Covid 19 Sci/med discussions only

[HardToHandle]

WHO’s Maria Van Kerkhove has been walking back the asymptomatic assertions, under a fair amount of scientific and US government pressure. The core element relative to the general population is up to 40% of transmission does come from asymptomatic or minimally symptomatic carriers, at least according to models.
https://www.theguardian.com/world/20...sion-very-rare

Real life is probably something situationally different and less than 40%, but the early studies found clear evidence of spreading without much serious symptoms. The US CDC and other US government authorities certainly believe asymptomatic spread played a significant part in the US outbreak (distracting from the Charlie Foxtrot of the CDC testing rollout). Probably asymptomatic spread is going to be a bigger First World issue than the entire globe.

Van Kerkhove looks to have a good background and indicated she has been seeing unpublished data. Some of the context is relative to the tepid WHO guidance on masks, which says “use of a mask alone is insufficient to provide an adequate level of protection”. My experience is the UK and Canada were resistant when the US made the mask recommendation, but they eventually caved in.
https://www.who.int/publications/i/i...ncov)-outbreak

[WillBrink]

A few Docs in NYC sounded the alarm on this early on (see OP) as did a handful of others:

Study: Most N.Y. COVID Patients on Ventilators Died

WEDNESDAY, April 22, 2020 (HealthDay News) -- The largest analysis of hospitalized U.S. COVID-19 patients to date finds that most did not survive after being placed on a mechanical ventilator.

The study included the health records of 5,700 COVID-19 patients hospitalized between March 1 and April 4 at facilities overseen by Northwell Health, New York State's largest health system.

Among the 2,634 patients for whom outcomes were known, the overall death rate was 21%, but it rose to 88% for those who received mechanical ventilation, the Northwell Health COVID-19 Research Consortium reported.

The new findings "provide a crucial early insight into the front-line response to the COVID-19 outbreak in New York," Dr. Kevin Tracey, president and CEO of the Feinstein Institutes for Medical Research, said in a Northwell Health news release.

Cont:

https://www.webmd.com/lung/news/2020...rk-study-shows

[WillBrink]

Tangential to the issue above and more, this nurse started with short vids on what she was seeing, which has been turned into a lengthy investigation. As always, one has to take with critical eye as to bias, motivations, and so forth, but it's still disturbing.

Vid title claims "deep state criminal hoax." I left this response:

"The vid exposes no such thing. It exposes what it shows: clueless people, medical mismanagement, dumb asses following bad medical advice, a massive over use of ventilators (and there may be a political aspect of that and an investigation should be done..) and a lot of medical professionals simple overwhelmed and unprepared for this entire thing. It sucks, it's very sad, and I hope those docs who sounded the alarm early it was not ARDs (such as Cameron Kyle-Sidell who was demoted for sounding the alarm), but I see ZERO support for any "deep state" hoax of any kind and you're only making things worse for all with that BS approach for clicks and views."

[1168]

, the overall death rate was 21%, but it rose to 88% for those who received mechanical ventilation,

I don’t yet know how studies will view the rona in the future, but such a study is difficult to interpret. People getting put on vents are sicker than those who are not. So of course they are more likely to die. It reminds me of a half brained study on EMT vs Paramedic care that found that patients treated by paramedics were more likely to die. It determined this using ALS vs BLS billing codes. Well, no shit, people having cardiac arrest are more likely to die than people with stubbed toes.

All that said, I’ve said before that caution should be used with intubation and vents. It baffled me how widely used this treatment was, and baffled me even more when certain intensivists and ED docs suddenly concluded that not everyone with COVID19 needs to be intubated, as if that wasn’t obvious all along.

Side note, about 10% of my co-workers currently have it.

[Caduceus]

1168
Early in the US response, there was a push to intubate early. The idea was to minimizes aerosolization and contamination of the ED and staff.

Then people started dying, and "we" moved to "avoid if possible" strategies. High flow O2 and positive pressure, while higher risk to others, is likely saving patient lives.

Good luck to coworkers. Would love to hear how that happened.

[WillBrink]

This would bode well for herd immunity and reducing mortality rates if accurate.

The True Coronavirus Case Tally in The US Could Be Over 80 Times Larger Than Reported

The US may never know the true tally of its coronavirus infections – but scientists are getting closer to an accurate count. New research suggests that many millions of infections went undiagnosed in March, even as testing ramped up.

The nation's current case count hovers around 2.4 million. But a study published Monday in the journal Science estimated that the US saw 8.7 million coronavirus cases from March 8 to 28.

The country's official tally indicates there were about 100,000 infections during that time period, suggesting that the real-life outbreak was more than 80 times larger than the one reported.

To arrive at this estimate, the researchers looked at reports of flu-like illnesses among outpatients using the Centres for Disease Control and Prevention's influenza surveillance system.

Many states, including Colorado, Louisiana, Maryland, New Jersey, New York, Oregon, Pennsylvania, and Washington, reported a surge of illnesses in March – about 2.8 million – that weren't attributable to the flu or seasonal respiratory diseases.

The researchers think most of those were coronavirus cases that went undiagnosed because of limited testing capacity or false-negative test results. They also estimated that only one-third of coronavirus patients in the US sought medical care in the first place, since many coronavirus cases are asymptomatic or mild.

https://www.sciencealert.com/the-tru...-than-reported

[Averageman]

I think it is a scare tactic to suddenly make numbers so very important, if you are asymptomatic or if you don't have the virus take precautions and continue to do whatever you are doing. Because whatever it is you are doing is good, it works for you.
We started talking about these ventilators almost immediately and almost immediately patients had an up tick in dying, that was what March/April? Suddenly after how many deaths, ventilators are being found to be part of the issue rather than the cure?
I'm glad these Doctors aren't working on me.

[Nowski87]

I just tested positive, my sister tested positive and so did my parents. Would any one like to know what it's like in these four cases what it is/was like to have Covid19?

[jpmuscle]

I think it is a scare tactic to suddenly make numbers so very important, if you are asymptomatic or if you don't have the virus take precautions and continue to do whatever you are doing. Because whatever it is you are doing is good, it works for you.
We started talking about these ventilators almost immediately and almost immediately patients had an up tick in dying, that was what March/April? Suddenly after how many deaths, ventilators are being found to be part of the issue rather than the cure?
I'm glad these Doctors aren't working on me.

I blame Cuomo. But just the same it seems odd that the med community jumped in deep and seemingly completely blind on the vent measures without validation.


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[Arik]

I just tested positive, my sister tested positive and so did my parents. Would any one like to know what it's like in these four cases what it is/was like to have Covid19?

Sure!

I had a coworker who got sick. Him, his kids, wife and both parents. From what he described the kids, ages 5-12 or so, were sick for a day. They started feeling sick towards the second half of the day. All of the next day they were sick and the following day they were fine towards the evening. His wife had a slight cold. He had high fever, constant sweating, week long headache and pneumonia. None of which he was hospitalized for. The hospital gave him meds for the pneumonia and sent him home. He said took him 2 weeks to feel normal. His parents spent 3 weeks in the hospital.


I've been debating on getting tested. In Jan we had one guy at work get weird sick. It was like he had a flu but not, which is why I say "weird". He had all the symptoms of a flu but in a few days he felt fine and came to work only to leave early because he started feeling sick. This went on for about 3 weeks. Some of use were beginning to tell him to see another doctor because this didn't seem like a typical flu. He got over it and shortly after I got sick. Had cold like symptoms with a minor temp. Nothing crazy. Stayed home for a day just in case. Lasted a few days with runny nose, slight temp and over sick feeling.