Coronavirus COVID-19 - Global Health Pandemic #48

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  • #1,001
Thinner and wiser? I must be doing it wrong, I'm on target for fatter and drunker.
Literally LMAO
Same here OMG-- this working from home, being home all day sitting here, stuffing whatever snacks I can find into my mouth even when Im not hungry.
Then, because we are so busy with work, I am pulling my hair out trying to keep up so I start pouring whatever alcoholic beverage I see first once I punch out of work. LOL
And our wonderful "higher up" boss, my boss' boss did a WebEx Happy hour starting at 3PM last week. Bring on the booze whilst working hahhaha

I started losing weight after the holidays in preparation for my daughter's wedding in July and having to go "Mother of the Bride" dress shopping"
There are no bridal shops or stores open for me to go shopping but I am adding the weight back on YIKES
I am putting a halt on this binge eating crap and going to start walking
I think I will start on ----- Monday** Hehehehehe
 
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  • #1,002
Calling all procrastinators to unite-tomorrow. That's my motto :D
 
  • #1,003
Literally LMAO
Same here OMG-- this working from home, being home all day sitting here, stuffing whatever snacks I can find into my mouth even when Im not hungry.
Then, because we are so busy with work, I am pulling my hair out trying to keep up so I start pouring whatever alcoholic beverage I see first once I punch out of work. LOL
And our wonderful "higher up" boss, my boss' boss did a WebEx Happy hour starting at 3PM last week. Bring on the booze whilst working hahhaha
I am putting a halt on this binge eating crap and going to start walking.

I started losing weight after the holidays in preparation for my daughter's wedding in July and having to go "Mother of the Bride" dress shopping"
There are no bridal shops or stores open for me to go shopping but I am adding the weight back on YIKES
I think I will start on ----- Monday** Hehehehehe

I bothered getting on an exercise bike this morning. Baby steps. You can do it!
 
  • #1,004
I bothered getting on an exercise bike this morning. Baby steps. You can do it!
Ugh guess it's time to go for a walk in the woods while the sun's still out.
 
  • #1,005
I wonder how they feel about their decision right about now. The graph isn't scaled by population but Sweden, Norway and Denmark are fairly close in size.

Wow. The thing is, this is our chance to learn what happens when CoVid gets a good hold on a fairly healthy (but aged graded) society. Sweden is providing such valuable data. Question is - when will it stop being exponential?? And what will happen next?

After Sweden, we will a better idea of the actual mortality rate of CV (and it might be closer to 1% than we thought :eek:) and also the demographics of it.

All the stats are available at the website:

Coronavirus Disease (COVID-19) – Statistics and Research

upload_2020-4-18_16-29-12.png


Sweden isn't doing well with case fatality rate. Average age in Sweden is 41.

upload_2020-4-18_16-36-49.png
 
  • #1,006
  • #1,007
Is there a separate thread for the president's speeches? I haven't seen it yet today but given the incredulous reaction I wondered if it's being discussed elsewhere?
 
  • #1,008
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  • #1,011
Yeah. We all need to mind ourselves, unless something egregious is happening. House divided and all that. The title would make me click on it in outrage. But this is what it says in the article (which is quoting his Tweet), so it doesn't sound like he's asking me to personally narc on you...although the "anything" would definitely encourage cranks.

"When you see a crowd, when you see a line that’s not distanced, when you see a supermarket that’s too crowded -- anything -- you can report it right away so we can get help there to fix the problem.”

This sounds more like getting help to get store managers to do a better job, or to have police do some crowd control in public spaces that are getting to be too much. JMO.
 
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  • #1,012
Is there a separate thread for the president's speeches? I haven't seen it yet today but given the incredulous reaction I wondered if it's being discussed elsewhere?

Surely you jest! :D I can’t imagine it would be allowed here. :eek: I’m watching music to soothe my soul. :)
 
  • #1,013
The Book of Critical Care

March 2, 2020 by Josh Farkas
Last updated 4/16 (recently updated text marked in green)

This has everything. This may have been posted already

-cytokine storm: diagnosis & treatment overview

evidence-based diagnosis of cytokine storm in COVID-19 ?

  • Cytokine storm seems to be a major driver of mortality in COVID-19. This implies that validated prognostic markers in COVID-19 related to inflammation can be used to define patients with COVID-19 cytokine storm.
  • This strategy has the advantage of being disease-specific to COVID-19 (rather than trying to retrofit another scoring system onto COVID-19).
  • A diagnosis of cytokine storm could therefore be based upon the presence of severe respiratory failure plus abnormalities in ferritin, C-reactive protein, D-dimer, lactate dehydrogenase (LDH), and absolute lymphocyte count (figure above).
    • Cutoff values aren't intended to drive absolute binary decisions, but rather as rough guidelines. These cutoff values are derived from several studies on prognostication in COVID-19 (see section on prognosis). This diagnostic strategy is consistent with some ongoing RCTs investigating tocilizumab (here and here).
    • Rapid deterioration in the laboratories supports the presence of cytokine storm (especially if this occurs despite the use of low-dose steroid).
  • Using this approach, patients diagnosed with cytokine storm will have a high likelihood of mortality. This may constitute an evidence-grounded rationale for more aggressive treatment of this subset of patients.
treatment of cytokine storm in COVID-19 ?
  • There is no well-established or evidence-based treatment for cytokine storm in COVID-19.
  • Patients with COVID-19 and cytokine storm are at high risk of death without aggressive therapy. Low-dose steroid appears inadequate to quell inflammation in these patients (e.g. 50 mg hydrocortisone q6hr or 1 mg/kg/day prednisone).
  • More powerful immunosuppression may be beneficial. Possible options include:
    • Higher doses of steroid (e.g. 60-125 mg IV methylprednisolone q6hr for up to 3 days, with tapering as soon as the C-reactive protein starts falling). Pulse-dose steroid has been described for the treatment of influenza-induced hemophagocytic lymphohistiocytosis, so there is some precedent for this in the literature (Ando 2006, Asai 2012)
    • Tocilizumab (more on this below). Theoretically this may be the best strategy, but supplies of tocilizumab are severely limited.
    • IL-1 inhibitors (e.g. anakinra)(Shakoory 2016).
    • JAK inhibitors (e.g. ruxolitinib)(Zandvakili 2018).
Sections
personal protective equipment (PPE)
diagnostic approach for admitted patients

stages of illness & timing of therapies

antiviral therapy
noninvasive ventilation (BiPAP & CPAP)
invasive mechanical ventilation
disaster ventilation strategies
extubation
renal failure
anti-bacterial therapy
disseminated intravascular coagulation
glycemic control & diabetes
general prognosis
podcasts


https://emcrit.org/ibcc/covid19/#transmission








 
  • #1,014
Well, the two are co-morbid. Some of the dead surely had both. In fact, when it first appeared in SoCal, the first deaths were autopsied (old people's home) and 2 people had CoVid, flu AND pneumonia. So for old people, bringing down the viral/bacterial load from other diseases is crucial if they want to live longer. Not everyone does want to live to be 110 though.

We are selfish creatures, although some of us are pretty darned altruistic. The Guardian had a heartbreaking podcast where an American reporter went inside Brooklyn Hospital and reported to a UK host - the hero of the story, Dr. Josh R., well - let's just say I couldn't sleep last night, worried about him, his health, his staff and what they're doing. Heroes, every one of them.

If it weren't for the altruistic ones, anthropologists theorize that our species wouldn't be here at all, or at least not in the numbers we are in. Our history is filled with magnificent sacrifices made by parents for children, grandparents for the community, smart people for medicine, doctors and nurses for others, etc., etc.

It's amazing to me, though, that daily death rates of, say, 100 people in one's home state, do not make most people care about the social distancing. Until someone they know and love dies.

By the way, all those people who gather in public to protest the distancing and closures (without masks) are going to get the virus in higher numbers. Young people who are overweight are in the risk group and boy, are there a ton of them in those crowds. The older overweight people are clearly ready to die for this cause (but are they conscious of that or not? I can't tell - the ones who think this is a hoax aren't just selfish, they've got some kind of cognitive impairment or something).

I posted a graph earlier that analysed 4,000 deaths and 9 out of 10 had an underlying health condition, heart disease, alzheimers, diabetes, etc so a lot of people think, this isn't going to affect me and those people would be the ones who want to go about their regular lives. The protesters are not necessarily going to get the disease as the infection rate is fairly low IMO.
 
  • #1,015
Is there a separate thread for the president's speeches? I haven't seen it yet today but given the incredulous reaction I wondered if it's being discussed elsewhere?

It's probably political? I haven't heard it or heart anything about it. I suspect he wants to "reopen." So do we all.
 
  • #1,016
Is there a separate thread for the president's speeches? I haven't seen it yet today but given the incredulous reaction I wondered if it's being discussed elsewhere?

In relation to Canada, Trump announced today that the USA international border with Canada could open as soon as next month.

Canada said that is not happening. I suspect that many things will happen in Canada before the country will open the border to foreigners.
 
  • #1,017
I posted a graph earlier that analysed 4,000 deaths and 9 out of 10 had an underlying health condition, heart disease, alzheimers, diabetes, etc so a lot of people think, this isn't going to affect me and those people would be the ones who want to go about their regular lives. The protesters are not necessarily going to get the disease as the infection rate is fairly low IMO.
Infection rate is low? How did we get to over 700,000 confirmed cases then? We are almost at 40,000 deaths as well.
So whoever modeled 60,000 total deaths is way off.
 
  • #1,018
It looks like Sweden cases are still increasing, and rates are higher than neighbouring countries.

View attachment 243492

Coronavirus Disease (COVID-19) – Statistics and Research
One reason for the higher number of cases in Sweden compared to the other Nordic countries is that Sweden has about twice as many inhabitants than the other countries.

When you look to the number of cases per 1 million inhabitants (at Coronavirus Update (Live): 2,324,731 Cases and 160,434 Deaths from COVID-19 Virus Pandemic - Worldometer ) today the difference isn't that much higher compared with Norway and Denmark. Finland is the country with the fewest cases.

Total number of cases / cases per 1M population :
Faeroe Islands 184 /3,766
Iceland 1,760 / 5,158
Finland 3,681 / 664
Norway 7,036 / 1,298
Denmark 7,242 / 1,250
Sweden 13,822 / 1,369

As you can see, the two countries with the lowest number of cases are those who have been hardest hit in comparison to their population.
 
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