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Corona Virus Public Service Announcement, stay home if you are older

Corona Virus Public Service Announcement, stay home if you are older

andy.connor.e | March 9, 2020

Not sure why you're telling me to not follow Trump as if that was ever a valid decision to begin with. I would not go to the president for health info for starters. Boosting the immune system could help, especially for those who are susceptible like myself. Does it "work"? Probably not a valid statement. Look at it more of a lowering your chance of getting sick.

Neomaxizoomdweebie | March 9, 2020

A MAGA hatter at the NIH conducted this study...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314618/

derotam | March 9, 2020

@SCCRENDO: Can you point me to the scientific statistically relevant analysis that says the mortality rate for COVID-19 is less than the Flu's what .7%?

SCCRENDO | March 9, 2020

My suggestion not to follow Trump was a general suggestion. There is a tendency for people to believe their President. But not wise at this time. Andy I posted a 20 min video. That will give you a good perspective and tell you what you should do with having to do anything stupid that is a waste of time

SCCRENDO | March 9, 2020

Here is the video link again
https://www.youtube.com/watch?v=LH-8zhCgxtQ

derotam | March 9, 2020

@SCCRENDO: Thanks for a video that does not give what I specifically asked for.

Neomaxizoomdweebie | March 9, 2020

It is a good video, SCCRENDO, but yours is not the final and only answer. I cannot fathom why you would seek to stand in the way of people educating themselves on ways to better armor their bodies against infection. Using your identity politics to shoot down ideas that are thousands of years old and proven to be healthful is immoral at best.

andy.connor.e | March 9, 2020

The video does not really have anything to do with boosting your immune system. Its good, but it focuses on transmission of the virus.

derotam | March 9, 2020

And since you wanted to point to statements from a random doctor, here are some statements from the WHO

"Mortality for COVID-19 appears higher than for influenza, especially seasonal influenza"

"data we have so far indicate that the crude mortality ratio (the number of reported deaths divided by the reported cases) is between 3-4%"

"For seasonal influenza, mortality is usually well below 0.1%"

Look, I completely understand that as time goes on, and as infections are better diagnosed we will get a better handle on what the actual mortality rate is, but trying to just say "ohh it's less than the flu" with no bases is irresponsible in and of itself, just as saying something strictly to induce a panic.

sbeggs | March 9, 2020

Oh no Boomer

rxlawdude | March 9, 2020

@Neo, there's a long history of people like you with wonderful ideas to "arm yourself against [insert the latest disease outbreak]." They are called "Snake Oil Salesmen."

Neomaxizoomdweebie | March 9, 2020

How predictable. rxlawdude to the rescue. Keep pushing those drugs, rxdude. The sheeple are helpless without you.

andy.connor.e | March 9, 2020

That is a good try @rxlaw

andy.connor.e | March 9, 2020

Looks like NYC port authority has COVID. NYC going into lockdown sooner than later would be good for all regions between NYC, capital district, and boston. Millions of people travel that route.

SCCRENDO | March 9, 2020

@derotam. We do not know yhe mortality because we are not doing widespread testing. So we do not know how many asymptomatic cases there are. The 3-4% number is old data and the mortality does appear to be less. Older folk and those with diabetes etc are still at higher risk. The data from Wuhan gives a more reliable picture because it has been there for months and the incidence is dropping quite significantly
@rxlawdude. Well said. While it is not worth the energy picking fights with anti-science morons snake oil salesman are not always completely harmless, Thus they need to be called out. People will ultimately believe who they want to believe. Be it good sound medical advice or the "tantalizing" promises of a snake oil salesman.

jessicajameson29 | March 9, 2020

Hello, I hope all are happy. I'm new to this forum. I'm starting a business about a vehicle shipping company. Please guide me and support me.

andy.connor.e | March 9, 2020

I can guide you to the 'delete my account' page

WW_spb | March 9, 2020

Lol andy

Neomaxizoomdweebie | March 9, 2020

Funny that I’m being accused of selling snake oil because of talking up other peoples research on strengthening the immune system via fasting. The whole point of selling snake oil is the sale! There is no money to be made by me or anyone by convincing people to skip a few days of eating. SCCRENDO and rxlawdude on the other hand... those two stand to continue making a fortune through pushing their expensive potions...
I’ll take meds when I need them and not a minute sooner. Until that day I will continue living as healthy as possible through time tested dietary methods and exercise. Fake doctors and fake lawyers will continue making their insane quantities of money. Not much I can do about that on an electric car forum.

SCCRENDO | March 9, 2020

@neo. You are hallucinating on your magic mushrooms. I don’t see where @Rxlawdude and myself are making money. I have tried to provide information that the administration is not providing and provide sound advice. In contrast you have found a diet that seems to work for you. And you are trying to promote it as a potential solution to Corona virus. You are medically illiterate and trust me there is no scientific evidence that intermittent fasting will enhance anyone’s immunity to corona virus. Whether you make money or not, conning the public to partake in unproven therapies is snake oil. You may ask what is the harm even if it is useless. Well the harm is that people may believe you and not take appropriate precautions. Sadly you are trolling these fora looking for some relevance in your miserable little life. But believe me nobody here really cares what a MAGA hatter like you has to say. And I am quite happy to ignore you. But it is my social responsibility to let everyone know when people like you irresponsibly post information that could potentially harm anyone who believes you.

Neomaxizoomdweebie | March 9, 2020

Wash your hands. Don’t touch your face. Stay home if you are infirm.
That is all. Nothing else. Do not research anything. None of it is true even if studies have been done. They’re right wing fake studies. Very dangerous. Even though muslims fast all of the time, very dangerous. Socrates fasted all of the time, totally dangerous and caused his death (not hemlock).

Ross1 | March 9, 2020

Not my president.

A recent --6 years ago?--tour on The Nile (Egypt), they had a novel aircon system. Water is pumped from the Nile under the boat, a sewer really, and sprayed in fine droplets over the upper deck. That is, the passengers, the bar, the beer, the drinks, cocktails. Everything is sprayed with Nile to keep it cool. Egyptian Kool Aid.
Cool eh?

Neomaxizoomdweebie | March 9, 2020

“You are medically illiterate and trust me there is no scientific evidence that intermittent fasting will enhance anyone’s immunity to corona virus.”

You are 100% correct. There hasn’t yet been a double blind RCT on the novel Coronavirus vs fasting You got me there. Nobody has had time to do that one yet in the last month or two. We’re working in it, though. Be patient. Haha. Patient. No pun intended.
The classic argument of the doubting Thomas: There is no evidence that xyz is effective so don’t do it.
My reply: There is also no evidence that xyz is ineffective but plenty of evidence that it is safe. Now stand aside, I’m taking command of your stagnant mess.

WW_spb | March 10, 2020

Someone tell Fish to stay home... Shoot, does it mean he will post here more?

derotam | March 10, 2020

SCCRENDO | March 9, 2020 "The 3-4% number is old data and the mortality does appear to be less....The data from Wuhan gives a more reliable picture because it has been there for months and the incidence is dropping quite significantly"

Do you even look at data before you try and say anything? Let go ahead and look at the data YOU are attempting to use to make a statement about lower mortality rate...

Wuhan(Hubei, China)- 1/22/20 through 3/9/20... Here's the mortality rate from the 46 daily reported numbers for that location. https://imgur.com/a/ivNzcwE

In case you don't want to look at it here are the highlights. 1/22 - 3.8%, 2/22 - 3.6%, 3/9 - 4.44%

andy.connor.e | March 10, 2020

@Neo

I tried once to say that turmeric could possibly help reduce inflammation and i got immediately attacked saying i was telling people to stop taking their medicine. SCC's mind reads and interprets things differently than what the reality is when it comes to medicine.

Neomaxizoomdweebie | March 10, 2020

@andy,
Yeah, SCC is a real character. Its too bad how closed minded and institutionalized some doctors can be. I’m glad mine keeps an open mind and recognizes what my lifestyle changes have accomplished (without meds). Maybe SCC feels threatened if the “medically illiterate” figure a few things out for themselves.

SCCRENDO | March 10, 2020

@derotam. the 3-4% number is of confirmed cases. But there are many people who are infected but do not become ill. So the percentage of people who get the virus but do not die is far lower

derotam | March 10, 2020

@SCCRENDO: and yet you still make statements like these:

"The 3-4% number is old data and the mortality does appear to be less"

Prove it, where is the "appearance"? The current visual appearance is the JHU data using WHO, CDC and other sources.

"The data from Wuhan gives a more reliable picture because it has been there for months and the incidence is dropping quite significantly"

While the rise of confirmed cases has slowed, the number of deaths is rising out of proportion to the new confirmed cases, causing the recorded mortality rate to INCREASE.

derotam | March 10, 2020

With that said separately to stress the conflict in your statements with current EVIDENCE...

I agree that overall the mortality rate will PROBABLY end up less overall, specifically because as you said that there are an unknown number of unknown cases. How much less we don't know yet, it is all way to new to have any answers to that yet.

SCCRENDO | March 10, 2020

@derotam. If you look at my video at around 1:56 they showed the data from Wuhan, If you look at the graph there were multiples more asymptomatic cases vs symptomatic cases. The asymptomatic cases may be people who feels well or people who are sick yet diagnosed with other diseases initially. They have been extensive testing so they know how many are infected. We are not testing as much as we should here so we don't have the total numbers. While I agree both figures are important from a public health standpoint I think it is more important to know what percent of those infected will die.

TeslaTap.com | March 10, 2020

@SCCRENDO - Thanks for your reasoned thinking and finding the video. Great introduction and tips. Not sure why there is so much pushback trying to make the Pres look good. It's not a political issue. Valid science is needed to combat it, not hoaxes and blame.

derotam | March 10, 2020

@SCCRENDO, yes, the rate at which new confirmed cases has been dropping, that is not being disputed...but the number of deaths from the non-recovered confirmed cases is RISING.

According to the data on hand that has been reported, the mortality rate has been INCREASING.

My complaint is with your statement of "The 3-4% number is old data and the mortality does appear to be less" That statement is FALSE and NOT supported by current evidence.

derotam | March 10, 2020

Let me rephrase, your statement that mortality "APPEAR(s) TO BE LESS" is FALSE because there is no appearance of that based on the reported data.

rxlawdude | March 10, 2020

From a great post on TMC by user Highway2Heel:
My wife provided this update to me from the Infectious Disease Association of California (IDAC) Northern California Winter Symposium on Saturday 3/7. In attendance were physicians from Santa Clara, San Francisco and Orange Counties who had all seen and cared for COVID-19 patients, both returning travelers and community-acquired cases. Also present was the Chief of ID for Providence hospitals, who has 2 affected Seattle hospitals under his jurisdiction. Erin Epson, CDPH director of Hospital Acquired Infections, was also there to give updates on how CDPH and CDC are handling exposed health care workers, among other things. Below are some of the key take-aways from their experiences.

1. The most common presentation was one week prodrome of myaglias, malaise, cough, low grade fevers gradually leading to more severe trouble breathing in the second week of illness. It is an average of 8 days to development of dyspnea and average 9 days to onset of pneumonia/pneumonitis. It is not like Influenza, which has a classically sudden onset. Fever was not very prominent in several cases. The most consistently present lab finding was lymphopenia (with either leukocytosis or leukopenia). The most consistent radiographic finding was bilateral interstitial/ground glass infiltrates. Aside from that, the other markers (CRP, PCT) were not as consistent.

2. Co-infection rate with other respiratory viruses like Influenza or RSV is <=2%, interpret that to mean if you have a positive test for another respiratory virus, then you do not test for COVID-19. This is based on large dataset from China.

3. So far, there have been very few concurrent or subsequent bacterial infections, unlike Influenza where secondary bacterial infections are common and a large source of additional morbidity and mortality.

4. Patients with underlying cardiopulmonary disease seem to progress with variable rates to ARDS and acute respiratory failure requiring BiPAP then intubation. There may be a component of cardiomyopathy from direct viral infection as well. Intubation is considered “source control” equal to patient wearing a mask, greatly diminishing transmission risk. BiPAP is the opposite, and is an aerosol generating procedure and would require all going into the room to wear PAPRs.

5. To date, patients with severe disease are most all (excepting those whose families didn’t sign consent) getting Remdesivir from Gilead through compassionate use. However, the expectation is that avenue for getting the drug will likely close shortly. It will be expected that patients would have to enroll in either Gilead’s RCT (5 vs 10 days of Remdesivir) or the NIH’s “Adaptive” RCT (Remdesivir vs. Placebo). Others have tried Kaletra, but didn’t seem to be much benefit.

6. If our local MCHD lab ran out of test kits we could use Quest labs to test. Their test is 24-48 hour turn-around-time. Both Quest and ordering physician would be required to notify Public Health immediately with any positive results. Ordering physician would be responsible for coordinating with the Health Department regarding isolation. Presumably, this would only affect inpatients though since we (CHOMP) have decided not to collect specimens ordered by outpatient physicians.

7. At facilities that had significant numbers of exposed healthcare workers they did allow those with low and moderate risk exposures to return to work well before 14 days. Only HCW with highest risk exposures were excluded for almost the full 14 days (I think 9 days). After return to work, all wore surgical masks while at work until the 14 days period expired. All had temperature check and interview with employee health prior to start of work, also only until the end of the 14 days. Obviously, only asymptomatic individuals were allowed back.

8. Symptom onset is between 2-9 days post-exposure with median of 5 days. This is from a very large Chinese cohort.

9. Patients can shed RNA from 1-4 weeks after symptom resolution, but it is unknown if the presence of RNA equals presence of infectious virus. For now, COVID-19 patients are “cleared” of isolation once they have 2 consecutive negative RNA tests collected >24 hours apart.

10. All suggested ramping up alternatives to face-to-face visits, telemedicine, “car visits”, telephone consultation hotlines.

11. Sutter and other larger hospital systems are using a variety of alternative respiratory triage at the Emergency Departments.

12. Health Departments (CDPH and OCHD) state the Airborne Infection Isolation Room (AIIR) is the least important of all the suggested measures to reduce exposure. Contact and droplet isolation in a regular room is likely to be just as effective. One heavily affected hospital in San Jose area is placing all “undifferentiated pneumonia” patients not meeting criteria for COVID testing in contact+droplet isolation for 2-3 days while seeing how they respond to empiric treatment and awaiting additional results.

All PUIs in Monterey Country so far have been negative.

SCCRENDO | March 10, 2020

@Teslatap. This is the point I am trying to make. Nobody has all the answers.But I would look to the experts. The expert is Dr Anthony Fauci from the CDC. Unfortunately Trump only cares what this will do for his reelection, is ignorant and lies all the time. Sadly we have a bunch of MAGA hatters on this thread who are trying to boost their own sad little egos. While it is good to be tolerant of all opinions snake oils like paprika and intermittent fasting have nothing to do with Corona virus and can give people a false sense of security. Looking at the overall picture I believe we are now being over cautious. But that is good. I had booked for a trip to Israel for my nephew's wedding. But Israel now has a 2 week quarantine requirement for everyone entering the country. So I cancelled my trip. The annual endocrine society meeting in San Francisco at the end of the month was also cancelled. I am holding off booking any further travel for the moment. In my practice I am trying to limit contact. As an old fashioned physician I still examine patients. But I wash my hands well afterwards and ask my patients to do the same. In realty they are more likely to get Corona Virus from than me getting it from them.

SCCRENDO | March 10, 2020

@rxlawdude. Thanks for the info. Sounds correct.

Here is the financial perspective
https://www.cnbc.com/2020/03/10/morningstar-market-sell-off-is-a-gross-o...

Neomaxizoomdweebie | March 10, 2020

“Market sell-off is a ‘gross overreaction’ to a ‘severe but manageable flu,’ Morningstar says”
Sounds like something Trump said. I think it was the other headline SCC posted.
“ Trump's minimized view of the coronavirus crisis puts his re-election at risk”

jimglas | March 10, 2020
jimglas | March 10, 2020

Young, healthy PA ("low risk") that is having a rough go of Covid-19:
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html

SCCRENDO | March 10, 2020

They have upped the ante in our area today. 1st case at our hospital was in contact with multiple staff members prior to diagnosis. Many are now in quarantine. All staff who vacation in foreign countries on the list need to home quarantine for 2 weeks before returning to work. Our diabetic educators have to do phone consults and no more face to face. The airlines have been great and gave me full credit for my cancelled trips without penalty. In the absence of central leadership the local authorities are being over cautious. I personally prefer that they be overcautious than under cautious.

jimglas | March 10, 2020

new rochelle on full shutdown

SCCRENDO | March 10, 2020

Dear leader thinks that the Covid 19 tests all almost as perfect as his Ukranian phone call. Ground zero is Washington State and they have Jay Inslee an intelligent proactive governor. California is under control. Cuomo seems to have it in hand in New York. That is all good news because we have a drunk senile captain driving the ship

Ross1 | March 10, 2020

Thanks Rx lawdude.
I shared with a hospital GM travelling, was intending to go to Italy.
Hope that was OK.

SCCRENDO | March 11, 2020

To Donald Trump, intermittent faster Neo, paprika Andy and other snake oil salesman the most effective measure is quarantine and event cancellation
https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-c...

SCCRENDO | March 11, 2020

And an epidemiologists perspective on Corona Virus

SCCRENDO | March 11, 2020

And an epidemiologists perspective on Corona Virus

SCCRENDO | March 11, 2020
Neomaxizoomdweebie | March 11, 2020

SCCRENDO,
Quarantine, no shit. Other doctors that I follow have additional steps that could be beneficial. Unlike what you are trying to portray, fasting was never described by me or anyone as an impenetrable shield against corona virus or any other disease. I appreciate that you are an expert in human hormones but I’m also listening to those who have a broader appreciation of what makes a human whole.

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