OG doc. AMA on COVID-19

Doc, I regularly (sometimes multiple times a day) use a neti pot to flush out my sinuses with salt water.  It has had a very beneficial impact on my seasonal allergies, I have not had a respiratory illness (to which I have historically been prone) in a long time.  Is this advisable or contraindicated?

Kwang - 

Didn't read the entire thread.


What is the typical treatment if you get diagnosed? 


Depends on what your docs believe in and where you live.

In the US, most treatments are considered entirely supportive. IV Fluids, tylenol, oxygen if necessary. If you become really sick, you might be given chloroquine +/- remdesivir.

Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 


my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

youarewhatiswrong - 

Doc, I regularly (sometimes multiple times a day) use a neti pot to flush out my sinuses with salt water.  It has had a very beneficial impact on my seasonal allergies, I have not had a respiratory illness (to which I have historically been prone) in a long time.  Is this advisable or contraindicated?


Neither. This has never shown to decrease your likelihood of catching the flu. It definitely helps for many other things (including allergies) and clearing your sinuses and clearing mild sinusitis, but no data on COVID. So carry on :)

southcraw -
ons ear - Those of you with older and very "at risk" parents or friends, what precautions are you taking? Are you letting them go anywhere or just to certain places where they will run into very few people? My mother is 72 and has heart problems and we aren't letting her do much of anything aside from go to the local post office..grocery shopping is off limits and she's mostly fine with this

Am I going overboard with these precautions or should we take even more?wjat would those be exactly? Anyone else in the same boat?

Post office seems scetch to me.


 


manority of people lick envelopes still. It’s why my brothers courthouse job makes me nervous for him

Somone who works at a courthouse in California was  (allegedly) the first respoted case in one of their counties. I'd definitely take precautions working in any job where you are interacting with large groups. 

mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 


my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.


Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

Jump Kick -
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 


my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.


Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

The assumption is that aerosolization (excretion of infectious particles in the air) is mainly and perhaps only caused by sneezing, coughing, spitting or other abrupt airflow disturbances like tracheal suction.


There’s evidence that virus aerosol particles can linger in the air for a few hours, and they were demonstrated in air samples from Wuhan ICUs and restrooms. But no evidence that this can be caused to a significant degree by just breathing.


However, this early on, no evidence does not necessarily mean a lot. Besides, droplets can be spread on surfaces without coughing etc. from infected persons without symptoms (preliminary studies suggest asymptomatic rates of 50-60% of all cases!!) and is probably a lot more contagious, so don’t wait for coughs before taking distancing precautions.


 

If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?




this guy who has Coronavirus has gone viral with his experience. He’s type 1 diabetic.

BigJohnSTEWD - If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?





Ideally, try to have that person alone at home.

If that's not possible, wash hands regularly, keep your distances (at least 6 feet), minimize the time being in the same room, keep that person confined to 1-2 room (and let that person to their own bathroom).

Job Security -
Jump Kick -
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 


my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.


Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

The assumption is that aerosolization (excretion of infectious particles in the air) is mainly and perhaps only caused by sneezing, coughing, spitting or other abrupt airflow disturbances like tracheal suction.


There’s evidence that virus aerosol particles can linger in the air for a few hours, and they were demonstrated in air samples from Wuhan ICUs and restrooms. But no evidence that this can be caused to a significant degree by just breathing.


However, this early on, no evidence does not necessarily mean a lot. Besides, droplets can be spread on surfaces without coughing etc. from infected persons without symptoms (preliminary studies suggest asymptomatic rates of 50-60% of all cases!!) and is probably a lot more contagious, so don’t wait for coughs before taking distancing precautions.


 

I think this paper is right up your alley. Chances are you already came across this 


 


https://science.sciencemag.org/content/early/2020/03/13/science.abb3221

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?

Sandy Pantz - 

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?


Hydroxychloroquine should work if chloroquine does. And has a much better safety profile. It's being studied in a trial.

https://clinicaltrials.gov/ct2/show/NCT04307693

I do think this a STUPID trial. You're unlikely to die in mild COVID infections. And notice the bogus primary outcome.

1 Like

mataleo1 -
Sandy Pantz - 

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?


Hydroxychloroquine should work if chloroquine does. And has a much better safety profile. It's being studied in a trial.

https://clinicaltrials.gov/ct2/show/NCT04307693

I do think this a STUPID trial. You're unlikely to die in mild COVID infections. And notice the bogus primary outcome.

Thanks!

BigJohnSTEWD - If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?




Safest option is probably isolation on a separate floor/outhouse/trailer/tent with separate bathroom/kitchen facilities from rest of household. If you don’t have vulnerable individuals in household, probably not worth it. Simpler, less strict distancing measures may be effective also (hand-hygiene, masks/PPE etc).

It sucks working in health care because hospitals won’t close down. I can’t stay home and keep my baby away from day care. 
 

we’ve had a few patients test positive, I’m just concerned those nurses or doctors that were exposed to the patients could potentially spread something to their kids.

Trump/Pence in tv now talking about buying a "massive" about of ventilators and about setting up "MASH"like field hospitals.

 

Saw a stat recently about best guess for the # of vents in the US at 64,000.

 

mataleo1 -
In Limbo - 
NoNeed4aScreenName - 
The_Pundits_Ghost -

Just saw this online. Im guessing you would agree with this statement?

https://www.instagram.com/p/B9pNnGonB-E/

Theres also some fear mongering going in the same manner as the old email forwards. 

SIft through the disinformation

i personally spoke with Drs. and Nurses that work in some of NYC's most well known, public hospitals

..Bellevue Hospital (the flagship hospital of NYC....LAw & Order SVU always has seens there and about Bellevue hospital) emergency room, which is normally ocnsidered crazy, is beyond crazy at this point

there are so many people, that hallways are crowded, cops are sent in for crowd control and they are supposedly starting to set up tent screening centers outside on the city block

NY pres and methodist hospital is experiencing a severe shortage of surgical and protective masks, gloves, swabs, goggles, etc......and are prioritizing who they hand them out to....meaning  many staff who normally wear masks and gloves, may not have them at this time

it is very real, and the stress and panic you hear form the nurses and doctors working within those confines is very palpable

Thank you for reporting this and, no, this is not exaggerated in the slightest.

gov cuomo and trump working ahnd in hand, with no bullshit politics....to have the army corps of engineers come in to renovate, expand, existing hospitals and to build some off site medical centers all throughout NYC and NY parts of NY

the employees have been pleading and begging for measures liek this and thankfully there is a response

Someone please post:

https://youtu.be/zfjcEiW-Rzc

I've just left work early, on my way to pick up my daughter because the school has informed me she is coughing a lot. 

I don’t want to give in to panic but she is under 3 and we've just had report of a newborn born eith CODVID 19. Not sure at that stage if this was in utero or a possible virus mutation which will now affect kids.

 

OP, please share your wisdom.