Coronavirus COVID-19

[Mamabug]

It's here - covid-19 now in my town. Someone told me it is someone two blocks away. He and his family are self quarantined. Eerily quiet around here

Scary!

There are just 9 cases in KS right now -- all of them two or three hours away from me.

Stay safe!

[Nabbosa]

Weekend radio story on fatality rate

I found this an interesting listen, and there's a link to the physician's print article on this site, too:

https://www.wnycstudios.org/podcasts...que-petri-dish

In case it doesn't work (I forget if I can post links or not), it's from On the Media's March 12 show.

Not sure how this particular information applies to the general population, because people on a cruise ship are likely higher-than-average income, and possibly better health overall (due to the income, and also because people with certain medical conditions just won't go on a ship for a long trip). But it's one of the few times I've heard someone point out that we don't know who is NOT getting sick in the general population because of the lack of testing. So we might also not know how many people with underlying conditions are carrying but not having symptoms. But maybe I'm just trying to be optimistic?

[Myoak]

... But it's one of the few times I've heard someone point out that we don't know who is NOT getting sick in the general population because of the lack of testing. So we might also not know how many people with underlying conditions are carrying but not having symptoms. But maybe I'm just trying to be optimistic?

By all accounts, dear friend, you have put your finger on why this virus is destined to continue spreading... lack of testing to know who is infected and walking around infecting others. They don't know they have it because people with minor symptoms still cannot get tested. Nor have many with major symptoms been tested, less than 60k as of today.

Two weeks ago our illustrious leaders promised 1 million tests by the end of that week. Last, they promised 4 million by the end of last week. Obviously, neither was true. Every day we hear that tomorrow they will begin extensive testing, and every day they fail. The US has tested less than 60k total since the virus arrived!!!

Today, I heard an estimate that 60k to 900k in the US are infected. If true, infection will spread like wildfire. It takes several days before someone infected shows symptoms. So, the people testing positive today got infected several days ago. I will post additional particulars in the next post.

Happy talk during the first couple of weeks rather than preparation has, very likely, tragically doomed many, many loved ones and crippled our nation's healthcare providers.

The lack of testing is infuriating because it is the kind of incompetence which leads us to colossal failures as a society.

[Myoak]

A major feature of COVID-19 is dyspnoea, or difficulty breathing.

We can learn a few things from stats in China regarding COVID-19.

Quote “Median time from illness onset to dyspnoea was similar in survivors and non-survivors, with a median duration of dyspnoea of 13·0 days (9·0–16·5) for survivors (table 2; figure 1). In survivors, the median duration of fever was 12·0 days (8·0–13·0) and cough persisted for 19·0 days (IQR 12·0–23·0; figure 1). 62 (45%) survivors still had cough on discharge and 39 (72%) non-survivors still had cough at the time of death. The dynamic profiles of fever, cough, and dyspnoea are shown in the appendix (p 6)…” End Quote

Also, as personal testimony… two reasons Ocrevus has been suspended in this house is because when a vaccine for the virus is developed, I want my spouse to be in position of being able to get vaccinated. A recent infusion of Ocrevus would preclude vaccination. We all should realize a vaccine is months away, at best, but it will come, IMO.

The other major reason for halting is because Ocrevus devastates lymphocytes and here is what the China COVID-19 study says about baseline lymphocytes...

Quote “Baseline lymphocyte count was significantly higher in survivors than non-survivors; in survivors, lymphocyte count was lowest on day 7 after illness onset and improved during hospitalisation, whereas severe lymphopenia was observed until death in non-survivors.” End Quote.

Each individual will have their own plan.

Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study

https://www.thelancet.com/journals/l...566-3/fulltext

[Myoak]

Here is the problem...

Only 500 tests available at one location and more than 500 cars lined up before the drive through for testing opened for the day. A PwMS there wanted tested days ago but still cannot get tested. Cars were jammed on the highway leading to the test site. Now home and very ill.

Staying away from others as much as possible seems the only course, at this point. If they don't test, the numbers will be lower, that must be the plan.

https://www.wsfa.com/2020/03/17/upda...til-wednesday/

[KoKo]

Swabs in short supply

Testing Swabs Run In Short Supply As Makers Try To Speed Up Production

The two top makers of the highly specialized swabs used to test patients for the novel coronavirus are straining to keep up with the demand, even as both the Italian and U.S. governments are working with them to increase production, including at a key manufacturing site in the midst of Italy's outbreak.

The nasopharyngeal swabs required for the coronavirus tests are quite different from your standard Q-tips — and the exploding need for them has created a bottleneck in the soaring demand for diagnoses.

https://www.npr.org/sections/health-...-up-production

[KoKo]

Ohio Department of Health

•Due to a shortage of testing materials, it has become necessary to tighten testing criteria for individuals who may have COVID-19.

•Although the number of test kits is increasing, the materials needed for specimen collection are critically short nationwide.

•At this point, we need to restrict testing to those who are most severely ill, are moderately ill with a high risk of complications -- such as those who are elderly or have serious medical issues -- and professionals who are critical to providing care and service to those who are ill.

•In these circumstances, prompt laboratory results are required. Specimens should be processed in hospitals with a testing capacity that can promptly provide results, at a facility that has acceptable turn-around time, or through the Ohio Department of Health Public Health Laboratory. If specimens are being sent to the ODH lab, the person requesting the test should contact the local health department. The local health department then coordinates with the ODH Bureau of Infectious Diseases to prioritize these tests.

https://coronavirus.ohio.gov/wps/por...g-for-covid-19

[Myoak]

Dr. Daniele Macchini, an Intensive Care Unit physician in Bergamo, a city near Milan, shared his experience of working in a hospital where exhausted staff battle to save patients. His Facebook post was picked up in an Italian newspaper and translated on Twitter by Dr Silvia Stringhini, an epidemiologist and researcher based at the Geneva University's Institute of Global Health.

Dr Daniele Macchini's post, translated by Dr Silvia Stringhini

"After much thought about whether and what to write about what is happening to us, I felt that silence was not responsible.

"I will therefore try to convey to people far from our reality what we are living in Bergamo in these days of Covid-19 pandemic. I understand the need not to create panic, but when the message of the dangerousness of what is happening does not reach people I shudder.

"I myself watched with some amazement the reorganization of the entire hospital in the past week, when our current enemy was still in the shadows: the wards slowly 'emptied', elective activities were interrupted, intensive care were freed up to create as many beds as possible.

"All this rapid transformation brought an atmosphere of silence and surreal emptiness to the corridors of the hospital that we did not yet understand, waiting for a war that was yet to begin and that many (including me) were not so sure would ever come with such ferocity.

"I still remember my night call a week ago when I was waiting for the results of a swab. When I think about it, my anxiety over one possible case seems almost ridiculous and unjustified, now that I've seen what's happening. Well, the situation now is dramatic to say the least.

"The war has literally exploded and battles are uninterrupted day and night. But now that need for beds has arrived in all its drama. One after the other the departments that had been emptied fill up at an impressive pace.

"The boards with the names of the patients, of different colours depending on the operating unit, are now all red and instead of surgery you see the diagnosis, which is always the damned same: bilateral interstitial pneumonia.

"Now, explain to me which flu virus causes such a rapid drama. And while there are still people who boast of not being afraid by ignoring directions, protesting because their normal routine is 'temporarily' put in crisis, the epidemiological disaster is taking place. And there are no more surgeons, urologists, orthopedists, we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us.

"Cases are multiplying, we arrive at a rate of 15-20 admissions per day all for the same reason. The results of the swabs now come one after the other: positive, positive, positive. Suddenly the E.R. is collapsing.

"Reasons for the access always the same: fever and breathing difficulties, fever and cough, respiratory failure. Radiology reports always the same: bilateral interstitial pneumonia, bilateral interstitial pneumonia, bilateral interstitial pneumonia. All to be hospitalized.

"Someone already to be intubated and go to intensive care. For others it's too late... Every ventilator becomes like gold: those in operating theatres that have now suspended their non-urgent activity become intensive care places that did not exist before.

"The staff is exhausted. I saw the tiredness on faces that didn't know what it was despite the already exhausting workloads they had. I saw a solidarity of all of us, who never failed to go to our internist colleagues to ask, 'What can I do for you now?'

"Doctors who move beds and transfer patients, who administer therapies instead of nurses. Nurses with tears in their eyes because we can't save everyone, and the vital parameters of several patients at the same time reveal an already marked destiny.

"There are no more shifts, no more hours. Social life is suspended for us. We no longer see our families for fear of infecting them. Some of us have already become infected despite the protocols.

"Some of our colleagues who are infected also have infected relatives and some of their relatives are already struggling between life and death. So be patient, you can't go to the theatre, museums or the gym. Try to have pity on the myriad of old people you could exterminate.

"We just try to make ourselves useful. You should do the same: we influence the life and death of a few dozen people. You with yours, many more. Please share this message. We must spread the word to prevent what is happening here from happening all over Italy.

"I finish by saying that I really don't understand this war on panic. The only reason I see is mask shortages, but there's no mask on sale anymore. We don't have a lot of studies, but is it panic really worse than neglect and carelessness during an epidemic of this sort?"

[pennstater]

Sharing a family story. I am sure there are so many similar stories. We all take for granted what our healthcare professionals do. But at a time like this, it highlights the commitment and personal sacrifices they make.

I have 2 nieces and nephews who are RNs - My niece is in hospital setting, with a 3 year old and 4 month old infant and breastfeeding. My nephew is in a large assisted living setting and his wife is a hospital nurse. They have a 4 year old and 3 month old which is being breast fed. Even if one of them stayed home, they are still at risk.

My niece works in ICU at a large hospital. Her husband was just layed off. They asked for volunteers initially to take care of covid-19 patients. Pre-kids, she would have volunteered. As numbers increase and more people will be needed, it will be all hands on deck. She said like many hospitals, they don't have enough of the right equipment and safety wear. So her husband, toddler, and infant may be moving in with his parents. She is torn on whether to continue to pump, since it would be at work and also not sure if passes to infants thru breast milk. My heart breaks for them. In tears just typing this out.

Please keep all our healthcare workers in your thoughts and prayers.

[NoraS]

Prayers for your family, Pennstater. I saw a clip this morning that says that Italy is extending its lockdown into April because of the number of medics who've become infected. The health professionals are our only chance to beat this, so someone needs to provide more support and better protection to them. Without them, we don't stand a chance.

On the homefront, I'd thought I was finally getting through to my mother, but she's fighting isolation every step of the way. She refuses to grasp that we don't know exactly how this is spreading and thinks that visiting family and friends (and eating out and going shopping) is okay as long as no one coughs or sneezes on other people. I'm going on the assumption that we're all carriers now and have to act accordingly, but she's arguing with me constantly that I'm paranoid and she's not going to let this "simple flu" affect her life.

Seasha, my son has finally wised up, at least for now. He and his friends have stopped their game-playing and are limiting their public activities. For the move here, he had the idea (once all this settles down, if it settles down) that he could convert my unused detached garage into a game room of sorts for his entertaining and that all visitors could use my spare bathroom in the cellar to completely avoid my living areas. That should help a lot.

[Mamabug]

Sharing a family story. I am sure there are so many similar stories. We all take for granted what our healthcare professionals do. But at a time like this, it highlights the commitment and personal sacrifices they make.

I have 2 nieces and nephews who are RNs - My niece is in hospital setting, with a 3 year old and 4 month old infant and breastfeeding. My nephew is in a large assisted living setting and his wife is a hospital nurse. They have a 4 year old and 3 month old which is being breast fed. Even if one of them stayed home, they are still at risk.
...

Please keep all our healthcare workers in your thoughts and prayers.

Yes; my daughter is an RN. She is currently less busy than usual, because she works in the OR and patients are cancelling surgeries. But, she anticipates that the OR will likely soon be closed except for emergency surgeries, and the nurses will be used as needed. She has a 2 year old and a 3 year old. No breastfeeding issues, but, she is a young parent.

I'm keeping your niece and nephew in my thoughts.

[Myoak]

This is my understanding about Covid-19 testing.

All of the states have tests (the ability to test has always been available by oral swabbing and sending to CDC labs, but now states can test and get results sooner from in-state labs.)

The states determine the protocol for testing.

For example, in Ohio, those tested are:

*Anyone with symptoms who has been to an area with an active outbreak

*Those with symptoms who had come into contact with someone with a positive diagnosis for COVID-19

*Those with symptoms not attributed to another illness.

Myoak, are you wanting every person in the US to be tested?

"A small town in Italy appears to have wiped out coronavirus — with zero new cases this week — after an experiment that called for widespread testing, according to a report.

Researchers wrote in an op-ed for the Guardian that the northern town of Vň started testing all 3,000 residents on March 6 after it became home to the country’s first coronavirus death.

University of Padua professor Andrea Crisanti and Antonio Cassone, who is the former director of the department of infectious diseases at the Italian institute of health, said the pilot study involved testing even residents who didn’t show symptoms of the virus.

“We made an interesting finding: at the time the first symptomatic case was diagnosed, a significant proportion of the population, about 3%, had already been infected — yet most of them were completely asymptomatic,” the researchers wrote.

The researchers said the practice “established a valuable principle: testing of all citizens, whether or not they have symptoms, provides a way to control this pandemic.”

“This allowed us to quarantine people before they showed signs of infection and stop the further spread of coronavirus,” the researchers wrote.

The result was testing was able to help eradicate the spread of the virus in under 14 days, the report said.

https://nypost.com/2020/03/22/corona...d-out-illness/

[pennstater]

A Big shout out to nurses and doctors

My niece who is an ICU nurse told me they are being asked to wear their N95 mask for a week. She also told me something heartbreaking. Like many hospitals, they need to backfill RNs from other areas of the hospital.

So they have to learn ICU procedures and care, have to deal with the stress of caring for covid-19 patients without the normal preventative procedures and protections, and also have to learn to deal with death. Nurses from other floors are usually not used to death. This is baptism by fire.

I have never thought about this before. A huge thank you to all the nurses and doctors not only physically on the front line, but also emotionally. May God bless you and keep you safe and healthy.

[Seasha]

A huge thank you to all the nurses and doctors not only physically on the front line, but also emotionally. May God bless you and keep you safe and healthy.

Amen to this! My brother-in-law who has been retired for a few years now, just renewed his nursing license in case he is needed in an emergency setting. Selfishly, I hope he is not needed, but it just shows the willingness of others who strive to give help in these unprecedented times, thinking less of their own health over those who are suffering.

They are all heroes

[Myoak]

... My brother-in-law who has been retired for a few years now, just renewed his nursing license in case he is needed in an emergency setting. Selfishly, I hope he is not needed, but it just shows the willingness of others who strive to give help in these unprecedented times, thinking less of their own health over those who are suffering.

They are all heroes

Nurses truly are heroes in all of this! May God bless and keep them safe as they sacrifice for all of us.

Lack of testing among HP's is improving so slowly it remains a huge problem...

A nurse worked for a week while infected with the coronavirus. The hospital wasn’t testing staff.

New York, April 1, 2020 at 9:23 AM EDT - Updated April 1 at 2:00

"Testing remains a major problem in the battle against the coronavirus as hospitals grapple with a shortage of test kits and long wait times for results.

This reality is particularly dangerous for healthcare workers.

A nurse says she worked for about seven days at two hospitals in New York City while infected with the coronavirus.

She went undetected because her hospital wasn't testing the staff.

She doesn't want to reveal her name or where she works for fear she'll be fired.

“Two weeks ago, I was feeling back pain, a lot of back pain, and then one night had really bad chest pain,” the nurse said.

She continued to work, wearing the same gown and mask all day, patient to patient.

“I’m touching that mask. It’s on my face. I’m putting it back on. Virus flies in the air. It goes right up in my nose. It’s so easy to get contaminated when you have to put on something that already has virus on it,” she said.

Because the emergency room refused to test staff, she went there in the middle of the night when she knew a friend would be on duty.

“I said, ‘Please, just this one time, I want to make sure I don’t have it. I don’t want to spread anything,’ and so she tested me,” the nurse said.

It took five days for the results to come back. She tested positive. The nurse worries she infected staff members and patients...

“...this nurse ended up working while infected. Fortunately, the nurse feeling better now and is in isolation at home.

She thinks there are other doctors and nurses working at hospitals while infected and that that scares her. “Nobody wants to get this virus,” she said.

In addition to testing kits, personal protective equipment and ventilators are also in short supply."

live5news.com/2020/04/01/nurse-worked-week-while-infected-with-coronavirus-hospital-wasnt-testing-staff