is a relatively short acting benzodiazepine.  Benzodiazepines are indicated for acute alcohol withdrawal and will help bring down hypertension from acute alcohol withdrawal.  But due to short half life of midazolam, using a longer acting benzodiazepine like Ativan or Librium might be better for acute hypertension associated with alcohol withdrawal.  

I think it's very likely alcohol withdrawal, even mild to moderate in people who don't self identify as being at risk, is likely a significant contributor to bad outcomes during the acute management of covid ARDS.  To the extent this is being considered by the front line docs, and can be co-managed, more lives may be saved.

---> I could be wrong.  just my opinion.  Still tell any docs or triage about regular alcohol use to be safe.

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2 minutes ago, BNB said:

https://www.snopes.com/fact-check/us-coronavirus-test/

I keep hearing people say we rejected tests.
That's false.
 

Interesting. Thanks for pointing that out.

https://www.nytimes.com/2020/03/17/health/coronavirus-tests-who.html (NY Times - Behind a paywall)

"A spokeswoman for the W.H.O. said she did not know what Dr. Birx was referring to, but the agency had been supplying kits to member nations since January."

Maybe it is the truth that America didn't reject the testing kits, but then it raises the subsequent question - why didn't Birx, Fauci, and the rest of the Trump administration push to get kits considering that the US is a member nation??? Looks like more could and should have been done by our physician leaders when it was being reported that the coronavirus was a hoax.

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23 minutes ago, atomheartbevo said:

Wife was on a walk with our son, and walked by the nearby Randall’s.   She saw what is probably the same guy I saw before going in  - he had gloves and an N95 mask on, but was in shorts, a t-shirt, and no glasses.   For the surly doctors, he seems kind of unprotected, yes?

He’s definitely unprotected from me and my patented surprise roundhouse kick-to-the-face.

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Just now, hornian said:

WilCo County Judge just issued new orders in effect until May 11:

  1. No gatherings of 10 or more in WilCo

  2. WilCo dining rooms closed, but allow take away or no contact

  3. WilCo bars closed - indoor and outdoor

Hays just went the same way. 

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12 minutes ago, C-Man said:

He will be reasonable and settle for $2 Trillion.

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14 minutes ago, KYHorn said:

For you chloroquine folks. Sounds promising, but I don't know anything about this guy's credibility

 

I took Chloroquine for 5 days last week when I was pretty certain I had been sick w Covid for about 5-6 days.  Felt notably better 3 days later.  My elderly folks in Dallas got an Rx from their PCP in Dallas after communicating info about it with them.  Step-dad takes anti-arrhythmia meds so pharmacist wouldn't fill over weekend until could talk w doc (fuuuuuuuuuk).  So mom ordered from online pharmacy in MX.  But now pharmacist finally releasing it.  Also, not every pharmacy exactly has this in stock.  I had to hunt for it where I am then had to spin a story to convince them I was going scuba diving in Honduras to prevent malaria instead of off label use to get the pharmacist to let me have it.  jfc.

 

 

Edited by triplehorn
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1 hour ago, GreenspointTexas said:

I read that study yesterday and I don't think they allowed for any improvement in the ventilator or available beds/icu situations over time, nor did they consider the discovery of proven intermediate mitigating drug cocktails etc.  I'm not saying they should have, but those improvements are going to happen to one degree or another to lessen the worst case scenarios.

Additionally, the second wave assumptions seem pretty dire considering we will have just been doing this for months already.  Still pretty bad though.

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18 minutes ago, C-Man said:

Here’s an intellectual exercise:  what if China agreed to dismiss ALL debt the US owes it as restitution for the virus, but let’s us know through back channels that if we elect to accept the deal they would no longer lend us money.  What’s the move?

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1 minute ago, Pato del Muerto said:

Here’s an intellectual exercise:  what if China agreed to dismiss ALL debt the US owes it as restitution for the virus, but let’s us know through back channels that if we elect to accept the deal they would no longer lend us money.  What’s the move?

Take it 

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20 minutes ago, triplehorn said:

not great.  Common knowledge is that a typical sign of alcohol withdrawal is acute transient hypertension, even of a withdrawal severity not requiring formal medical detox.  Safe to say that anyone going to the ER with possible covid acute respiratory distress should be sure to notify triage about alcohol use.  If by chance you're admitted and get intubated, that's important history you may not be able to communicate after you're tubed.  

Just glancing at mechanical ventilation sedation protocols on the web, looks like propofol is most used, or midazolam if propofol is poorly tolerated.  Midazolam (Versed) is a relatively short acting benzodiazepine.  Benzodiazepines are indicated for acute alcohol withdrawal and will help bring down hypertension from acute alcohol withdrawal.  But due to short half life of midazolam, using a longer acting benzodiazepine like Ativan or Librium might be better for acute hypertension associated with alcohol withdrawal.  

I think it's very likely alcohol withdrawal, even mild to moderate in people who don't self identify as being at risk, is likely a significant contributor to bad outcomes during the acute management of covid ARDS.  To the extent this is being considered by the front line docs, and can be co-managed, more lives may be saved.

---> I could be wrong.  just my opinion.  Still tell any docs or triage about regular alcohol use to be safe.

Sobering.... and I'll see myself out...

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  • hayden_horn changed the title to Formerly DT: COVID-19 - Featuring Lots of Politics, now CR because political talk not going away


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