Coronavirus COVID-19 - Global Health Pandemic #45

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Coronavirus: What do the figures tell us about Boris Johnson's chances of a full recovery?

Well, news that the prime minister hasn't been put on a ventilator could be a crucial sign, according to the latest figures from an intensive care research centre.

Numbers won't tell the full story, as every case depends on a multitude of extremely personal factors, but, like those now-famous charts showing the curve of cases and deaths, they can help us get a sense of the bigger picture.

<snip>

These figures come from the Intensive Care National Audit & Research Centre (ICNARC) which releases reports on patients with COVID-19 admitted to ICUs.

The latest was published on Saturday and examines the experience of 2,249 patients.

Most are still receiving treatment so we must be careful about drawing conclusions, but there are currently outcomes for 690 patients, around half of whom have died.

This bare fact shows just how serious admission to critical care is for most patients.

But anyone wondering specifically about Mr Johnson can find hope in another statistic.

According to his official spokesperson, the prime minister has not been placed on a mechanical ventilator, instead receiving "standard oxygen treatment", most likely using a device which blows air into the lungs.

Patients who don't go on a ventilator in the first 24 hours in an ICU survive 83% of the time.

Those who are put on a ventilator in that period have a much lower survival rate - just 32%.

This is correlation, not causation, so we don't know why that is, but while it's worth stressing again the limited nature of the data, on an individual level, this is good news.

Quite the opposite was reported based on the same study if I'm not mistaken.
From the video Dr. JOHN CAMPBELL did, he said
Of the 690 people admitted to ICU

67.9% needed advanced respiratory support ( ventilator)
Of that 67.3% died.
*in other words the ventilator was of no help. The protocols are being reassessed because the outcome is very disappointing.
20200407_182258.jpg
It's @ 15 min on video.
I may be confused!
MOO
 
EMA provides recommendations on compassionate use of remdesivir for COVID-19 | European Medicines Agency

"During an extraordinary virtual meeting held on 2 April 2020, EMA’s human medicines committee (CHMP) gave recommendations on how the investigational antiviral medicine remdesivir should be used for treating coronavirus disease (COVID-19) in compassionate use programmes in the European Union.

Compassionate use programmes, which are set up at the level of individual EU Member States, are intended to give patients with a life-threatening, long-lasting or seriously disabling disease and no available treatment options, access to treatments that are still under development and that have not yet received a marketing authorisation.

In this case Estonia, Greece, the Netherlands and Romania requested an opinion from the CHMP on the conditions under which early access to remdesivir through compassionate use could be given to patients with COVID‑19. In severe cases, COVID-19 can cause pneumonia, severe acute respiratory syndrome, multi-organ failure and death.

"Clinical trials remain the gold standard for the collection of robust data on the safety and effectiveness of investigational medicinal products, but the CHMP acknowledges the need for a harmonised approach to compassionate use in the EU to allow access to remdesivir for patients who are not eligible for inclusion in clinical trials”, said Dr Harald Enzmann, the chair of the CHMP. “The CHMP encourages the company to make remdesivir available in a fair and transparent way to those Member States wishing to take part in international clinical trials or treat patients in compassionate use programmes.”

Remdesivir has been shown to be active against SARS-CoV-2 and other types of coronavirus (i.e. SARS-CoV and MERS-CoV) in laboratory studies; however, there are currently only limited data on the use of remdesivir in patients with COVID‑19."

So EU countries can use Remdesivir for CV19 patients.
 
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You are mistaken. Not everybody admitted to ICU needed a ventilator, only 67 % ( or two thirds) needed a ventilator. Of those who were put on a ventilator, 67% ended up dying, which means 33% of people put on a ventilator didn't die. So ventilator saved a third of people who were put on a ventilator. Obviously they would have liked to save more, but it's not correct that ventilator was of no help.
 
Poor Idaho! This could get very unpleasant. We had to deal with Ammon Bundy in Oregon in 2016.

SANDPOINT, Idaho — Inside an old factory building north of Boise, a few dozen people gathered last week to hear from Ammon Bundy, the man who once led an armed takeover of an Oregon wildlife refuge.

The meeting, which appeared to violate orders by Gov. Brad Little of Idaho to avoid group gatherings, was an assertion of what Mr. Bundy said was a constitutional right to peacefully assemble. But Mr. Bundy said he also hoped to create a network of people ready to come to the aid of those facing closure of their businesses or other interference from the government as a result of the coronavirus outbreak.

“If it gets bad enough, and our rights are infringed upon enough, we can physically stand in defense in whatever way we need to,” Mr. Bundy told the meeting. “But we hope we don’t have to get there.”
https://www.nytimes.com/2020/04/07/us/coronavirus-idaho-bundy-patriot.html
A ‘Liberty’ Rebellion in Idaho Threatens to Undermine Coronavirus Orders

Similar here:

Ammon Bundy: ‘I Want the Virus Now’

Ugh. I remember those days. Please, no more drama, dudes. We're full up.
 
My 19 yo son is in the ER. He was there 2 days ago and told he had pleural effusion/water on his lung. He left NY state 2 weeks ago. He's clearly worse and struggling to breath. No one was allowed to go back in with him. A police officer was there to tell my mil the rules had now changed. Please pray for him and that he can advocate for himself while he can also barely breath. He's only 19 yo and he barely slept last night.
I’m very sorry @beatrixpotter. I’m so empathetic reading into your anguish. I will pray for the both of you. I know that right now ~ He’s your tiny baby boy. You will do anything to take away his pain. You would trade places with him in a heartbeat. Hold this love inside of you. Love yourself and your son. Hold him tight as you hug and hold yourself.

Feel the ❤️ Send it to him in your mind.
He will receive. Just believe.
 
That's a good video Mary. I wouldn't wear a bandana that doesn't fit tight as shown in your earlier post. Something fashioned to go under your chin. Let us know if u need any further help and be safe.
 
I just want to say thanks to everyone for the ventilator conversation in the last thread. It is really depressing but I was somewhat, uh relieved for lack of a better term, to see that you all were discussing this bc at that very moment I was having the same conversation with my family. I’m afraid one of them who is undergoing chemo MAY have been exposed during a hospital treatment recently so they are now in isolation, etc. Anyway too much to talk about atm and highly personal and distressing but thanks everyone for being here.
ETA: @mickey2942 we also had the same discussion you referred to. We decided this member can’t just stay at home and die, even though that’s what they want, bc it’s too much for the other relatives in the house to watch them gasp for air, etc., cross exposure, etc. Nutshell. So anyway the decision was made to seek hospitalization and die there and say bye via Facebook or whatever if it happens. This member also said there’s no reason for family to fly from out of state bc that is risky and also there’s no point because you can’t go in to see them anyway. So we will plan to have a ceremony, etc after it happens IF it happens. We are accepting that chances are slim this family member will survive due to their age and serious health conditions with cancer and chemo, if they do contract the virus.

I wanted to add this info to the ventilation conversation.

There is a SHORTAGE in our country of the drugs/medications people need to be on a ventilator. Hopefully, every hospital has received these much needed drugs by now.

Nobody can tolerate being ventilated without sedation. Covid-19 patients are put into a medically induced coma before being placed on a ventilator, so they do not suffer.

"Hospitals are in dire need of injectable fentanyl, used to safely place patients on ventilators and keep patients sedated so their lungs can heal. The demand for fentanyl, hydromorphone and morphine spiked 67% in March compared to January, according to Vizient, Inc, which helps healthcare providers manage their supply chains. At the same time, the fill rate for Vizient members had dropped to 73% by March 25."

The DEA placed restrictions on the production of injectables, as well as oral prescription opioids. There was a shortage well before the Coronavirus pandemic.

The groups, including the American Hospital Association, American Medical Association, American Society of Anesthesiologists, American Society of Health-System Pharmacists, and Association for Clinical Oncology had to ask the DEA to up the manufacturing of the drugs that patients need while on a ventilator.

A VERY SERIOUS ISSUE

Dr. Michael Ganio, director of pharmacy practice and quality at ASHP, said doctors will be forced to use different and less common combinations of sedatives if shortages continue to mount. That increases the risk of medical errors, he said.

The DEA last week agreed to relax inventory controls for manufacturers, allowing them to produce and store more than 65% of their annual quota throughout the duration of the emergency.

"This exception does not authorize any manufacturer to exceed his previously established annual manufacturing quota," the DEA wrote.
Patients may receive paralyzing drugs, in addition to sedatives, to increase the ventilator’s effectiveness. If the sedatives are not effective, a patient could potentially gain consciousness but be unable to alert medical staff.

https://www.thedoctorpatientforum.com/images/Downloads/GRD-DEA-Letter-CII_1.pdf

Exclusive: Opioid supply crunch for U.S. coronavirus patients prompts appeal to relax limits

Health groups urge feds to relax opioid production limits amid coronavirus

ASHP STATEMENT ON THE PREVENTING DRUG SHORTAGES ACT-ASHP

IMO
Inserting the tube without sedating patients. Keeping patients comatose. I hope this did NOT happened to anyone, that they had the drugs needed

It is upsetting, everything that led to a drug shortage. Why it happened to begin with, to the point the DEA placed quotas on manufacturing opioids. Many people can't get their pain medications filled at pharmacies. It is getting more difficult, they are just not in stock anymore. I have been following this for three years. It is a whole other subject

Then there is the misinterpreted 2016 CDC Opioid Prescribing guidelines...

Prayers @beatrixpotter and @margarita25 for your family members.
 
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India agrees to release unproven 'corona drug'

Another article about hydroxychloroquine.

"India has agreed to lift an export ban on a drug US President Donald Trump has called a "game-changer" in the fight against coronavirus, despite reservations from medical experts.

The decision came after Mr Trump warned of "retaliation" if India did not drop the ban on hydroxychloroquine exports.

The president has repeatedly touted the drug as a possible cure for Covid-19, despite a lack of proof.

India is one of the world's largest manufacturers of hydroxychloroquine.

It is unclear how much will now be exported. Anurag Srivastava, spokesperson for the Ministry of External Affairs, said on Tuesday that the "the stock position could allow our companies to meet the export commitments that they had contracted".

What happened between the US and India?
President Trump - who, according to the New York Times, owns a "small personal financial interest in Sanofi, the French drugmaker that makes... the brand-name version of hydroxychloroquine" - called Indian Prime Minister Narendra Modi on Sunday, a day after India banned all exports of the drug "without exception". "
 
Husband and I are making signs tonight and will show up at our Hospital tomorrow eve. 6:45-7:15. Along with others. Line up in our vehicles, hold up our signs and honk our horns. We will catch the day shift leaving and the night shift coming in. Support our front liners and of course our Daughter and Son who work there.
 
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