Hello guys,
I am not one to immediately fan the flames of conspiracies, but I still permit the possibility for their occurence if palpable evidence arises…
Exhibit A?
https://www.theguardian.com/politics/2020/mar/26/gordon-brown-calls-for-global-government-to-tackle-coronavirus
The temporary seems suspect when delivered by a politician.
May your gardens be deemed grandiose in the Summer sun,
Bren
thanks. Is there some way for people without TVs to watch this later on the internet?
I don’t see where to start a new forum topic on my phone, so sharing here. From a fellow alum in my nationwide business school network:
——One of my firm’s portfolio companies (www.ID.me) launched a shared workspace in partnership with slack exclusively for healthcare providers (doctors, nurses, etc.) so they can share best practices on the pandemic. In the first few days they have over 1,500 healthcare professionals sharing info/best practices. Thought it would be useful to this topic and vice-versa. Please share with healthcare professionals.
Workspace: https://covid.slack.com/
Article on the effort: https://insights.id.me/press/id-me-launches-covid-19-real-time-collaboration-workspace-on-slack/
Jim H,
Thank you, I just finished watching that Medcram video. A week ago I watched on Youtube a two part series on fever from Dr. John Campbell. I know some people have commented here that they don’t watch him much after he hadn’t vetted someone… But putting the Medcram video together with Campbell’s two videos in which he breaks down the body’s natural and deliberate process, using a fever as a defense mechanism. He went through pyrexia(another word for fever), cytokines, hypothalamus, pyrogens, shivering, interferons, anti-viral enzymes, lymphocytes, antibodies, phagocytes, neutrophils, monocytes, macrophages, etc. and all need pyrexial temperatures to occur more efficiently and quickly. Putting them together I’m definitely leaning towards not taking advil, tylenol, etc.
“Reducing fever, good or bad”:
https://www.youtube.com/watch?v=gJqSdmNNwW4
“Reducing fever, part 2”:
https://www.youtube.com/watch?v=rDijpnCOoFc
Linda
I would try Youtube first. Last week when both the mayor of Portland Oregon & the governor had a press conference, I found it on Youtube, I don’t remember but maybe half an hour or one hour later?
Linda
Linda, it sounds like you dehydrate the way my mother always did!
I also have the Excaliber. Love it. But I don’t dehydrate veggies so much - I don’t particularly care for dried/reconstituted vegetables, and I have enough (from mom - they were always included in birthday and Christmas packages!) for a couple apocalypses. But I make lots of jerky and fruit leathers.
I just watched this video and shared it on Facebook. Excellent contribution to our discussion here. Thanks!
VT Gothic,
I understand, and with experimentation (for me) I discovered the trick is to rehydrate them and give them plenty of time stewing in a crockpot long enough (especially squash), or on the stove.
Linda
From a Scientific American article:
Most public health experts agree that the general public should not routinely wear facemasks. It’s not helpful...Sheesh! No examination of the arguments at all, though the article, to be fair, was not specifically about the efficacy of face masks.
I am so tired of hearing how the CFR is on this. Now they are citing what I stated would be our best sample. The diamond princess. However, I am positive they are hiding deaths from that. Because virtual all of the deaths were reported almost in the first week after they were released. AND the course of illness is much longer. If they are not hiding it, Then it is as I stated in about 5 other posts. These people are celebrity status, all the stops will be pulled out for treatment and with exceptional treatment , i believe - the CFR is only 1%. But without treatment , you have something like 10-15%… I am not sure these people understand - medically assisted disease CFR and no interaction CFR. I want to see all the people who were infected on the DP and how many were hospitalized… As we know this is 1% with the flu// So… are you telling me that the DP hospitalization rate was 7 people ? yeah we have 10 dead./ so how is this not in itself 15 times the flu? And that is with exceptional infront of media and world healthcare… What happens with no hospital intervention… I’d bet there were at least 25% if not 35% of the DP that were hospitalized./ please share those simple numbers that are available… Why are they not provided? can anyone see if they can get this?
Yes, when i bought mine - nothing but reviews and pictures with their pot plants. It seems that only people need these if growing pot. Like you cant need to grow stuff because of lack of sun… which I have where I am in the armpit of US - with the gulf rain maker. Also, I have tried some potted tomatoes on my deck… where i would move them to shoot through the clouds and little sun… but the squirrels and raccoons would roll those just before they were ready to pick… So, its indoor for me – or no food.
I like seeing the discussion about container gardening, although I have heard that you need to be careful what kind of plastic you use to plant food in, because certain plastics leech chemicals into the soil and the plant. Any thoughts on which types of plastic buckets to use or avoid? I assume food grade plastic buckets are ok, the kind you use for storage would also be ok to plant in. I’ve never planted in plastic buckets, but I have used galvanized stainless steel garbage cans filled with soil and compost, so as to have less bending over and room for deep roots. Not as easy to move, though.
Its very sad what is happening in Italy, This, I am sure is beginning to happen in the US…
Its very sad-- please read.
https://www.reuters.com/article/us-health-coronavirus-italy-ethics-speci/special-report-all-is-well-in-italy-triage-and-lies-for-virus-patients-idUSKBN2133KG
NPR had an article on the lack of Germany numbers which implied that the low numbers are the result of very early and aggressive testing. Something like 120,000 a week. Wow that’s how to do it.
I did suspect one thing. Apparently each of the federal regions in Germany have independent health jurisdiction. No CDC level group, so the reaction has been different fro each region. I wonder has this fractured nature affects reporting.
https://www.npr.org/2020/03/25/820595489/why-germanys-coronavirus-death-rate-is-far-lower-than-in-other-countries
I’ll tell you what, all those that say its nothing, just the flu, step forward for inoculation, bring your whole family, and sign that you will not take my antibiotics, saline IV, hospital bed, vent, etc… - u should have no issue, its just a flu… it doesnt kill healthy normal people
I didn’t think my prediction would come true this quickly. It’s not even the weekend yet.
Fear not, all is well. The stock market is telling us so. Nothing to worry about here. Record unemployment claims but the market rejoices. We live in an age of ignorance and insanity.
Sent to me by another ER doc in Richmond, VA.
I am an ER MD in New Orleans. Class of 98. Every one of my colleagues have now seen several hundred Covid 19 patients and this is what I think I know. Clinical course is predictable. 2-11 days after exposure (day 5 on average) flu like symptoms start. Common are fever, headache, dry cough, myalgias (back pain), nausea without vomiting, abdominal discomfort with some diarrhea, loss of smell, anorexia, fatigue. Day 5 of symptoms- increased SOB, and bilateral viral pneumonia from direct viral damage to lung parenchyma. Day 10- Cytokine storm leading to acute ARDS and multi-system organ failure. You can literally watch it happen in a matter of hours.
-
81% mild symptoms,
----------- Jim H and MarkM posted the second part of this essay already. But I'll do it again as stuff is hard to find in these threads. -----------Patient presentation is varied. Patients are coming in hypoxic (even 75%) without dyspnea. [This is very unusual!] I have seen Covid patients present with encephalopathy, renal failure from dehydration, DKA. I have seen the bilateral interstitial pneumonia on the xray of the asymptomatic shoulder dislocation or on the CT's of the (respiratory) asymptomatic polytrauma patient. Essentially if they are in my ER, they have it. Seen three positive flu swabs in 2 weeks and all three had Covid 19 as well. Somehow this *** has told all other disease processes to get out of town. China reported 15% cardiac involvement. I have seen covid 19 patients present with myocarditis, pericarditis, new onset Heart Failure and new onset atrial fibrillation. I still order a troponin, but no cardiologist will treat no matter what the number in a suspected Covid 19 patient. Even our non covid 19 STEMIs at all of our facilities are getting TPA in the ED and rescue PCI at 60 minutes only if TPA fails. Diagnostic CXR- bilateral interstitial pneumonia (anecdotally starts most often in the RLL so bilateral on CXR is not required). The hypoxia does not correlate with the CXR findings. Their lungs do not sound bad. Keep your stethoscope in your pocket and evaluate with your eyes and pulse ox. Labs- WBC low, Lymphocytes low [lymphopenia], platelets lower then their normal, Procalcitonin [a marker of bacterial infection] is normal in 95% CRP and Ferritin elevated most often. CPK, D-Dimer, LDH, Alk Phos /AST/ALT commonly elevated. Notice D-Dimer- I would be very careful about CT PE these patients for their hypoxia. The patients receiving IV contrast are going into renal failure and on the vent sooner. Basically, if you have a bilateral pneumonia with normal to low WBC, lymphopenia, normal procalcitonin, elevated CRP and ferritin- you have covid-19 and do not need a nasal swab to tell you that. [SP note--So you can see here how the statistics will be far lower than the actual cases as PCR testing is being skipped much of the time now.] A ratio of absolute neutrophil count to absolute lymphocyte count greater than 3.5 may be the highest predictor of poor outcome. The UK is automatically intubating these patients for expected outcomes regardless of their clinical presentation. [SP--Normally the neutrophils and lymphocytes are about equal in number. So this ratio >3.5 says the lymphocyte count is REALLY really low.] An elevated Interleukin-6 (IL6) is an indicator of their cytokine storm. If this is elevated watch these patients closely with both eyes. Other factors that appear to be predictive of poor outcomes are thrombocytopenia [low platelet counts] and liver function tests [LFTs] 5x upper limit of normal. Disposition I had never discharged multifocal pneumonia before. Now I personally do it 12-15 times a shift. 2 weeks ago we were admitting anyone who needed supplemental oxygen. Now we are discharging with oxygen if the patient is comfortable and oxygenating above 92% on nasal cannula. We have contracted with a company that sends a paramedic to their home twice daily to check on them and record a pulse ox. We know many of these patients will bounce back but if it saves a bed for a day we have accomplished something. Obviously we are fearful some won't make it back. We are a small community hospital. Our 22 bed ICU and now a 4 bed Endoscopy suite are all Covid 19. All of these patients are intubated except one. 75% of our floor beds have been cohorted into covid 19 wards and are full. We are averaging 4 rescue intubations a day on the floor. We now have 9 vented patients being "held" in our ER transferred down from the floor after intubation [because there are no critical care beds for them]. Luckily we are part of a larger hospital group. Our main teaching hospital repurposed space to open 50 new Covid 19 ICU beds this past Sunday so these numbers are with significant decompression. Today those 50 beds are full. They are opening 30 more by Friday. But even with the "lockdown", our AI models are expecting a 200-400% increase in covid 19 patients by 4/4/2020.
- 14% severe symptoms requiring hospitalization,
- 5% critical.
Treatment Supportive worldwide 86% of covid 19 patients that go on a vent die. Seattle reporting 70%. Our hospital has had 5 deaths and one patient who was extubated. Extubation happens on day 10 per the Chinese and day 11 per Seattle. Plaquenil which has weak ACE2 blockade doesn't appear to be a savior of any kind in our patient population. Theoretically, it may have some prophylactic properties but so far it is difficult to see the benefit to our hospitalized patients, but we are using it and the studies will tell. With Plaquenil's potential QT prolongation and liver toxic effects (both particularly problematic in covid 19 patients), I am not longer selectively prescribing this medication as I stated on a previous post. We are also using Azithromycin, but are intermittently running out of IV. Do not give these patient's standard sepsis fluid resuscitation. Be very judicious with the IV fluids [commonly given for sepsis] as it hastens their respiratory decompensation. Outside the DKA and renal failure dehydration, leave them dry. Proning vented patients significantly helps oxygenation. Even self proning the ones on nasal cannula helps. [Have people lie face down.] Vent settings- Usual ARDS stuff, low volume, permissive hypercapnia, etc. Except for Peep of 5 will not do. Start at PEEP of 14 and you may go up to 25 if needed. Do not use BiPAP- it does not work well and is a significant exposure risk with high levels of aerosolized virus to you and your staff. Even after a cough or sneeze this virus can aerosolize up to 3 hours. Do not use nebulizer treatments. Use MDI. you can give 8-10 puffs at one time of an albuterol MDI. Use only if wheezing which isn't often with covid 19. If you have to give a nebulizer must be in a negative pressure room; and if you can, instruct the patient on how to start it after you leave the room. Do not use steroids, it makes this worse. Push out to your urgent cares to stop their usual practice of steroid shots for their URI/bronchitis. We are currently out of Versed, Fentanyl, and intermittently Propofol. Get the dosing of Precedex and Nimbex back in your heads. One of my colleagues who is a 31 yo old female who graduated residency last May with no health problems and normal BMI is out with the symptoms and an SaO2 of 92%. She will be the first of many. I PPE best I have. I do wear a MaxAir PAPR the entire shift. I do not take it off to eat or drink during the shift. I undress in the garage and go straight to the shower. My wife and kids fled to her parents outside Hattiesburg. The stress and exposure at work coupled with the isolation at home is trying. Everyone is scared; patients and employees. But we are the leaders of that emergency room. Be nice to your nurses and staff. Show by example how to tackle this crisis head on. Good luck to us all."
Unfortunately, it’s also wonderful for not-so-neighborly neighbors or “visitors” who may come along, in the bucket gardener’s absence, and “transplant” your garden into their garden. I can foresee a scenario where this occurs.
Czech Republic citizens all wear masks - and that is good. My question is - when will they be able to not wear masks?
I see this: Boarders are Locked or Everyone in the country (at all times) wear masks until the curve is flaten.
Those remaining with the virus recover or die. The virus is defeated.
If the country allows citizens to put away the masks - the Coronavirus needs to be defeated or they risk reintroduction of the virus and a repeat of the process to flatten the curve for round 2, round 3 etc. – is that right?
If this is the pattern until a vaccine is developed, until a cure for the virus is found or as your graph showed in previous videos (the one with the bouncing balls)… we all get exposed at some time and develop immunity to the virus but that only comes from exposure, right? Or would that also be achieved by vaccine?
So I am thankful for Czech Republic and their proactive steps to protect their people. They are leading the Westernern world with wearing masks. When will they be able to not wear the masks? Just wondering.
Granted, it is beast to reduce the number of exposures and sickness - no argument. I think we will wear masks for a long time…