Coronavirus Crisis: Main Thread

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Re: Coronavirus Crisis: Main Thread

Postby Elvis » Wed Jul 08, 2020 4:10 pm

FWIW — original post on Facebook


Dr. Loftus' full post:

"I'm in a hotspot hospital in a hotspot region (Coachella Valley, Inland Empire, CA). We just converted the entire second floor of our hospital to COVID-19 care yesterday, July 1. We have 65 inpatients with COVID-19 in a hospital with 368 beds. It is the same at our other 2 hospitals in the Valley. We spent yesterday deciding the ethical way to divide up limited remdesivir (30 patients' worth) for the hospital patients. My 20 incoming interns for our IM resident were exposed to COVID 2 weeks ago during their computer chart training; apparently 100% of our computer trainers had COVID19. One intern tested positive 7 days later and I insisted we re-test them all again, as there are almost certainly other cases with minimal symptoms. I raided my household and took my entire supply of face shields to the hospital for the residents to wear on their first day, and I paid $1000 of my own money to equip all of my residents with medical-grade face shields. I require all residents to wear a surgical mask or N95 with face shield if they are within 6 feet of another human, patient or coworker.

Roughly 20% of our inpatients die. Only 30% of our ventilated patients survive. (We try to avoid ventilation at all costs. Some people insist on being full code and decompensate despite high flow with face mask, proning, dexamethasone, antibiotics, and a cocktail of famotidine, zinc, Vitamin D, Vitamin C, NAC, and melatonin--we throw everything we can at each case, so long as it won't hurt them.)

My administrative assistant, who sits adjacent to the interns, just went home with COVID symptoms. Her test is pending.

In the Southwest, we are experiencing catastrophic exponential growth. I have had multiple families--siblings, parent-child, spouses--admitted with COVID-19. I had a 31 year old come in satting 78% on room air; he had been sequestering himself in his bedroom for a week to avoid infecting his elderly parents, with whom he lived. His sister, the only person he saw outside his immediate household in the 10 days prior to onset of fever, cough, and dyspnea, had also had fevers but had tested "negative" at our other large hospital so he thought it was safe to visit her. (Sigh. The Quest PCR test is about 80% sensitive, we think--it had emergency approval, so sensitivity data was not required. The Cepheid rapid COVID PCR test is 98.5% sensitive but is in short supply due to limited reagent availability.)

I'm glad some of you are sheltered from what unbridled COVID-19 looks like. It's a hell show. This is July. What do you think my hospital will look like in winter?…

This is real. Doctors in places with proper public health responses will see few cases in their hospitals--like UCSF--but let me tell you something: The laws of physics and biology don't change. If you're in an unaffected region, an introduction and poor governance and low use of physical distancing and masks will give you an exponential increase in no time flat (i.e. 2-4 weeks). That's pandemic math. And 20% of the population infected needs a hospital. You will run out of beds with an unbridled pandemic. There is almost ZERO pre-existing immunity to SARS-CoV-2. There may be some "priming" of T-cell responses due to exposure to other "benign" beta-coronaviruses, but we have no idea if that explains the 20-40% of people who seem to get minimal symptoms. Asymptomatic infected persons, however, can, and do, spread COVID to those who die from it.

By the way: I've seen scary looking CT scans of the lungs that look like terrible interstitial pneumonia in a patient who had ZERO symptoms and SaO2 94% on room air. She came in for palpitations and the intern overnight got a chest CT for cardiac reasons. We didn't know it was COVID until her test came back 36 hours later. So "asymptomatic" does NOT mean "no biological activity." The virus replicates furiously in people who feel fine. Kids can spread this as easily as grown ups, even if they feel okay.

Related: I've talked to two previously healthy patients ages 32 and 44 who are 3 and 4 months, respectively, post their acute COVID. They continue to have cough, nightsweats, fever, fatigue. How many survivors have "post-COVID syndrome"? We don't know. Less than 20% but we're not sure. I've asked my hospital to allow me to establish a post-COVID clinic to care for and study survivors. Both NIH and UW are planning similar efforts based on my dialogues with them.

Autopsies show anoxic brain injury in many patients who died of COVID, not to mention microthrombi throughout the lungs and megakaryocytes in massive infiltrations in their hearts and other organs. People get heart failure, lung fibrosis, and permanent kidney injury from COVID-19. This is a disease of the vascular systems, and it can affect any organ, with lungs and kidneys being especially at risk.

In early May, thanks to lockdown, our census of 55 came down to 10 COVID cases, and for a brief moment, I actually had hope that the worst nightmares I had about COVID, as a biohazard virology-trained hospitalist, would not come to pass. Then we re-opened, without test/trace/isolate systems anywhere close to adequate. Eight weeks ago my county decided to make masks "optional," despite 125 doctors begging them not to do that. Now we're worse than we were in April. And it's getting worse every day.

You wanna see if COVID is real? Come walk on my COVID ward with me. It's real. Hearing people talk about it as if it's an exaggeration is, well, rage-inducing, honestly. Denial is the most common reaction to a pandemic. Denial is how the US will wind up with 1.1 million deaths instead of 30,000. I saw AIDS denialists get killed by their belief that HIV "isn't real, it's a pharma conspiracy of the medical industrial complex." Yeah, right, if you say so. I watched patients with those beliefs die.

The hardest part about this is, every new case I treat exposes me. I have assiduous hot zone technique. But no technique is bulletproof. If you keep exposing me to case after case, eventually, the virus will get through my defenses. I'm a 50 year old hypertensive. I don't expect to do well if I get infected. For now, I keep going to work. I'm one of the few pushing forward on COVID clinical trials, basic science, public health messaging, and diagnostic studies at my hospital. I feel a responsibility to keep going. I wake up with nightmares every morning at 4am. But I'm going to keep going for now. I feel very alone a lot of the time. People are not taking this seriously, and it's costing lives. -R

"Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic." — Michael O. Leavitt, 2007

- Richard A. Loftus, MD





https://kesq.com/news/2020/07/07/doctor ... hell-show/
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Re: Coronavirus Crisis: Main Thread

Postby conniption » Thu Jul 09, 2020 12:11 am

Hello All.
It's been a while.

I've been watching this gentleman's videos today thanks to a heads-up from Off-Guardian.

Crazy days.



Just a Little Prick (Part One)
70,795 views
•Jul 3, 2020

Vernon Coleman
106K subscribers

International best-selling author, Dr Vernon Coleman MB ChB DSc FRSA, looks at how Bill Gates now influences every aspect of our lives and explains how Gates has used his vast wealth to give him extraordinary power over public health policies.
For more unbiased information about other important issues, please visit http://www.vernoncoleman.com The transcripts of the videos that YouTube banned are also on the website (click on the 'Health' button then go to the top of the page).



...
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Re: Coronavirus Crisis: Main Thread

Postby liminalOyster » Sun Jul 12, 2020 2:05 am

Anyone know if there was ever a definitive (or just worthy/convincing) outcome of the nicotinic hypothesis that nicotine may play preventive role against COVID-19? Seems like it just sort of fizzled away. I haven't dug deep but am not seeing much current in Google News.
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Re: Coronavirus Crisis: Main Thread

Postby liminalOyster » Mon Jul 13, 2020 4:25 pm

FWIW, I started having mild symptoms a few days ago and got tested today. 3-5 days until results.

I'm a presumably healthy white guy in his early 40s, mildly overweight but not significantly with no major underlying conditions other than periodically pre-hypertensive under stress. I don't drink, smoke or use drugs (the odd yearly psychedelic but not in a few years) though have chewed nicotine gum for a couple years now (so here's hoping its a cytokine modulator!.)

My partner and young child are getting tested tomorrow also.

Keep us in your thoughts (even if you're a skeptic.) Thanks.
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Re: Coronavirus Crisis: Main Thread

Postby Grizzly » Mon Jul 13, 2020 4:34 pm

Gosh, yikes! keep us posted liminal...
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Re: Coronavirus Crisis: Main Thread

Postby liminalOyster » Mon Jul 13, 2020 5:18 pm

Grizzly » Mon Jul 13, 2020 4:34 pm wrote:Gosh, yikes! keep us posted liminal...


Thanks Grizzly. As may be known from my myco-foraging thread, I'm also a rabid forager and hoping (ironically) I may have underwashed specimens and thus exposed myself to a swampland soil borne pathogen. We shall see!
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Re: Coronavirus Crisis: Main Thread

Postby Elvis » Mon Jul 13, 2020 5:23 pm

"Frankly, I don't think it's a good idea but the sums proposed are enormous."
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Re: Coronavirus Crisis: Main Thread

Postby Belligerent Savant » Tue Jul 14, 2020 3:35 pm

liminalOyster » Mon Jul 13, 2020 3:25 pm wrote:FWIW, I started having mild symptoms a few days ago and got tested today. 3-5 days until results.

I'm a presumably healthy white guy in his early 40s, mildly overweight but not significantly with no major underlying conditions other than periodically pre-hypertensive under stress. I don't drink, smoke or use drugs (the odd yearly psychedelic but not in a few years) though have chewed nicotine gum for a couple years now (so here's hoping its a cytokine modulator!.)

My partner and young child are getting tested tomorrow also.

Keep us in your thoughts (even if you're a skeptic.) Thanks.


Prayers to (spiritual entity/ies of preference) for a swift recovery (and mild symptoms) for you and yours, Liminal. If you're willing to share, let us know how it plays out (both for your collective results and the -- hopefully mild -- onset of symptoms).
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Re: Coronavirus Crisis: Main Thread

Postby liminalOyster » Tue Jul 14, 2020 7:15 pm

Belligerent Savant » Tue Jul 14, 2020 3:35 pm wrote:
liminalOyster » Mon Jul 13, 2020 3:25 pm wrote:FWIW, I started having mild symptoms a few days ago and got tested today. 3-5 days until results.

I'm a presumably healthy white guy in his early 40s, mildly overweight but not significantly with no major underlying conditions other than periodically pre-hypertensive under stress. I don't drink, smoke or use drugs (the odd yearly psychedelic but not in a few years) though have chewed nicotine gum for a couple years now (so here's hoping its a cytokine modulator!.)

My partner and young child are getting tested tomorrow also.

Keep us in your thoughts (even if you're a skeptic.) Thanks.


Prayers to (spiritual entity/ies of preference) for a swift recovery (and mild symptoms) for you and yours, Liminal. If you're willing to share, let us know how it plays out (both for your collective results and the -- hopefully mild -- onset of symptoms).


Thanks BS. I'm alright I think. Thus far my symptoms have been limited to stomach distress and loss of appetite (plus some fatigue with intermittent body aches that might be attributed to other stuff.) but feels more intense/persistent than I will say that I have slowly felt progressively better. Ate a BLT for lunch and stomach's fine. So (apoogies, vegans/vegetarians), am likely on the up and up. At this point, I am pretty much expecting the test to be negative but apparently (according to doc friends), "mild" covid can look pretty much like this. We'll see.
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Re: Coronavirus Crisis: Main Thread

Postby Harvey » Tue Jul 14, 2020 9:36 pm

Derren appears for illustrative purposes only. I can't stop wondering, is there potentially a negative effect analogous to the placebo effect. Knowledge+imagination+suggestion? Not a nocebo as such. What we might have called a curse not too long ago, before a curse could be amplified by a billion cross platform messages and a billion more voices. I'm thinking out loud, just Ignore me if that's too annoying.

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Is just to love
And be loved
In return"


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Re: Coronavirus Crisis: Main Thread

Postby Wombaticus Rex » Wed Jul 15, 2020 11:20 am

Via: https://www.fox35orlando.com/news/fox-3 ... 19-results

After FOX 35 News noticed errors in the state's report on positivity rates, the Florida Department of Health said that some laboratories have not been reporting negative test result data to the state.

Countless labs have reported a 100 percent positivity rate, which means every single person tested was positive. Other labs had very high positivity rates. FOX 35 News found that testing sites like one local Centra Care reported that 83 people were tested and all tested positive. Then, NCF Diagnostics in Alachua reported 88 percent of tests were positive.


Presumably there are not an infinite sum of labs in Florida -- I know the state is densely populated, but I'm going to assume that's some godawful florid prose...

How could that be? FOX 35 News investigated these astronomical numbers, contacting every local location mentioned in the report.

The report showed that Orlando Health had a 98 percent positivity rate. However, when FOX 35 News contacted the hospital, they confirmed errors in the report. Orlando Health's positivity rate is only 9.4 percent, not 98 percent as in the report.

The report also showed that the Orlando Veteran’s Medical Center had a positivity rate of 76 percent. A spokesperson for the VA told FOX 35 News on Tuesday that this does not reflect their numbers and that the positivity rate for the center is actually 6 percent.

FOX 35 News went on to speak with the Florida Department of Health on Tuesday. They confirmed that although private and public laboratories are required to report positive and negative results to the state immediately, some have not. Specifically, they said that some smaller, private labs were not reporting negative test result data to the state.

"The Department immediately began working with those labs to ensure that all results were being reported in order to provide comprehensive and transparent data," a spokesperson for the Florida Department of Health said. "As the state continues to receive results from various labs, the Department will continue educating these labs on proper protocol for reporting COVID-19 test results."


It's important to note the framing here: "in the report, in the report, in the report." However, it's not coming from the labs, it's coming from the Florida Department of Health.

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Re: Coronavirus Crisis: Main Thread

Postby Nordic » Wed Jul 15, 2020 3:56 pm

Harvey » Tue Jul 14, 2020 8:36 pm wrote:Derren appears for illustrative purposes only. I can't stop wondering, is there potentially a negative effect analogous to the placebo effect. Knowledge+imagination+suggestion? Not a nocebo as such. What we might have called a curse not too long ago, before a curse could be amplified by a billion cross platform messages and a billion more voices. I'm thinking out loud, just Ignore me if that's too annoying.

Image



I have experienced this suspicion since the beginning.

The stupid useless “masks” are certainly nothing but a placebo. And we’re as close to having a civil war over them as anything I’ve seen in my life. “True Believers” vs “Non Believers”.

I tell people these masks use the exact same technology as a crucifix does to protect you from demons.

I’m actually not joking although it seems like I am.
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Re: Coronavirus Crisis: Main Thread

Postby DrEvil » Wed Jul 15, 2020 4:21 pm

^^Unlike crosses masks do work. They reduce the amount of droplets spewing from your mouth and nose when talking, coughing or sneezing. It's not to stop you from getting infected, but to stop you from infecting others, or at least reduce the chance of it happening. It's not going to stop the spread, but it will help slow it down.
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Re: Coronavirus Crisis: Main Thread

Postby norton ash » Wed Jul 15, 2020 5:17 pm

Hey, Nordic, how's Trump doing these days? Wear your mask.
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Re: Coronavirus Crisis: Main Thread

Postby liminalOyster » Wed Jul 15, 2020 6:40 pm

Man this is a mega-fucking-bummer of a thing to read as I sit waiting for my fucking test results. Though I'm feeling better than I was a few days ago and thinking it's possible I had something foodborne, but am happy to have gotten tested due to potential exposure circumstances beyond my control.

To put this into perspective - and duh yes I'm talking different sorts of pathogens - anyone who has every tried to cultivate mushrooms (as I did three times in 2018) get's a major wake up call about just how well Lysol (a product I'd never used before), still air and masks work, how full of pathogens the air is, how much AC and air flow can affect them, etc.

I fancy myself a relatively smart cat but was humbled to realize the degree to which I had underestimated all those measures. The currently popular agar plate images floating around showing a guy sneezing on plates with and without a mask are pretty rudimentary science.

I'll put myself out there today and say I'm 90% convinced that COVID was an accidental leak of a biowarfare agent (and I suggest Melinda Cooper's academic book, Life as Surplus for those who think that's tinfoilery) but obviously "masks" when worn correctly and following protocol "work." Indeed, if they didn't (and related measures) we would never had developed this thing in the first place.

We're nowhere near a "civil war" over masks, just watching mass hysteria take different forms including uneducated wannabe libertarians having embarrassing tantrums at big box stores and pissy white NPR liberals doing their usual bitchfest about those poor idiot working class republicans etc.

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