COVID-19

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ertyu
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Re: COVID-19

Post by ertyu »

It's ok, you can still panic. Says cnn: in JP some old lady from middle of nowhere died of pneumonia and they decided to test her for shits and giggles, she was positive. She didn't go anywhere or have contact with anyone suspicious. Virus is out, it's a matter of time.

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Ego
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Re: COVID-19

Post by Ego »

https://www.medrxiv.org/content/10.1101 ... 20022707v1

Estimates 1.8 undetected cases for every detected case globally (outside of China).

jacob
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Re: COVID-19

Post by jacob »

https://www.dw.com/en/africa-confirms-f ... a-52384446

First case in Africa.

An asymptotic person has tested positive in Egypt. I didn't find anything about their nationality. It should be noted that China has a strong presence in Africa with Chinese workers likely returning(?) as the new year's celebrations are ending.

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Jean
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Re: COVID-19

Post by Jean »

ertyu wrote:
Fri Feb 14, 2020 4:40 pm
It's ok, you can still panic. Says cnn: in JP some old lady from middle of nowhere died of pneumonia and they decided to test her for shits and giggles, she was positive. She didn't go anywhere or have contact with anyone suspicious. Virus is out, it's a matter of time.
That's calming to me. I understand from this event that it's already around, and that it isn't catastrophic.

Lucky C
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Re: COVID-19

Post by Lucky C »

Cases outside US are approx. doubling every week and currently confirmed around 600. With potentially asymptomatic infections over long incubation periods, and the possibility that R0 is significantly higher than initial estimates, each case in a new location is a potential patient zero for exponential growth. We can treat people better in the developed world vs. China but we are also not going to be locking people in their own homes... I picture Americans having more of an IDGAF attitude toward the disease and not wearing masks, not suspending travel plans, etc.

If this doubling every week persisted for only 3 more months (so mid-May), that would be 4 - 5 million confirmed cases and of course when we get to those kinds of numbers we would be very limited in our testing and reporting ability, ability to contain it, etc. Since that is only a few months away, I don't really see a reason to believe that it will be held to a few thousand cases. Even if growth slows to say doubling every 2 weeks, it seems to me at least as likely to saturate the population than to die out in the next few weeks. If it seems unlikely that it will go on to infect many millions, keep in mind that about 26 million people get infected by the flu each year in the US alone, and this coronavirus is significantly more contagious.

Just my guess and I don't mean to cause people to worry. I'm only trying to be realistic and I think the virus eventually getting to areas where myself or loved ones work or live is a more realistic expectation than thinking it won't reach us.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

The time to truly worry is when we start seeing sustained community transfer that we can't trace back to China. That is, when people start getting sick on a sustained and community basis, and when contact tracing no longer helps. Note that the CDC is now testing for COVID-19 in patients that test negative for flu in Seattle, LA, and a few other places. They chose these locations based on which airports have the most traffic with China.

So when Seattle has a community outbreak, that's when we're doomed. :lol:

Note that if COVID-19 does come to a city near you, the best thing to do is practice social distancing. During the Spanish flu pandemic, cities with better hygiene and better social distancing measures had far fewer deaths. This could also be why Wuhan has been hit so hard. With poor air quality, more crowded living conditions, and more smokers, you would expect more transmission and deaths.

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Ego
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Re: COVID-19

Post by Ego »

https://www.taiwannews.com.tw/en/news/3876197
“It’s highly possible to get infected a second time. A few people recovered from the first time by their own immune system, but the meds they use are damaging their heart tissue, and when they get it the second time, the antibody doesn’t help but makes it worse, and they die a sudden death from heart failure.”
Granted, this is third hand. Which drugs used to fight viral pneumonia cause heart damage?

-----

Bought another 100 of the thin n95 masks this morning for $3.

Be safe without losing the ability to unlock your phone. $40

https://faceidmasks.com/#about

thrifty++
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Re: COVID-19

Post by thrifty++ »

@Ego - OMFG 100 N 95 masks for $3!! How did you get them for that price? I bought three of them for $32.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Maybe they're talking about getting pneumonia a second time immediately after the virus is gone? A lot of deaths from viral respiratory illness are actually caused by a secondary bacterial infection.

ETA: also not exactly sure on the details, but some antivirals, like interferon, can cause cytokine storm type symptoms. Not sure if that's what they're talking about? Your body makes interferon naturally, and too much immune stimulation can cause inflammation/tissue damage.

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Ego
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Re: COVID-19

Post by Ego »

thrifty++ wrote:
Sat Feb 15, 2020 6:36 pm
@Ego - OMFG 100 N 95 masks for $3!! How did you get them for that price? I bought three of them for $32.
Yeah, I was digging through a giant box as the seller unloaded and found about twenty packs of 100 masks each. I was tempted to buy them all but when he yelled $3 everyone around me got excited so I starting tossing them to the group. One pack should be enough. I manage a building with fiftysome tenants so I will probably be sharing them.
AnalyticalEngine wrote:
Sat Feb 15, 2020 6:46 pm
A lot of deaths from viral respiratory illness are actually caused by a secondary bacterial infection.
I was reading a treatment protocol for serious cases of viral pneumonia and was surprised that it involves administering antibiotics as the patient is vulnerable to bacterial infection while their system is fighting the virus.

I've been working on a list of useful tools for treating viral pneumonia at home. Our goal would be to avoid hospitals if at all possible and to know when to go to the hospital in the unlikely event treatment is necessary. Our hospital down the street is the place where the worst cases are taken during any emergency and they are currently treating two people who are Covid-19 positive.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Esh, did you guys hear they let 2k people off that cruise ship that docked in Cambodia? These people went sight seeing then flew home all over the world. But later on, they tested an American woman for the coronavirus, and she tested positive. So they've just sent 2k exposed people flying all across the globe. :shock: Given how bad it's been on the Princess Plague Diamond, this is pretty concerning.

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Ego
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Re: Wuhan Coronavirus

Post by Ego »

@AE, Sheesh!
Ego wrote:
Fri Feb 07, 2020 10:30 pm
So it looks like the pandemic is coming. Imagine you've been transported back to the first week in January. You live in Wuhan. And you know what you know today. You can't leave the area. You know the pandemic is coming. What do you do?
Image

So, today I bought the Vicks personal steamer on the right for $1. Good for loosening mucus in the lungs. It works perfectly but is missing the face mask. I figure I can jerry-rig something if necessary. I also got the nebulizer on the left for $2. I can cross the border and get some albuterol for it (among other meds) if things continue to deteriorate.

I thought I scored an oxygen concentrator for $4 but it turned out to be a c-pap machine. Hah!

There are a few vendors who specialize in second-hand medical supplies and they have collectively increased their prices for pulse oximeters to $20 anticipating that they will soon fetch far more. I believe pulse oximeters will be the most useful tool in determining the severity of pneumonia. They are still only $11 from Walmart. I know I will find one for $1 at some point in the next few weeks so I have hesitated to order one.

Boxes of medical gloves are selling for $10. They used to be $4-5. I didn't see any masks today.

Suggestions?

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

Ego wrote:
Sun Feb 16, 2020 10:18 pm
I believe pulse oximeters will be the most useful tool in determining the severity of pneumonia.
Suggestions?
I'm not giving medical advice, but I want you to know a couple things so you don't make mistakes if someone actually gets sick.

Pulse oximeters are helpful, but a healthy person can compensate really well. So even if someone's Spo2 in the 90's, but they are short of breath, wheezing, with elevated respiratory rate (normal is 12-16/minute range for an adult), they could still need medical attention. Acute, severe, respiratory distress is also often accompanied by increased heart rate, it could lead to respiratory arrest and cardiac arrest. Also, sometimes people will increase respiratory rate due to metabolic acidosis resulting from an infection in an attempt to compensate body Ph. They breath quickly but Spo2 can be normal or even higher than normal. Metabolic acidosis requires medical care. Additionally, decreased depth of breathing due to inflammation from viral or bacterial pneumonia can cause Co2 to build up. This person may still have normal Spo2 readings from the pulse oximeter. This is respiratory acidosis, which requires medical care. These are just a few examples where pulse oximeters alone are NOT really helpful, there are more.

Some (Edit: corrected from albuterol) nebs are regularly used for respiratory distress but they also have side effects. They could have steroids so it decreases immune response and often elevates heart rate further. If breathing is bad enough that you feel you need to use one on someone without an Rx, you should seek out medical care instead.

I guess what I'm saying is, if someone is struggling with breathing, it is a medical emergency and should not be treated at home when there's a hospital around the corner, even if you have some of the right tools. Not to mention the fact that the CDC is still operating under containment protocols. So they need to know if people are getting infected in the community. If it is happening, it could change how we as a nation respond to this threat. So your individual data is really important for the health of others at this point in time. Putting on a face mask, washing hands, avoiding exposure to other people, seeking medical care and getting tested, is literally the best thing anyone can do if they get ill at this point.
Last edited by classical_Liberal on Mon Feb 17, 2020 12:33 am, edited 1 time in total.

RealPerson
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Re: COVID-19

Post by RealPerson »

@c-L
Agreed with everything you said, except that Albuterol is a steroid. These are rescue inhalers and do not contain steroid. There are long term steroid inhalers but Albuterol is not one of them. Albuterol has no effect on the immune system but can contribute to tachycardia as you pointed out.

classical_Liberal
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Re: COVID-19

Post by classical_Liberal »

@realperson
Thanks for the correction. I was thinking of DuoNebs, which has the steroid component as well.

RealPerson
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Re: COVID-19

Post by RealPerson »

No problem. I know you are very knowledgeable. My concern was that people reading this thread who are Albuterol users would get worried about using their inhaler.

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Sclass
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Re: COVID-19

Post by Sclass »

My mom’s hospice team had one of those oxygen machines. They came to collect it up right after she passed away along with the nebulizer. They left some masks, tubes and albuterol. I just put it aside in case I wanted to make something out of it. I bet you could nebulize with one of those ultrasonic fog makers. I have one for a mini zen garden pond thing I built. It is just a fish tank air pump and an ultrasonic fountain transducer from eBay I got for $5. I saw the oximeter on mom’s desk. I haven’t moved it for a year. I tried it on myself to see if it worked. Cool device.

If you really want the oxygen machine, I bet there are companies who gather that stuff up and resell it. I stumbled across a place with thousands of hospital beds once. My guess is if your infection gets that bad you’re doomed. I keep seeing the photos of the 34 yo whistle blower doctor in Wuhan and he has the breathing apparatus on. Didn’t help him. Maybe his organs crashed.

Call Apria. Maybe they have old ones that can be refurbed.

They also provided us tanks but we never used those. I don’t think they run long. I was thinking of using them for welding but they collected them up when they collected the machine.

My gut feel is a big nursing home will have some equipment lying around gathering dust. Maybe it’s just a matter of asking and bringing a $20 bill.

Is it just me or does this sound over the top?

There seem to be some experimental treatments in China using HIV drugs and anti inflammatory drugs that are being used in the wards. It reminds me of how traditional Chinese medicine was developed...shotgun approach and see what works. Apparently there have been some anecdotal successes. Perhaps you can score some off a person being treated for HIV?

This is a real mind hole that sucks you in the more you worry about it. I must say I can work myself up into a paranoid frenzy if I let my mind run.

AnalyticalEngine
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Re: COVID-19

Post by AnalyticalEngine »

Given an ounce of prevention is worth a pound of cure, my strategy is roughly:

1. Don't travel
2. Stay away from people who travel or are sick
3. Try not to panic until we have community transfer in my town
4. If community transfer happens in my town, lock myself in my house until the epidemic ends

If I actually contract COVID-19, well, then it was nice knowing you all. :lol:

I was doing some research into other viral respiratory illnesses, and there's this thing called Post Viral Fatigue Syndrome (or chronic fatigue syndrome) that can be a complication to severe viral infections. It's a bit of a weird disease, but it can last years after the viral infection is over. :shock: I think my biggest fear would be developing some chronic illness after the initial recovery.

jacob
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Re: COVID-19

Post by jacob »

@AE - Where would you draw the line in practice for the in-town community transfer though? Put it another way, I submit that there will be a moving goal post effect as infections get "normalized". For example, one of the first cases in the US was in Chicago. That person did infect a relative (spouse). I suppose that doesn't quite count as community transfer, but still ...

In practice, the disease will linger around for months ... so locking oneself in will likely turn into "limited going out for supplies"-runs for all but those who store a year's worth of freeze dried peas under the bed (and work from home or can afford not to work). Ultimately, people will take measured risks ... and disagree on the measure.

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Ego
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Re: COVID-19

Post by Ego »

First, I should say that despite devoting a good bit of attention to this outbreak, I am not worried, scared, afraid, terrified...

I am interested. It is interesting to me because I enjoy the what-ifs involved. A few years ago I went through the EMT program because I enjoyed it. For years I have read about infectious agents because.... I am strange like that.

So, no fear here. Just a topic I enjoy.
classical_Liberal wrote:
Sun Feb 16, 2020 11:45 pm
I guess what I'm saying is, if someone is struggling with breathing, it is a medical emergency and should not be treated at home when there's a hospital around the corner, even if you have some of the right tools.
Understood. I've said on more than one occasion above that my goal is to avoid hospitals. That is not completely accurately.

What would it be like if we were experiencing a crisis similar to China's? I wonder how our systems would fare. Hospitals overwhelmed. Severe staff shortages. Severe equipment and supply shortages. Would hospital staff show up to work if they were not provided adequate PPE? A lot of the disposables are subject to just-in-time supply lines. A lot of it comes from China. Would staff show up if they were experiencing infection rates similar to their counterparts in China? Would we be able to scale up as quickly and as thoroughly as China? Would we be able to quarantine the population as well as they have?

I guess what I am doing is imagining a world where a reasonable, knowledgeable person such as classic_Liberal would agree that going to an overwhelmed, understaffed, undersupplied hospital is worse than staying at home and self treating with basic tools. It will probably never happen but it costs almost nothing.

Think of it like Taleb's Black Swan investing approach.

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