Covid 19 Sci/med discussions only

[WillBrink]

Thank you. I've been struggling to keep current with what is what and that was very useful.

By far the most useful doc I have found in my non med opinion and he updates it regularly. If you or anyone here has anyone hospitalized, make sure they see that doc. Far as I know, most are still treating it like classic ARDS and that's ending very badly, in the 70-80% mortality rate from what I read. Maybe those in the trenches can comment on those figures.

[WillBrink]

Member Troutrunner, who is an ED Doc, without enough posts to post in general asked me to post these resources:

PulmCrit – Understanding happy hypoxemia physiology: how COVID taught me to treat pneumococcus

https://emcrit.org/pulmcrit/happy-hypoxemia-physiology/

EM:RAP COVID-19 Resources

https://covid.emrap.org/

[WillBrink]

As expected, a lot more people have been exposed to Covid as antibody testing starts to take place:


COVID-19 Antibody Seroprevalence in Santa Clara County, California

Abstract

Background Addressing COVID-19 is a pressing health and social concern. To date, many epidemic projections and policies addressing COVID-19 have been designed without seroprevalence data to inform epidemic parameters. We measured the seroprevalence of antibodies to SARS-CoV-2 in Santa Clara County. Methods On 4/3-4/4, 2020, we tested county residents for antibodies to SARS-CoV-2 using a lateral flow immunoassay. Participants were recruited using Facebook ads targeting a representative sample of the county by demographic and geographic characteristics. We report the prevalence of antibodies to SARS-CoV-2 in a sample of 3,330 people, adjusting for zip code, sex, and race/ethnicity. We also adjust for test performance characteristics using 3 different estimates: (i) the test manufacturer's data, (ii) a sample of 37 positive and 30 negative controls tested at Stanford, and (iii) a combination of both.

Results The unadjusted prevalence of antibodies to SARS-CoV-2 in Santa Clara County was 1.5% (exact binomial 95CI 1.11-1.97%), and the population-weighted prevalence was 2.81% (95CI 2.24-3.37%). Under the three scenarios for test performance characteristics, the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases.

Conclusions The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases. Population prevalence estimates can now be used to calibrate epidemic and mortality projections.

https://www.medrxiv.org/content/10.1....14.20062463v1

[SeriousStudent]

Been nice had they just been given a vacation and kept all the info within one location but that’s just my OCD speaking. Sorry for the sidetrack, carry on.

They were. We banned five people after numerous warnings - I banned three myself. I should not have the tell a grown-ass man multiple times to act like an adult. Yet here we are.

I'm watching this thread very closely as well.

Sorry for the sidetrack, carry on.

[ABNAK]

They were. We banned five people after numerous warnings - I banned three myself. I should not have the tell a grown-ass man multiple times to act like an adult. Yet here we are.

I'm watching this thread very closely as well.

Sorry for the sidetrack, carry on.

Everything I've seen so far wasn't even questionable in this thread. I think some people took the hint.

[ZGXtreme]

They were. We banned five people after numerous warnings - I banned three myself. I should not have the tell a grown-ass man multiple times to act like an adult. Yet here we are.

I'm watching this thread very closely as well.

Sorry for the sidetrack, carry on.

Thank ya

[mack7.62]

The real scandal is that China could have contained it but instead released it on the world.

Chinese Coronavirus Is a Man Made Virus According to Luc Montagnier the Man Who Discovered HIV

https://www.gilmorehealth.com/chines...iscovered-hiv/

Contrary to the narrative that is being pushed by the mainstream that the COVID 19 virus was the result of a natural mutation and that it was transmitted to humans from bats via pangolins, Dr Luc Montagnier the man who discovered the HIV virus back in 1983 disagrees and is saying that the virus was man made.

[ramairthree]

As expected, a lot more people have been exposed to Covid as antibody testing starts to take place:


COVID-19 Antibody Seroprevalence in Santa Clara County, California

Abstract

Background Addressing COVID-19 is a pressing health and social concern. To date, many epidemic projections and policies addressing COVID-19 have been designed without seroprevalence data to inform epidemic parameters. We measured the seroprevalence of antibodies to SARS-CoV-2 in Santa Clara County. Methods On 4/3-4/4, 2020, we tested county residents for antibodies to SARS-CoV-2 using a lateral flow immunoassay. Participants were recruited using Facebook ads targeting a representative sample of the county by demographic and geographic characteristics. We report the prevalence of antibodies to SARS-CoV-2 in a sample of 3,330 people, adjusting for zip code, sex, and race/ethnicity. We also adjust for test performance characteristics using 3 different estimates: (i) the test manufacturer's data, (ii) a sample of 37 positive and 30 negative controls tested at Stanford, and (iii) a combination of both.

Results The unadjusted prevalence of antibodies to SARS-CoV-2 in Santa Clara County was 1.5% (exact binomial 95CI 1.11-1.97%), and the population-weighted prevalence was 2.81% (95CI 2.24-3.37%). Under the three scenarios for test performance characteristics, the population prevalence of COVID-19 in Santa Clara ranged from 2.49% (95CI 1.80-3.17%) to 4.16% (2.58-5.70%). These prevalence estimates represent a range between 48,000 and 81,000 people infected in Santa Clara County by early April, 50-85-fold more than the number of confirmed cases.

Conclusions The population prevalence of SARS-CoV-2 antibodies in Santa Clara County implies that the infection is much more widespread than indicated by the number of confirmed cases. Population prevalence estimates can now be used to calibrate epidemic and mortality projections.

https://www.medrxiv.org/content/10.1....14.20062463v1

Data points like these continue to match up with what I previously posted.

We have to take this hit.

It is not going away.

There is plenty of ICU and vent capacity for otherwise healthy, relatively young outliers,
if we stop putting 70 year old DNR/hospice end stage ALS patients whose family decides they want everything done, 88 year old found down needing dialysis new renal failure patients with COPD, AFIB, sepsis, pneumonia, UTI, hip fracture, rhabdomyolysis, with dementia, and bed ridden 60 year old 340 pound, hemiplegic from a stroke, COPD, pneumonia, CHF, and CAD patients on vents.

Some huge medical centers are getting about a 10% weaned from the vent rate, with very reliable predictors of who is never coming off the vent.

No single medication, or combination of medications is going to be a magic bullet for a cure. The medical background and underlying conditions of many of these patients is such that they would never be coming off the vent completely independent of COVID.

Statistically, these deaths are overwhelmingly and predominately coming from those likely to die at any time from underlying age, conditions, risks, etc.

Keep your fingers crossed, but a vaccine is far from guaranteed.

I wish America had not taken a painful punch to the face with a shattered, bleeding nose.
But a tourniquet to the neck on everyone is not the cure to broken noses on some.
Especially when the people with a broken nose already had a non survivable brain tumor.

People typically struck hard by this are also over represented with the contraindications for Hydroxychloroquine, or even a macrolide.

The risks for massive viral loads we are exposing or emergency, critical, and intensive care resources to,
In futile care for natural end of life events, and the resources they tie up,
Risk using up a system that will be unable to maximize survival among actual, recoverable victims leading a productive, and otherwise able to return to productive, lives.

We have literally let people out of prison so they don’t catch COVID, that have murdered people that were not about to die of COVID or anything else.

I can’t properly condense and convey the insanity.

[Arik]

Data points like these continue to match up with what I previously posted.

We have to take this hit.

It is not going away.

There is plenty of ICU and vent capacity for otherwise healthy, relatively young outliers,
if we stop putting 70 year old DNR/hospice end stage ALS patients whose family decides they want everything done, 88 year old found down needing dialysis new renal failure patients with COPD, AFIB, sepsis, pneumonia, UTI, hip fracture, rhabdomyolysis, with dementia, and bed ridden 60 year old 340 pound, hemiplegic from a stroke, COPD, pneumonia, CHF, and CAD patients on vents.

Some huge medical centers are getting about a 10% weaned from the vent rate, with very reliable predictors of who is never coming off the vent.

No single medication, or combination of medications is going to be a magic bullet for a cure. The medical background and underlying conditions of many of these patients is such that they would never be coming off the vent completely independent of COVID.

Statistically, these deaths are overwhelmingly and predominately coming from those likely to die at any time from underlying age, conditions, risks, etc.

Keep your fingers crossed, but a vaccine is far from guaranteed.

I wish America had not taken a painful punch to the face with a shattered, bleeding nose.
But a tourniquet to the neck on everyone is not the cure to broken noses on some.
Especially when the people with a broken nose already had a non survivable brain tumor.

People typically struck hard by this are also over represented with the contraindications for Hydroxychloroquine, or even a macrolide.

The risks for massive viral loads we are exposing or emergency, critical, and intensive care resources to,
In futile care for natural end of life events, and the resources they tie up,
Risk using up a system that will be unable to maximize survival among actual, recoverable victims leading a productive, and otherwise able to return to productive, lives.

We have literally let people out of prison so they don’t catch COVID, that have murdered people that were not about to die of COVID or anything else.

I can’t properly condense and convey the insanity.

So who gets to pick who dies and at what point? How "unhealthy" does one have to be before you say no?

So far I'm reading a lot 50+ perfectly functional people who may or may not have had some underlying issue but were NOT about to die from it within the next year.

[ramairthree]

So who gets to pick who dies and at what point? How "unhealthy" does one have to be before you say no?

So far I'm reading a lot 50+ perfectly functional people who may or may not have had some underlying issue but were NOT about to die from it within the next year.

That’s the exact point point I am trying to make.

You have relatively young, healthy people that take a huge viral load or have the worst luck with a bad cascade. You just have to get them over the hurdle.

You have people with minor levels of underlying disease or a treatable / controllable significant condition, like a 50-60 year old with an unknown nearly occluded coronary artery that with a stent would buy him possibly 25 more normal years. We all should want resources available for them.

But we tie up resources with end stage, terminal condition patients in futile, end of life care.

Hospice/DNR patients. These get sent to the ED all the time by families who freak out and change their mind. With a big use of resources and man hours. These are terminal condition patients with no survivability that are supposed to be kept comfortable at home with resources allocated for this in exchange for not tying up futile effort resources. Should family members be allowed to break the patient’s pre-existing wishes tying up resources?

Palliative chemotherapy/radiation therapy patients. These are terminal patients they are just trying to keep more comfortable before they die. Is this a valid use of resources to put them on a vent? If the vent fails to oxygenate them and the family is demanding ECMO does that make any sense?