Coronavirus COVID-19 - Global Health Pandemic #34

[PommyMommy]

The doctors caring for these patients have a vast more amount of actual expertise than google provides. These games of "gotcha" on twitter, social media and now here seem to be more about politics than the current health crisis.

If the FDA has already approved the drugs, they may be used for the treatment of patients with COVID-19. Physicians make judgment calls all the time. I'm not about to second-guess the physicians who are treating Covid-19 patients.
JMO


Understanding Unapproved Use of Approved Drugs "Off Label"
Why might an approved drug be used for an unapproved use?
From the FDA perspective, once the FDA approves a drug, healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient.

You may be asking yourself why your healthcare provider would want to prescribe a drug to treat a disease or medical condition that the drug is not approved for. One reason is that there might not be an approved drug to treat your disease or medical condition. Another is that you may have tried all approved treatments without seeing any benefits. In situations like these, you and your healthcare provider may talk about using an approved drug for an unapproved use to treat your disease or medical condition.

Huh? What does games of "gotcha" on twitter or social media mean? I don't follow.

From the CDC:

Coronavirus Disease 2019 (COVID-19)
There are no US Food and Drug Administration (FDA)-approved drugs specifically for the treatment of patients with COVID-19.

At present clinical management includes infection prevention and control measures and supportive care, including supplementary oxygen and mechanical ventilatory support when indicated.

An array of drugs approved for other indications as well as several investigational drugs are being studied in several hundred clinical trials that are underway across the globe.

 

[MyBelle]

Didn't they determine that a lot of the transfer on the Diamond Princess was through the food trays? I can't find the article, but I'm sure I read that. Anyone else remember this?

I don't remember but those on the cruises in cabins with sealed windows were breathing a hell of a lot of recirculated air after the quarantine was imposed. Photos of some of those cabins show a very small, confined space. Aircraft also use recirculated air. The majority of cases in my state still consist of travel-related exposure and people who have been in close proximity to the traveler such as family/friends.

JMO

 

[Midwestmom2019]

Thank you. I was much younger and so naive back then. I assumed ICU's could cure anything. I knew nothing about sepsis or ARDS and the high rates they kill hospitalized patients. One in 3 patients who die in hospitals, die of sepsis. That's 270,000 Americans every year and has included my grandmother and my 43-yo otherwise healthy son-in-law.

Data and Reports

Nursing homes are even worse.

 

[MyBelle]

Huh? What do games of "gotcha" on twitter or social media have to do with anything? I don't follow.

From the CDC:

Coronavirus Disease 2019 (COVID-19)
There are no US Food and Drug Administration (FDA)-approved drugs specifically for the treatment of patients with COVID-19.

At present clinical management includes infection prevention and control measures and supportive care, including supplementary oxygen and mechanical ventilatory support when indicated.

An array of drugs approved for other indications as well as several investigational drugs are being studied in several hundred clinical trials that are underway across the globe.

Physicians CAN prescribe FDA approved drugs for Covid-19 and they are doing so for "infection and prevention control measures and supportive care."

I provided a CDC link. Not sure why you don't want to believe that is true. Nebraska has had no deaths and we've had contaminated patients since mid-February with the Princess Cruise passengers who tested positive.

 

[PommyMommy]

Physicians CAN prescribe FDA approved drugs for Covid-19 and they are doing so for "infection and prevention control measures and supportive care."

I provided a CDC link. Not sure why you don't want to believe that is true. Nebraska has had no deaths and we've had contaminated patients since mid-February with the Princess Cruise passengers who tested positive.

I didn't say physicians can't prescribe FDA-approved drugs. I said there are no FDA-approved drugs specifically for the treatment of patients with COVID-19. I also provided a CDC link.

Here it is again:

Coronavirus Disease 2019 (COVID-19)
There are no US Food and Drug Administration (FDA)-approved drugs specifically for the treatment of patients with COVID-19.

 

[MyBelle]

Nursing homes are even worse.

Yes, they are. My son sent me the story today about EMTs in his community not entering a nursing home until the EMT's temps were taken. It was for their safety and the residents' safety.

The media photos of those families sitting outside the windows in Washington were heart-breaking but I also think what is in effect today is because of tragic lessons learned with them.

 

[PommyMommy]

NEW JERSEY

New Jersey will release low-level offenders from jail to prevent coronavirus spread - CNN
The chief justice for New Jersey has ordered the release of hundreds of inmates in county jails by Tuesday "based on the dangers posed by Coronavirus disease 19."

"The reduction of county jail populations, under appropriate conditions, is in the public interest to mitigate risks imposed by Covid-19," New Jersey Chief Justice Stuart Rabner of the New Jersey Supreme Court wrote.

The inmates who may be released are those detained for probation violations, municipal court convictions, disorderly persons offenses and for fourth-degree or petty crimes, the order says.



[...]

 

[MyBelle]

Here is an article. I wonder why he was investigating as he seems to specialize in sleep behavior?

Coronavirus: two Diamond Princess passengers die as Japan defends quarantine

I think many world-wide are questioning the twisting of information to promote political agendas.

JMO

 

[PommyMommy]

What these 34-year-old and 26-year-old coronavirus patients have to say to young adults - CNN
They thought they were too young to be concerned about coronavirus, and then they tested positive.

[...]

More than 42,000 coronavirus cases have been reported in the United States, with at least 541 deaths -- and the numbers are climbing. Early testing showed that people with chronic conditions and older people were the most at risk for severe illness. But younger people are also getting sick and spreading the illness.
...

[...]

"Young people need to understand that by the age of 30, I'd say there's a good portion of us that do have some sort of underlying condition so we all need to be aware that we could have something that makes us a little bit weaker to this virus," she said.

[...]

Lowenstein thought that her role in the pandemic would be limited to an ally for those most at risk, she told CNN's Don Lemon. But on March 13, she developed a fever.

She stayed home until she got to the point that she could barely eat or speak because it was too much strain for how short her breath had become. By the time she got to a doctor, she had to be admitted for two nights.

[...]

Statistics for severe illness and fatalities of young adults from coronavirus are more promising than several other populations, but recent reports show they are still at risk.

A report released Wednesday by the US Centers for Disease Control and Prevention found that a smaller -- but still significant -- number of young people in the US faced serious complications. Twenty percent of those hospitalized with the virus, according to the CDC, were between 20 and 44 years old.

[...]

Birx called on "the millennial generation, our largest generation, our future generation" to practice social distancing and "really ensure that each and every one of you are protecting each other."

[...]

 

[SandyQLS]

What interests me, is not the ongoing escalating numbers of people who have caught COVID19, but what about the people in the community, or same household, who DID NOT get infected with COVID19?

I would be interested in what makes those people different from the rest. Did they eat more garlic? I don't know. Grasping at straws here.

Like many posters, I have a friend who suspects they may have had this virus in Jan/Feb, a very mild case. But no one they know has been sick at all.

And I keep thinking of the 12 year old girl who died in Austerlitz NY back in Dec. Her aunt said the whole extended family had been mildly ill, and this girl was the last to catch it. She was sick about a week, seemed to be doing better and well enough to want to eat. Then she suddenly needed CPR, was taken to ICU, and then died. Did the aunt say something about they had had foreign visitors? Anyway I just keep thinking about that girl and wondering if it was a case of COVID19.

Isn't that like the case of the woman who dropped dead in her kitchen waiting for her test result? Why didn't her fiance have a critical case?

 

[musicaljoke]

NEW JERSEY

New Jersey will release low-level offenders from jail to prevent coronavirus spread - CNN
The chief justice for New Jersey has ordered the release of hundreds of inmates in county jails by Tuesday "based on the dangers posed by Coronavirus disease 19."

"The reduction of county jail populations, under appropriate conditions, is in the public interest to mitigate risks imposed by Covid-19," New Jersey Chief Justice Stuart Rabner of the New Jersey Supreme Court wrote.

The inmates who may be released are those detained for probation violations, municipal court convictions, disorderly persons offenses and for fourth-degree or petty crimes, the order says.



[...]

I hope they have homes, food and health care upon release, or it might not mitigate risks to either the inmates or the public.

 

[PommyMommy]

US coronavirus outbreak sees its deadliest day yet as a third of Americans are ordered to stay home - CNN
One in three Americans have now been ordered to stay home as US health officials give dire warnings about what the next days of the coronavirus pandemic will look like.

[...]

"It's just going to get worse this week and worse next week," Dr. Leana Wen, a visiting professor at George Washington University, told CNN Monday night. "How bad it gets depends on the actions that we each can take today."

Wen's words echoes the prediction US Surgeon General Jerome Adams made Monday: "This week, it's going to get bad."

"We really, really need everyone to stay at home," he told NBC's "Today" show.
There were more than 42,660 coronavirus cases in the country Tuesday -- with about half in New York. At least 541 Americans have died.

[...]

"Across the globe we are seeing a growing sense of urgency, and we must all make some sacrifices to break the chain of infections and avert a worst-case scenario," she said in a statement.

[...]

"America, will again, and soon, be open for business," President Donald Trump said Monday. "A lot sooner than three or four months that somebody was suggesting. Lot sooner."

[...]

Last week, the White House released guidelines urging Americans to avoid eating at bars or restaurants and skip out on gatherings with more than 10 people.

And despite saying he had no plans for a nationwide quarantine, Trump said the outbreak could last up until July or August in the US. A federal plan obtained by CNN showed the government was preparing for a pandemic that could last for 18 months or longer.

[...]

But health officials have said a lack of powerful measures and residents ignoring directions of social distancing and isolation could result in more sharp increases of cases and hospitalizations that will overwhelm the country's health system.

"We are seeing doctors and nurses plead for medical equipment, plead for ventilators, plead for protective equipment," Dr. Wen said. "We are seeing things getting out of control with no sense of how we're going to get it under control.

[...]

In New York City, the epicenter of the US outbreak, Mayor Bill de Blasio said last week medical supplies in public hospitals would likely last through April. On Monday, he said they may last for another week.

"I can only guarantee ... we can get through this week with the equipment and supplies we have," de Blasio said. "That's the blunt reality."

[...]

"If we don't get ventilators this week, we are going to start losing lives we could have saved. I can't be blunter than that."

[...]

"The number of people who we're going to lose can easily be in the thousands," Cuomo said. "And God forbid we say, 'we could have saved them if we had the right equipment.' That's what keeps me up at night."

New York needs 30,000 ventilators, the governor said.

"It's a respiratory disease," he said. "And we're not getting the ventilators."

[...]

Working in a hospital without that protective equipment, a nurse in a South Texas hospital told CNN, is like "going to war with a water gun."

[...]

One Seattle Intensive Care Unit nurse told CNN she was told to wear a single N95 mask "indefinitely."

"We're being told that we have to use these until they're soiled, and if they get to that point we have to show them to our (supervisor)."

 

[SandyQLS]

All playgrounds were closed here today. The virus lives on metal and plastic for up to 3 days, and young children don't know how to remain 6 feet apart.

They yellow taped around the playground equipment in the parks here, too.

 

[PommyMommy]

ISRAEL

Coronavirus in Israel: Rise of over 200 confirmed cases brings total to 1,656
[...]

■ 1,656 Israelis have so far tested positive for the coronavirus, with the vast majority of cases mild and 49 recoveries. One patient has died and 31 are in serious condition

■ In the West Bank, 57 cases have been diagnosed so far, and 17 have recovered, the majority of them in Bethlehem. The Palestinian prime minister ordered a lockdown as of Sunday night. In Gaza, two cases were diagnosed in patients who returned from Pakistan

■ Israel's government approved emergency measures to limit movement of citizens and trade, shuttering cultural and recreational establishments as well as schools and universities and banning gatherings of over 10 people. Read the complete guide to the lockdown

■ No foreigners are allowed to enter Israel, unless they apply for special permits from the Foreign Ministry in advance and can prove they are able to self-quarantine for 14 days upon their arrival. Read the full guide for tourists and Israelis

[...]

 

[PommyMommy]

Arizona man dies after self-medicating with chloroquine to treat coronavirus

An Arizona man has died and his wife is in critical condition after they both took the drug chloroquine phosphate, which has been touted as a treatment for coronavirus despite a lack of study on it or approval by the World Health Organization.

The couple, both in their 60s, required immediate hospital assistance within 30 minutes of ingesting the drug, which is normally used at aquariums to clean fish tanks, according to Banner Health, which is headquartered in Arizona.

“Given the uncertainty around COVID-19, we understand that people are trying to find new ways to prevent or treat this virus, but self-medicating is not the way to do so,” said Dr. Daniel Brooks, Banner Poison and Drug Information Center medical director. “The last thing that we want right now is to inundate our emergency departments with patients who believe they found a vague and risky solution that could potentially jeopardize their health.”

[...]

 

[MyBelle]

CDC says coronavirus survived in Princess Cruise ship cabins for up to 17 days after passengers left
PUBLISHED MON, MAR 23 20205:49 PM EDTUPDATED 4 HOURS AGO

KEY POINTS

• The coronavirus can survive on surfaces for up to 17 days, a study published Monday by the Centers for Disease Control and Prevention says.
• The study examines two public health responses to COVID-19 outbreaks on the Carnival-owned Diamond Princess ship in Japan and the Grand Princess ship in California.
• The virus “was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated...” the researchers wrote.

Officers in protective gear enter the cruise ship Diamond Princess, where 10 more people were tested positive for coronavirus on Thursday, to transfer a patient to the hospital after the ship arrived at Daikoku Pier Cruise Terminal in Yokohama, south of Tokyo, Japan February 7, 2020.
Kim Kyung-Hoon | Reuters

The coronavirus survived for up to 17 days aboard the Diamond Princess cruise ship, living far longer on surfaces than previous research has shown, according to new data published Monday by the Centers for Disease Control and Prevention.

The study examined the Japanese and U.S. government efforts to contain the COVID-19 outbreaks on the Carnival-owned Diamond Princess ship in Japan and the Grand Princess ship in California. Passengers and crew on both ships were quarantined on board after previous guests, who didn’t have any symptoms while aboard each of the ships, tested positive for COVID-19 after landing ashore.


The virus “was identified on a variety of surfaces in cabins of both symptomatic and asymptomatic infected passengers up to 17 days after cabins were vacated on the Diamond Princess but before disinfection procedures had been conducted,” the researchers wrote, adding that the finding doesn’t necessarily mean the virus spread by surface.

“COVID-19 on cruise ships poses a risk for rapid spread of disease, causing outbreaks in a vulnerable population, and aggressive efforts are required to contain spread,” the CDC wrote, reiterating its guidance to vulnerable populations to avoid cruises during the pandemic.

Researchers from the National Institutes of Health, CDC, UCLA and Princeton University previously found that COVID-19 can last up to three days on plastic and stainless steel. That study also found that the amount of the virus left on those surfaces decreased over time.

The new study set out to determine how “transmission occurred across multiple voyages of several ships.” They noted that as of March 17, there were at least 25 cruise ship voyages with confirmed COVID-19 cases that were detected either during or after the cruise ended.

Almost half, 46.5%, of the infections aboard the Diamond Princess were asymptomatic when they were tested, partially explaining the “high attack rate” of the virus among passengers and crew.


The Diamond Princess and its 3,700 passengers and crew were quarantined at a Japanese port on Feb. 4 after a previous passenger was diagnosed with COVID-19 after he returned to Hong Kong. The ship quickly became what was at the time the largest cluster of confirmed COVID-19 cases outside of China with more than 800 passengers and crew eventually becoming infected.

Nine people died after disembarking the ship. The Japanese government and other nations eventually evacuated their citizens.

The researchers found that 712 of 3,711 people on the Diamond Princess, or 19.2% were infected by COVID-19.

The other ship included in the study, the Grand Princess, was forced to moor off the coast of California after two patients who had disembarked in California tested positive. A total of 78 cases were eventually tied back to the ship across two separate voyages. After several days, California officials brought the ship to the Port of Oakland, where passengers disembarked and were transported to federal quarantine facilities.

The Diamond Princess and Grand Princess accounted for more than 800 total COVID-19 cases, including 10 deaths.


VIDEO04:11
Cruise ship industry has hit ‘worst-case scenario’ because of coronavirus, says CFRA’s Tuna Amobi


CDC says coronavirus survived in Princess Cruise ship cabins for up to 17 days after passengers left[/QUOTE]

I didn't say physicians can't prescribe FDA-approved drugs. I said there are no FDA-approved drugs specifically for the treatment of patients with COVID-19. I also provided a CDC link.

Here it is again:

Coronavirus Disease 2019 (COVID-19)
There are no US Food and Drug Administration (FDA)-approved drugs specifically for the treatment of patients with COVID-19.

Everybody in America KNOWS there are no FDA approved drugs specifically for the treatment of patients with COVID-19. That doesn't mean other FDA approved medications aren't effective and physicians aren't using them. I truly do not understand why you want to dispute this practice. I think these medical hot spots should be applauded for their success.

JMO

 

[badgersmythe]

Boris Johnson announces dramatic coronavirus lockdown


Coronavirus UK: Boris Johnson announces dramatic lockdown | Daily Mail Online

 

[PommyMommy]

Coronavirus Tax Relief | Internal Revenue Service

The IRS has established a special section focused on steps to help taxpayers, businesses and others affected by the coronavirus. This page will be updated as new information is available. For other information about the COVID-19 virus, people should visit the Centers for Disease Control and Prevention (CDC) (https://www.coronavirus.gov) for health information. Other information about actions being taken by the U.S. government is available at COVID-19 | USAGov and in Spanish at Coronavirus COVID-19 | USAGov. The Department of Treasury also has information available at Coronavirus: Resources, Updates, and What You Should Know.

News Releases

• IR-2020-58, Tax Day now July 15: Treasury, IRS extend filing deadline and federal tax payments regardless of amount
• IR-2020-57, Treasury, IRS and Labor announce plan to implement Coronavirus-related paid leave for workers and tax credits for small and midsize businesses to swiftly recover the cost of providing Coronavirus-related leave
• Treasury News Release: Treasury and IRS Issue Guidance on Deferring Tax Payments Due to COVID-19 Outbreak
• IR-2020-54, IRS: High-deductible health plans can cover coronavirus costs

[...]

 

[rootbeer]

Long-term outcome after the acute respiratory distress syndrome: different from general critical illness?

Do people fully recover from Acute Respiratory Distress Syndrome?

 

[jjenny]

BBM. The patients who improve without any drugs likely were not hospitalized and on ventilators. At Nebraska Medicine, they are providing drugs to critically ill patients. I don't believe there is an ICU on the planet who would put someone on a ventilator and then assume they would "get better" without any medication at all. With Covid-19, there ARE approved drugs.

The purpose of this document is to provide information on two of the approved drugs (chloroquine and hydroxychloroquine) and one of the investigational agents (remdesivir) currently in use in the United States.

Coronavirus Disease 2019 (COVID-19)

They are not approved for the treatment of covid. They are being used off label as of now, since the clinical trials showing if they are effective are only starting. They also have side effects.