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post #3341 of 3485 Old 03-25-2020, 09:06 PM
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Originally Posted by Hondo View Post
Agree with much of what you say, even though it does in some instances contradict what some experts in the field seem to be saying.

One thing that caught my eye was that it was really not known that the virus could not become air born as smallpox. There was something about 700 people becoming infected on a ship and the airways were a possible suspect. And something about apartments in NY that did have circulating air was being changed.


Possibly and likely not, but it was out there. Don't remember the source but it was some infectious ex-spurt speaking about the unknowns. Also read that although warmer weather caused a drop off of flu it was not known if this virus would behave similarly although the thought was that it should.


I've just been reading what "seems" to be a little more serious "tone" among the national and international agencies and their members.



I'm a little confused at this point as I just read that several versions of the common cold were corona viruses. I need to do a search to clear up in my mind exactly what is a flu virus and what is a cold virus and where the Covid-19 fits in.
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post #3342 of 3485 Old 03-25-2020, 09:12 PM
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post #3343 of 3485 Old 03-26-2020, 01:40 AM Thread Starter
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Yes and it's being spread around, "Don't compare this to the flu." Of course it is good to both compare and contrast it to the flu.
It makes sense to compare this to the flu because it is a respiratory virus, it is spread through droplet transmission, and is surrounded by an outer fatty layer called an envelope like the flu. The outer layer is easily disrupted by soap or other cleaners, like the flu virus. The symptoms are also similar to the flu and other respiratory viruses.

Coronavirus kills people in the same way that flu does.
One way it can kill is if you get dehydrated from fluid losses (sweat from fever, respiratory and nasal secretions) and go into hypovolemic shock. Any kind of shock puts you at risk for acute respiratory distress syndrome (ARDS) which means you will end up on a ventilator. You can also go into respiratory failure from having your lungs fill up with secretions, your respiratory muscles wear out from coughing and breathing hard, until you are unable to take deep breaths and get good oxygen in and carbon dioxide out.
People who already have poor lung function from COPD or cancer will end up in respiratory failure more easily. People with poor heart function will also get into trouble easily. They are already circulating poorly so dehydration will quickly lead to organs not getting enough blood flow. A sick heart cannot tolerate higher heart rates from fever so will begin backing fluid up into the lungs instead of circulating it around the body.

It can be contrasted with the flu in that it may have different case mortality rates based on age or the duration of the illness, it lasts longer, it has a longer incubation period, and other differences.

I apologize I wanted to link that BBC article that mentioned how Italy reported their deaths in hospitals as all relating to coronavirus, but I can't find it again on Google. It was in a BBC news article, which I assumed meant it was sourced appropriately.

CDC reports that transmission is through droplet and possibly through surface contact, but that is a less usual way for it to spread.
https://www.cdc.gov/coronavirus/2019...nsmission.html
Our official word from infection control at the hospitals is that it is possible to aerosolize the virus doing certain respiratory procedures, but that it is less easily aerosolized than the flu virus due to its different structure. Coughing and things a person normally does will not make the virus airborne.

We need more data. But we also know the structure of the virus and it seems to behave like the other coronaviruses and respiratory viruses we know. On our hospital's respiratory panel we test for about 15 viruses, and they all transmit through droplets. There are others we don't test for, including the more usual coronaviruses that cause up to 30% of all "common cold" symptoms.
https://www.statnews.com/2020/03/17/...reliable-data/

If it helps anyone, we were given official information to give out to patients about FAQs regarding the coronavirus.

1) Should I stop taking NAIDS?
The reason this question is circulating is because of four cases in France where young patients developed serious symptoms from COVID and had also taken NSAIDS (Ibuprofen) early in their illness.
There is no evidence other than speculation that Ibuprofen can worsen COVID. Most likely the risk of having a high fever and dehydration for most people would be far higher than any potential risk from taking NSAIDs. In these cases the fact that NSAIDs were taken and the patients became worse could be entirely coincidental.

2) Should I stop taking Beta Blocker or ACE Inhibitor medication?
There was a study in China that related taking these medications to patients who died in China. However, this was hypothesis only and since the patients who were most ill had comorbidities that meant they were taking these medications, there is no way to relate the medications to the severity of the illness rather than the comorbidities themselves.

3) Should people avoid taking inhaled or oral steroids?
Given as a treatment for SARS, MERS or flu, steroids have not proven effective and possibly harmful. However, those were high dose steroids given to ICU patients and those who are taking inhaled steroids or oral steroids normally still should take them to prevent their underlying health conditions from worsening.

4) What about immune boosters like Vitamin C?
In doses that can be absorbed orally, there is still no data to support that they are effective.
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post #3344 of 3485 Old 03-26-2020, 09:31 AM
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Great post and link to a pretty good article. The author seemed to be concerned about the unintended consequences of some of the draconian measures being put in place, and he may be right, but then he may be wrong. He has credentials.


I did have a bit of a problem with one comment late in the article:



Quote: The vast majority of this hecatomb would be people with limited life expectancies. That’s in contrast to 1918, when many young people died. End Quote


My read was, " oh well, they were probably gonna die anyhow". I find it difficult to measure the value of one life against another which he "seemed" to be doing.


But yes, I do agree that "people" are over reacting and the news media is not helping.




over react.jpg

Last edited by Hondo; 03-26-2020 at 09:37 AM.
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post #3345 of 3485 Old 03-26-2020, 06:41 PM Thread Starter
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No, older people are not less important.

Forgot to mention common cause of death from covid or flu is the path of pneumonia to sepsis, then systemic inflammatory response which is shock.

Our hospital received more new ventilators yesterday. There are also lots of extra temporary staff in the cities that can be sent to us.

What is frustrating is a ton of new rules each day that are poorly thought out and other stupid things. Someone thought nurses couldn't be trusted with ppe so they are hiding a lot. We are protesting.

Everyone just wants a single n95 mask we can throw on if a covid patient codes so we can resuscitate them. I have one in my locker a nurse gave me but it is the wrong size. I don't care, I can live with myself if I get covid but not if I did not try to code someone just because they might have covid. So far our rule outs in the hospital have met very little criteria, meaning no fever, maybe a slight cough.

Last I checked the case mortality in the u.s. was around 0.1%. That is what some predicted.
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post #3346 of 3485 Old 03-26-2020, 08:37 PM
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There was an interview where Fauci predicted when everything was over and done the mortality would be 0.1% of the people that actually become infected.


I do not get flu shots so I am extra careful already plus I think I'm in the upper tier of health for my age group.



I just worry that the flu shots could depress my natural immune system allowing strains that are not protected by the shot to get in. I think I had some basis for that belief but I forget now.


Health care workers are really exposed. There should never ever be another situation where shortages of personal protection are allowed to become unavailable to the front lines.


That said, I did read an article from some source that looked legit, I forget the source, that said the masks only really helped the infected by keeping them from spreading. The author claimed there was so much air going around them that they didn't really protect the uninfected from becoming infected.


I of course don't know if that's true but I do have a 3M face mask with canisters that are very fine, forgot how small, that seals very tightly and does not let any air in other that through the canisters. If I were really concerned, that's what I'd wear. They are a bit of work to breath through though.


It just seem like te dust masks would at least catch something which would be some reduction.
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post #3347 of 3485 Old 03-26-2020, 08:51 PM
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Just read that the US has just passed 1,000 fatalities out of 68,000 reported cases. That is 3%. For the fatality rate to be 0.1% the actual number of cases would need to be 2 million plus. Or 29 out of 30 cases being unreported.
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post #3348 of 3485 Old 03-27-2020, 09:54 AM
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Oops. 14.7% with actual cases being 1 million.
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post #3349 of 3485 Old 03-27-2020, 02:20 PM
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Daily Mail - not the most reputable source - has 1,271 deaths / 85,381 tested positive. That is 1.49% but still unhelpful since some of those currently diagnosed WILL die in the future. That would drive the number up while a bigger denominator (we obviously don't know of all cases) would drive it down. We'd need a denominator of a million to drive it down to 0.12% and I really doubt the denominator is that high. Seems obvious it is worse than the flu, but probably not as bad as the WHO originally predicted. But a denominator of 170,000 would drive it to 0.75%.....


https://www.dailymail.co.uk/news/art...ronavirus.html

On a slightly positive note, the guy I know who has it (and a lot of complicating conditions) was briefly pulled off the respirator. It didn't go as well as hoped so they put him back on. But he had improved enough that they tried taking him off. No one is recommending optimism. Still a tough row to hoe ahead! True for him and true of the world.
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post #3350 of 3485 Old 03-28-2020, 05:16 AM Thread Starter
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Daily Mail - not the most reputable source - has 1,271 deaths / 85,381 tested positive. That is 1.49% but still unhelpful since some of those currently diagnosed WILL die in the future. That would drive the number up while a bigger denominator (we obviously don't know of all cases) would drive it down. We'd need a denominator of a million to drive it down to 0.12% and I really doubt the denominator is that high. Seems obvious it is worse than the flu, but probably not as bad as the WHO originally predicted. But a denominator of 170,000 would drive it to 0.75%.....

On a slightly positive note, the guy I know who has it (and a lot of complicating conditions) was briefly pulled off the respirator. It didn't go as well as hoped so they put him back on. But he had improved enough that they tried taking him off. No one is recommending optimism. Still a tough row to hoe ahead! True for him and true of the world.
Yes, it seems I added an extra zero by mistake, so using @Hondo 's numbers 1,000/68,000 = 1.5% (.015). I had seen similar numbers but accidentally added another zero to the 68,000. Wishful thinking I guess.

Good to hear your friend has trialed getting off the ventilator, @bsms . Hopefully he will be successful on his next attempt. Even trying can be helpful, since it can give the respiratory muscles some exercise for the next day or attempt.

Honestly not trying to be stubborn or "Polyanna," but I just don't think we have enough info to know if this is worse than the flu or not yet in the US. It may well be worse than the flu in other countries.
We just have not done enough tests to know. Possibly it is more deadly than the flu, a lot more deadly than most coronaviruses and less deadly than the SARS coronavirus.
When we have rapid coronavirus tests, we will know a lot more because we can test a lot more people.
For example, in my hospital we are testing very few people. Anyone who could have another reason for their illness will not be tested. Meanwhile, we test everyone with any symptom for the flu. We have had another person die from the flu in the past couple of weeks, and also a very sick one that might die tonight.

Around 600,000 covid tests in the U.S. so far. Meanwhile, every doctor's office can test for flu, and normally well over a million tests are run yearly (a couple years ago, around 1.2 million).

Quote:
Influenza viruses cause a substantial burden of illness each year in the United States, estimated at 9.2–35.6 million cases of infection, 4.3–16.7 million clinic visits, 140,000–710,000 hospitalizations, and 12,000–56,000 deaths.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038762/

I highly suspect the number of cases with a disease that seems as highly contagious as the flu must be much higher than what test results have shown us so far.
It is my opinion that if the news tracked the flu cases in the same way they are tracking the Covid, people would be as worried and panicked about the flu. Imagine when they told us the deaths for the year had gone over 30,000, or how many people were on ventilators, or when the infection rate reached 15 million. Yet we do not care about it. Not really. To me it seems somewhat selective to be so worried about this new virus and not about the flu.

But it does make me wonder if the world is now going to have an issue over every new outbreak of disease. I am hopeful that will not be the case. Something I think about is that we know social isolation is unhealthy if it goes on for very long. Some people have families but some do not. My M-I-L ended up isolating herself at home due to mental illness and it made her illness much worse. She is in a nursing home now and doing much better. She is funny though, her reason for isolating herself was fear of chemicals, and she is irrationally not worried about catching any disease but is quite worried about the chemicals that will be used by staff at the nursing home, in particular she has a fear of hand sanitizer. The staff have to lie and tell her they do not use it around her.

Another one I thought was funny was that DH's grandmother called me yesterday, she is in her 90s and she wanted to talk to a nurse. She said she had heard she should not get together with her friends and should wash her hands, and she wanted to know if that was true. Somehow she was just now hearing about all of this, even though she does have a TV. Luckily she only has been going to the grocery store across the road recently.

Back to horses, I did something stupid yesterday. Hero was being a little wild and hopping around, rearing on the lead. I let him loose to run 100 yards or so toward the barn, which I do sometimes and really shouldn't. He always stays near the herd, and the barn is quite far from roads, but you never know. Anyway, he ran over to another gelding's pen, spun around and kicked the metal gate super hard. Then he started lifting and shaking that leg for a while, and favoring it. I worried he might have damaged something, but he was walking on it somewhat OK when I left. Today he seemed normal, so maybe such a hard kick just made the bones or joints sore. I'll have to avoid letting him right next to those geldings he wants to mess with.
He has been his usual crazy and goofy self most of the time but very mellow under saddle lately, so that's great. I've been trying to reinforce that idea with lots of relaxed walking.

I'm experimenting with filling the tiny cracks in Amore's hooves where I suspect some WLD is hiding with No Thrush powder. I've been scrubbing the hooves, then when it wasn't satisfying me that I was getting in the cracks I was using Vetericyn. I could go through a $30 spray bottle in a few days so decided I better try the No Thrush. I believe it is not rough on live tissue like the Thrush Buster and some others might be. I was trying Thrush Buster but the cracks did not seem to be filling in.
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