OG doc. AMA on COVID-19

GrindOnLine -
jcblass - Someone please post:

 

 


Uhm. I don’t agree with most of that. I wish I could though.


Most of all the comparison of deaths to Influenza, which has been in circulation/season for half a year. Covid19 has been been in circulation in Europe/USA for what? 1 month? With early data suggesting an avg. time from infection to death (if death occurs) of 4 weeks. With all pandemics/contagious diseases like this, you must expect exponential growth in infected, sick and dead. Covid19 hasn’t had time to climb up the exponential slope yet. Compare it to influenza in 6 months, and hopefully it’s overblown, but all early indicators suggest this has much deadlier properties - and hoping that it respects seasons like the flu is optimistic, and so far, not convincing.


Edit: he’s right that media-induced panic and blame is the enemy of the good here, but going about one’ s business is what Italy did for a few weeks too long.

Job Security - 
GrindOnLine -
jcblass - Someone please post:

 

 


Uhm. I don’t agree with most of that. I wish I could though.


Most of all the comparison of deaths to Influenza, which has been in circulation/season for half a year. Covid19 has been been in circulation in Europe/USA for what? 1 month? With early data suggesting an avg. time from infection to death (if death occurs) of 4 weeks. With all pandemics/contagious diseases like this, you must expect exponential growth in infected, sick and dead. Covid19 hasn’t had time to climb up the exponential slope yet. Compare it to influenza in 6 months, and hopefully it’s overblown, but all early indicators suggest this has much deadlier properties - and hoping that it respects seasons like the flu is optimistic, and so far, not convincing.


Edit: he’s right that media-induced panic and blame is the enemy of the good here, but going about one’ s business is what Italy did for a few weeks too long.


AGREED Completely.

All indicators are suggesting this is something vastly different from the flu. Propagation, Virulence, Outcomes, Length of symptoms.

Talk to people from China, Italy, Spain and they'll tell why it resembles nothing like the flu. I've been practicing for a while and we deal with a flu season every year and i've never seen anything like this.

Dr. Drew is reprehensible. He claims the media is full of shit and then propagates misinformation himself. Dude should shut the fuck up.

1 Like

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.


 

Thank you.


once the dust settles (or even before) will there be a way to test if you had this in the past? Is there any indication that you build an immunity once you get it?

Jump Kick - 
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.


 

Thank you.


once the dust settles (or even before) will there be a way to test if you had this in the past? Is there any indication that you build an immunity once you get it?


Most people that get COVID do get protective antibodies (or antibodies at least) which show you've been exposed. However, it may not protect you from re-infection if it's mutated (or other factors)

that audio of dr. drew pinsky directly controverts what the cdc and dr fauci said today in the presidential address on this matter.

 

So how long will this likely last for? Impossible to speculate, but what estimates are we looking at?

Uhtred Ragnarson - 

So how long will this likely last for? Impossible to speculate, but what estimates are we looking at?


Assuming we could isolate every American in a separate room: 12-14 days.

Since there is still some movement from and to the US, and because isolation techniques are not in place, at least 4 weeks, most likely 2 months. This is dependent on many factors and may not be correct ultimately.

HillboFrateTrane -
Barry_BondsMVP -

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.

Kids are safe, dude. Zero deaths 9 and under worldwide. Very low mortality 10-20. 

Still wouldn’t want to take that chance. I think the point is to isolate this virus. Who wants to see their kid get sick anyways? I understand and know kids get sick at day care etc 

What can people (especially elderly, thinking of our parents) take in terms vitamins or natural foods to boost their immune system so they can be as resilient as possible to deal with the infection if they do get infected with the virus?

I've heard high levels of vitamin c and d are helpful but I'm not sure how legit that is.

BJ Penn Forever - 

What can people (especially elderly, thinking of our parents) take in terms vitamins or natural foods to boost their immune system so they can be as resilient as possible to deal with the infection if they do get infected with the virus?

I've heard high levels of vitamin c and d are helpful but I'm not sure how legit that is.


This has been discussed earlier:

Essentially:
-Nothing proven to work
-Your best bet is to be healthy: athletic, good weight, no chronic diseases, don't smoke, good diet, sleep.
-There are millions of supplements that have claims to boost the immune system: zinc, vit C, selenium, Echinacea but they are unproven aside from some data suggesting they help shorten the length of the common cold.
-Watch out what you take. Mega doses of Vit C should be ok. Mega doses of Vit D and you can die

mataleo1 -
BJ Penn Forever - 

What can people (especially elderly, thinking of our parents) take in terms vitamins or natural foods to boost their immune system so they can be as resilient as possible to deal with the infection if they do get infected with the virus?

I've heard high levels of vitamin c and d are helpful but I'm not sure how legit that is.


This has been discussed earlier:

Essentially:
-Nothing proven to work
-Your best bet is to be healthy: athletic, good weight, no chronic diseases, don't smoke, good diet, sleep.
-There are millions of supplements that have claims to boost the immune system: zinc, vit C, selenium, Echinacea but they are unproven aside from some data suggesting they help shorten the length of the common cold.
-Watch out what you take. Mega doses of Vit C should be ok. Mega doses of Vit D and you can die

Got it thanks. Yeah I won't be taking mega doses of D or talking my mom into it but I am gonna get her to eat more dark greens and some oranges.

mataleo1 -
GrindOnLine - 

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.


Serious complications of COVID are very unlikely in kids and deaths almost unheard of. If she has it, she'll be sick, but it very likely won't go anywhere. Thoughts are with you. Keep other members safe, you included.

Thanks mate.

ok, Doc, now ill ask for some advice/opinion for my personal situatiuon

 

i run a small office of 4-5 people these days

each of us is in our own separate room with doors and w e co not have any clietns of visitors coming in as of last Friday

 

with that we still interact with each other to a degree, handing over files and relaying msgs to each other

shyould I completely shut down my office and have the employees work from home?  they are insistent on working and dont mind

 

would stagerring employee work time to only have 2 people in the office be a viable idea?

In Limbo - 

ok, Doc, now ill ask for some advice/opinion for my personal situatiuon


 


i run a small office of 4-5 people these days


each of us is in our own separate room with doors and w e co not have any clietns of visitors coming in as of last Friday


 


with that we still interact with each other to a degree, handing over files and relaying msgs to each other


shyould I completely shut down my office and have the employees work from home?  they are insistent on working and dont mind


 


would stagerring employee work time to only have 2 people in the office be a viable idea?


I can only tell you what I've been told by people who do this thing for a living (it's not my area of expertise).

At this point, if you live in the US, you should consider shutting down the office especially if that work can be done from home. The risk to your employees seem minimal (not many employees, good isolation from one another) but there are too many unknowns at this point to take a risk.

Number of admitted covid-19 patients and ICU patients just doubled in the last 24 hours here. Parliament is putting newly epidemiology law amendments to use: Pretty much everything that wasn’t shut down is getting shot down, except grocery shopping and medical purposes, with strict hygienic requirements. Junior Doctors are getting moved from GP to hospitals and vacation/leave is getting cancelled. Even the queen is due to go on TV to adress the nation tonight.

About 3 weeks after the first imported cases here, it seems it’s time to tuck the chin and bite down on the mouth piece for a while.

Job Security -

Number of admitted covid-19 patients and ICU patients just doubled in the last 24 hours here. Parliament is putting newly epidemiology law amendments to use: Pretty much everything that wasn’t shut down is getting shot down, except grocery shopping and medical purposes, with strict hygienic requirements. Junior Doctors are getting moved from GP to hospitals and vacation/leave is getting cancelled. Even the queen is due to go on TV to adress the nation tonight.


About 3 weeks after the first imported cases here, it seems it’s time to tuck the chin and bite down on the mouth piece for a while.

On the worldometers site is says that there are only roughly 45 serious or critical conditions. 


 


Are there other publicly available stats?

Job Security-
"About 3 weeks after the first imported cases here, it seems it's time to tuck the chin and bite down on the mouth piece for a while."

Your last sentence sums this whole mess up quite damn well, that is indeed where we are at with this.

NoNeed4aScreenName -
Job Security -

Number of admitted covid-19 patients and ICU patients just doubled in the last 24 hours here. Parliament is putting newly epidemiology law amendments to use: Pretty much everything that wasn’t shut down is getting shot down, except grocery shopping and medical purposes, with strict hygienic requirements. Junior Doctors are getting moved from GP to hospitals and vacation/leave is getting cancelled. Even the queen is due to go on TV to adress the nation tonight.


About 3 weeks after the first imported cases here, it seems it’s time to tuck the chin and bite down on the mouth piece for a while.

On the worldometers site is says that there are only roughly 45 serious or critical conditions. 


 


Are there other publicly available stats?

82 inpatient. 18 ICU/tubed.


Only available in danish afaik. These numbers/graphs should be interpreted in the context of the Danish healthcare system though. Compared to a lot of other countries, more severely ill patient are cared for at a seemingly lower level of care; i.e. a lot are tended through “iv-treatment-at-home” if at all possible with home visits. And transfer to ICU is pretty much only when need of intubation, as a most low-level ICU-treatments, e.g. non-invasive ventilation, is usually done in non-ICU units. So the numbers probably look a bit better than in reality if you compare them to other countries.


And testing strategy was changed on March 13 to only test those with symptom severity warranting hospital admittance, so you can’t compare infected cases before/after that date.


https://www.sst.dk/da/Viden/Smitsomme-sygdomme/Smitsomme-sygdomme-A-AA/Coronavirus/Spoergsmaal-og-svar

Dryfly - Job Security-
"About 3 weeks after the first imported cases here, it seems it's time to tuck the chin and bite down on the mouth piece for a while."
 
Your last sentence sums this whole mess up quite damn well, that is indeed where we are at with this.

Yeah. Like mataleo put it... it feels so damn eery, because it’s quite, but you know the clock is ticking on the incubation period and noone knows how many are infected out in the population.

Feels like the episode of GoT where the Night King marches on the wall and you wait for shit to hit the fan.

edit: Just to clarify. I don’t want to fearmonger.  I’m not scared for my safety, and only slightly worried  about the safety of my older family members. I’m scared that my colleagues and I won’t be able to provide the care and treatment that patients will need in the next weeks, whether sick from covid-19 or something else. And what that will entail.