Coronavirus COVID-19 - Global Health Pandemic #44

[10ofRods]

There's an interesting debate going on among medical professionals (on the above twitter link) about the proper way to use a ventilator with patients who have COVID. The impression I got is that using high pressure to "force" more oxygen into the lungs is not effective and may lead to lung damage. They keep emphasizing that this is a NEW disease that likely requires new ventilator strategy/protocols.
Interestingly, there's anecdotal evidence that adults with Covid are presenting with O2 saturation at 70 or 80% who have no problem talking, laughing, breathing until they begin moving. Some are urging other docs to treat with O2 and don't intubate too early.
IMO

I'm reading several articles about how ventilators are not the way to go. Unfortunately, the way that CoVid robs us of oxygen is almost certainly related to how it binds with red blood cells and a number of other elements in the blood, robbing us of oxygen that way - lungs are relatively okay.

Even more unfortunately, there is little treatment for that. There are oxygen-saturating machines that can be used effectively. I also read that UK has only three of them. I think we have about 5 of them in California - so not much help. Hyperbaric oxygen chambers also work, but there are few of those as well - it's not at all scaleable. At this point, plasma from people who have survived seems to be promising but again, not scaled up yet. Several researchers are optimistic about drugs that will eventually denature the specific protein in CoVid that does this.

The recommendation to provide as much O2 without a ventilator, as is possible, appears to be the way many Italian and now New York physicians are trying to cope.

That low O2 level would explain why some people go to sleep feeling pretty okay and then wake up unable to move or almost unable to move.

 

[Gardenista]

There's an interesting debate going on among medical professionals (on the above twitter link) about the proper way to use a ventilator with patients who have COVID. The impression I got is that using high pressure to "force" more oxygen into the lungs is not effective and may lead to lung damage. They keep emphasizing that this is a NEW disease that likely requires new ventilator strategy/protocols.
Interestingly, there's anecdotal evidence that adults with Covid are presenting with O2 saturation at 70 or 80% who have no problem talking, laughing, breathing until they begin moving. Some are urging other docs to treat with O2 and don't intubate too early.
IMO

Crazy we could be treating patients the wrong way. Wow.

 

[gregjrichards]

France

France’s daily death toll from the coronavirus fell in the past 24 hours, the health ministry said on Sunday.

The health ministry data showed that 357 people died from Covid-19 in hospitals, compared with 441 in the previous 24 hours, taking the total toll in hospitals to 5,889. The ministry added that 2,189 people had died in nursing homes since March 1, taking France’s total death toll to 8,078.


United Kingdom

Her Majesty The Queen is making an address about the Coronavirus in 10 minutes you can watch it live here on Sky News U.K YouTube

 

[Alethea]

Have her call Cuomo. He’ll take her in a heartbeat moo.

Her basic skills, no matter what the specialty, I’m sure can be used somewhere if she gets laid off.

WHO also has courses and training on their website.

There are infinite job postings for health workers on various sites.

I hear ya though about nonessential medical workers, hadn’t thought about that. Hopefully they can retransition where they are most needed.

Our state still has relatively low numbers but the major hospital chains shut down all of the regular-care clinics over the past weeks and are offering tele-health for routine appointments. They’re redeploying the staff to new emergency units. Some of our ER doctors went down to NYC for 10 day deployments before the wave of hospitalizations happen up here.

 

[CoverMeCagney]

Drawing the line at organ meats, though. *shudder*

Maybe avoid bat and pangolin for now, too.

 

[24Roses]

Very sad news from Iowa today: April 5: 83 new COVID-19 cases in Iowa, 8 additional deaths
83 new positive results and 8 more have passed.This article talks about the % of cases and deaths being attritbuted to outbreaks in care facilities. We now have a total of 868 positive and 22 passed. 91 are currently hospitalized.
Iowa COVID-19 Information

 

[Trino]

Very sad news from Iowa today: April 5: 83 new COVID-19 cases in Iowa, 8 additional deaths
83 new positive results and 8 more have passed.This article talks about the % of cases and deaths being attritbuted to outbreaks in care facilities. We now have a total of 868 positive and 22 passed. 91 are currently hospitalized.
Iowa COVID-19 Information

And, as the cases and death tolls mount, the Iowa governor sees no need for a stay in place. STAY AT HOME: Iowa governor defends not introducing order

 

[Momof4RN]

Have her call Cuomo. He’ll take her in a heartbeat moo.

Her basic skills, no matter what the specialty, I’m sure can be used somewhere if she gets laid off.

WHO also has courses and training on their website.

There are infinite job postings for health workers on various sites.

I hear ya though about nonessential medical workers, hadn’t thought about that. Hopefully they can retransition where they are most needed.

Hi @margarita25 unfortunately it is something that is happening across the US and very unexpectedly. Less than 3 weeks ago we were over census and short staff and were being offered bonuses to come in on xtra shifts and overtime. Now we are facing mandated time off and possible layoffs. Realistically, we can’t all pack up and head to NYC. And even more realistically, if you are like me and have been on the job for over 20 years you aren’t going to be hired at your current salary and benefits elsewhere if you are hired at all. Many of us are just at a point of hope for the best but expect the worst. And hope that when this all passes our healthcare centers, primary care offices, specialty care offices can recover and rehire.
COVID-19 Hits Some Health Care Workers With Pay Cuts And Layoffs

 

[Legally Bland]

 

[BHughes]

CoVid robs us of oxygen is almost certainly related to how it binds with red blood cells and a number of other elements in the blood, robbing us of oxygen that way - lungs are relatively okay.

So these articles are saying patients are going through hypoxemia? If that is the case, pneumonia, pulmonary edema and other lung related illnesses can cause this also. This leads to hypoxia. Just seems it goes back to the lungs, IMO.
The symptoms of hypoxia are headache, shortness of breath, cough wheezing, etc. The same symptoms some people with Covid-19 are saying they had/have.

 

[margarita25]

Hi @margarita25 unfortunately it is something that is happening across the US and very unexpectedly. Less than 3 weeks ago we were over census and short staff and were being offered bonuses to come in on xtra shifts and overtime. Now we are facing mandated time off and possible layoffs. Realistically, we can’t all pack up and head to NYC. And even more realistically, if you are like me and have been on the job for over 20 years you aren’t going to be hired at your current salary and benefits elsewhere if you are hired at all. Many of us are just at a point of hope for the best but expect the worst. And hope that when this all passes our healthcare centers, primary care offices, specialty care offices can recover and rehire.
COVID-19 Hits Some Health Care Workers With Pay Cuts And Layoffs

What a clusterfudge all this is.

Bless everyone.

True you can’t just go to NYC!

 

[Trino]

Just what we're hearing in the US, right? She's a wonderful woman. Marvelous speech.

 

[Trudie]

I wonder if someone will reach out to try to help this family reintegrate into the community, and help protect them from the xenophobia and accusations that they are dealing with. We live in a smallish rural community also, and we are helping a small Chinese restaurant owner/family survive the situation right now, as no one wants to take out even take out orders from their very small off-main street restaurant. They have been there for years, although I've never been to the restaurant, and local business leaders downtown for years had lunch there and paid their bills only once a week or so. So now people are trying to help them out with gift cards, etc. so that they can pay their rent and raise their family.

The woman/children from HK will return to live there, one day. She does not need help. She brought her family to KY to flee the coronavirus outbreak. It mighta followed her party of 4. Upon arriving & settling, she had to shop, at where? WMT!
Then, mysteriously, the WMT deli/bakery employee nearly died. Unfortunately the patient went to stores (after being turned away from her doctor) to get OTC items to treat her symptoms, as advised. It was awful. Once she was finally tested, the hospital had to put appx 45 on lay-off/isolation status, attempt to backtrack every step the patient or staff took in the hospital, etc. etc.
I ride horses in that town all the time, if I or anyone I know had a farm mishap, we would never stop at the small town hospital, we’d head straight to Lexington. Jmo.

 

[Diddian]

Do you think she’s uninformed or simply defiant?

I think we have to do what we must to be the safest we can in our homes. It is moo that the biggest majority of the US population continue to live as before.
I never realized staying home might be such an issue, for so many. I’m happiest at home & can always find a project.

I think for nearly everyone, this is surreal. And for those who don't seek out information that is as reliable as possible for something so new and evolving and then choose to err on the side of lowering risk, it is easy to slip into denial when living with surreal. It doesn't help that our population had become increasingly fragmented and polarized before this happened, fostering distrust in both traditional and emerging information sources. I am not taking a side about this, just merely stating my observation that it is so.

I really wish our leaders would suggest a few things to unite people around those things we can unite around BESIDES fear, such as a 15 minute period of silence and candle-lighting each early evening to remember the dead and dying and raising of flags each morning as a silent thanks to the healthcare workers who march into enemy territory every day. We can do those things from our homes.

 

[ilovewings]

Coronavirus can spread through talking or breathing, prestigious panel tells White House - CNN

Don't know if this has been posted before: sorry if it has but it is terrifying: Scientists now believe that the virus is aeorosolized so
that you can get the virus by just having a conversation with someone that has the virus or even by the virus lingering in the air and you breathing it in: depends on certain conditions.

 

[Trudie]

Okay, I try not to complain about isolation. But, life is in fact unfair.

The hottest cowboy in the state just pulled in, he’s seeding or something. All I can do is watch from afar. Binocular time.......

 

[10ofRods]

So these articles are saying patients are going through hypoxemia? If that is the case, pneumonia, pulmonary edema and other lung related illnesses can cause this also. This leads to hypoxia. Just seems it goes back to the lungs, IMO.
The symptoms of hypoxia are headache, shortness of breath, cough wheezing, etc. The same symptoms some people with Covid-19 are saying they had/have.

What I'm reading says it does not all come back to the lungs - that even if your lungs were working properly your red blood cells may not bind to oxygen. In which case, only direct oxygenization of the blood works. The machine that re-oxygenates blood directly is called an ECMO. They are rare.

But this would explain the sudden deaths of people who do not have pneumonia. Obviously, having pneumonia would increase the problem, but if the underlying problem is not (mainly) the lungs but instead the ability of red blood cells to carry oxygen, that's a very different problem to solve.

I am not talking about the symptoms, I'm talking about research into the mechanism by which CV19 robs people of oxygen.

If your lungs were working perfectly and this theorized method of blocking oxygen from sticking to hemaglobin is correct, then the cure to this disease is to denature the spike protein of CV19 that is keeping red blood cells from carrying oxygen. Plasma transfusions seem promising and there's a big call for subjects in the NY region; Sweden is already carrying out such research, as are many tertiary care centers in the US.

Distant sequence similarity between hepcidin and the novel...

In other news, the hydroxychloroquine idea may not work and may, in fact, lead to major complications or death in persons with particular underlying conditions or who are taking other medicines for serious medical problems.

 

[Boston Corbett]

Only her fifth televised address in 68 years, other than at Christmas:

Those she has made include addresses at the time of the Gulf war in 1991, on the eve of the funeral of Diana, Princess of Wales, in 1997, following the death of the Queen Mother in 2002, and at the time of her diamond jubilee celebrations in 2012. (Guardian)​

 

[CoverMeCagney]

Thank you for posting, LB. She is amazing, 94 years old in a couple of weeks.
A couple of snippets:


I hope in the years to come everyone will be able to take pride in how they responded to this challenge, and those who come after us will say the Britons of this generation were as strong as any, that the attributes of self-discipline, of quiet good-humoured resolve and of fellow-feeling still characterise this country.

We should take comfort that while we may have more still to endure, better days will return: we will be with our friends again; we will be with our families again; we will meet again.

But for now, I send my thanks and warmest good wishes to you all.


Queen Elizabeth II
4th April 2020

 

[CSIDreamer]

What I'm reading says it does not all come back to the lungs - that even if your lungs were working properly your red blood cells may not bind to oxygen. In which case, only direct oxygenization of the blood works. The machine that re-oxygenates blood directly is called an ECMO. They are rare.

But this would explain the sudden deaths of people who do not have pneumonia. Obviously, having pneumonia would increase the problem, but if the underlying problem is not (mainly) the lungs but instead the ability of red blood cells to carry oxygen, that's a very different problem to solve.

I am not talking about the symptoms, I'm talking about research into the mechanism by which CV19 robs people of oxygen.

If your lungs were working perfectly and this theorized method of blocking oxygen from sticking to hemaglobin is correct, then the cure to this disease is to denature the spike protein of CV19 that is keeping red blood cells from carrying oxygen. Plasma transfusions seem promising and there's a big call for subjects in the NY region; Sweden is already carrying out such research, as are many tertiary care centers in the US.

Distant sequence similarity between hepcidin and the novel...

In other news, the hydroxychloroquine idea may not work and may, in fact, lead to major complications or death in persons with particular underlying conditions or who are taking other medicines for serious medical problems.

ECMO note. We lost a gentleman in our extended community this morning. Complication of covid 19 after being sedated and vented was kidney failure. Conventional dialysis didn't work, so they tried continuous dialysis in the hope of getting him stable enough for ECMO. Sadly, they never reached that goal. I didn't know him, I'm just saddened by our loss as a community. Jmo