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Coronavirus 2019 (COVID-19) Official Thread
- Thread Starter Hueco
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Please don't post from farcebook, unless it's creditable and can be backed up! As it stands, conspiracy theory stuff doesn't fly round here!
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Obama and Biden depleted the stockpile during the H1N1 flu and failed to replenish it:
https://www.redstate.com/nick-arama/2020/03/24/biden-attacks-trump-over-masks-but-they-were-depleted-under-obama-and-never-restocked/
Two drugs that could help treat coronavirus - Trump was right, as usual. #WINNING
https://www.youtube.com/watch?v=93TpfCzpM3Y
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"New York has been hit hard by the coronavirus outbreak. As of Tuesday afternoon, Gov. Andrew Cuomo (D) reported upwards of 25,000 confirmed cases of the virus, with the majority of them concentrated in the five boroughs of New York City. "
thehill.com
34 years old:
www.nydailynews.com
www.deadlinedetroit.com
"Parnell was in his fifties and leaves behind three sons... Parnell is the department's second coronavirus death. A 38-year-old civilian 9-1-1 dispatcher died Monday."
Sad story:
www.nydailynews.com
"Police discovered the woman, 42, during a welfare check approximately 12 to 16 hours after she had died, according to County Coroner Richard Hawk, and posthumous tests confirmed that she had COVID-19. A report from the Atlanta Journal-Constitution said that her child, who is 4 or 5 years old, was in the house with her body at the time."
36-year-old NYC school principal dies of coronavirus complications
A New York City school principal died Monday from complications due to the coronavirus, becoming the first reported public school official in the U.S. to die from the disease.Education news no…
thehill.com
NYC paramedic hospitalized with coronavirus sedated, breathing with ventilator as condition worsens, family says
FDNY EMS paramedic Christell Cadet ? who shared her coronavirus struggle with the world last week from her hospital bed ? is now unable to breathe comfortably on her own and has been hooked up to a…
www.nydailynews.com
Detroit police captain dies of coronavirus, 18 officers test positive
www.deadlinedetroit.com
Sad story:
Georgia mom found dead of coronavirus in home with young child
A mammogram technician and mother of a young child was found dead from coronavirus in her Georgia home last week, state officials said on Monday. Police discovered the woman, 42, during a welfare c…
www.nydailynews.com
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My wife has a degree in epidemiology, and shared this article with me this morning.
The takeaway is this: At this point, we should behave as though we each have the virus already.
**********
From Nathan Ansbaugh:
Hi all,
I'm home from the hospital today, navigating a thousand emotions and thoughts over what has happened over the past 10 days with COVID-19 and, more so, trying to wrap my head around what is ahead of us. I don't necessarily want to spend time when I'm home from the hospital writing about COVID-19, but amidst all of the headlines I read, all of the conversations I see on social media, etc, I continue to feel that doctors in our communities share a responsibility to communicate with our friends, family, and communities the behind the scenes issues that are affecting patients, us as providers, and are rapidly trickling down to our communities locally and around the country/world.
First off, if this post was shared with and you don't know me, I am no COVID-19 expert, but I am an emergency physician at the major referral center here in Bend, Oregon. I have a masters in public health in epidemiology and biostatistics and a background working with the Oregon Health Authority and CDC in emerging infectious disease epidemiology. Turns out, I'm also human and I'm working through this like everyone is. If nothing else, I hope that little intro is enough of a disclaimer to allow me to be honest, imperfect, and transparent while doing my best to stay objective and level headed while I try to pass along some information and thoughts.
A lot has changed over the past week, and I think the biggest change for me personally has been a transition from an academically driven practical understanding of the potential severity of COVID-19 to a more somber, emotional, and a more in-my-face acquainted realization of the extreme obstacle in front of us.
I want to take this opportunity to address what I think is the biggest question- are we doing the right thing by social distancing, shutting down schools, restaurants, putting businesses at risk, etc? Is it worth people losing jobs, kids being hungry when their folks rely on school meals and are strapped for cash without any income currently, is it worth an economic collapse, is it worth the psychological consequences that we are all experiencing in our own way? If it is worth it, that why now? Why not with H1N1 or west nile or Zika or ebola or any of the other recent global pandemics? If it is worth it, when does this end and when does life begin to look normal again? Let me start where I will end. I wish it wasn't, but it is worth it.
In my last post, I mentioned how important it is to understand the numbers you see online or in the news. I mentioned the importance of asking, "What is the denominator?" Initially, the big question on the table was, what is the mortality rate? If 1000 people get the disease, how many are expected to die? We talked about the importance of knowing different characteristics about those 1000 people, such as age, comorbidities, etc? When we hear numbers like 3% mortality, we need to understand who those people are in the denominator who were tested, why were they tested, and how does this affect the numbers we are seeing?
The truth is, I thought we would be a lot further down the road to having real numbers, ideally having at least rough estimates of prevalence and incidence of COVID-19 in our communities (meaning the actual burden of disease in our communities- how many people actually have COVID-19 currently, and how many new cases we are seeing on a daily basis). I thought we would have more accurate and representative mortality data, data about the probability of significant complications like requiring intubation (a breathing tube with mechanical ventilation), having heart failure, or having other serious complications because of the illness. In reality, we are, for all practical purposes, no closer to answering those above questions in our local community let alone nationally than we were a week ago. Amidst this, in the past week, our group of emergency physicians have cared for dozens of people in the emergency department who we strongly suspect have COVID-19, but we have sent only a handful of tests to confirm the diagnosis because we simply do not have enough tests. The extremely limited number of tests and supplies that do exist are currently reserved for the sickest of the sick being admitted to the hospital or reserved for providers who are sick who need to be tested to ensure they can keep on working even if they feel like crap. Despite having more and more patients with suspected COVID-19, we still don't know when testing will be more readily available, and we are truly running out of supplies to protect ourselves in the hospital without a clear idea of whether more supplies will come any time soon.
So what makes this COVID-19 problem different from anything else?
1) We are WAY behind in our testing and data collection: we should be MUCH further down the pathway toward understanding the numbers than we are. Amongst sick people who are not in the hospital and are toughing it out at home, we really have no idea what percentage of people actually have COVID-19. We need to know these numbers before we can truly understand the mortality/morbidity numbers. When these numbers become more clear, only then can we more selectively target people who are at risk, clear people to go back to work, and know what resources we are actually going to need from a systems perspective.
Until testing happens more readily and more widespread, I'm afraid we are stuck.
2) We are beginning to doubt that we really know what this disease actually looks like: 10 days ago, we were pretty confident we could capture the vast majority of people by screening people for fevers or cough. Still, if you walk into our hospital, you get your temperature taken and they ask if you have cough or cold symptoms to screen out people with the disease. However, now we are hearing about/seeing impressive percentages of people who are tested for COVID-19 later in the course of their care because of other issues such as unexplained abdominal pain, low oxygen levels, confusion, etc, and we are seeing lots of people without cough or fever testing positive for COVID-19. This is not that unique for viruses as they can present in many ways. Influenza does this, rhinovirus does this, adenovirus does this, but these have predictable impacts on society and right now, COVID-19 does not. This makes triaging patients, mitigating the spread of infection, and protecting our community that much more difficult.
3) Younger/healthier people may be prone to more severe illness and death compared to their risk with other infections like influenza:
When comparing CDC data released on March 18, 2020 regarding COVID-19 and the CDC's most recent data for Influenza during 2018-2019, there appears to be an impressive difference in the percentage of younger people being hospitalized for COVID-19 compared to those with influenza. As we discussed, we currently have very limited data about the burden of COVID-19 in the population as a whole, but since we have been primarily testing people sick enough to be admitted to the hospital, we can make some loose comparisons between people admitted for COVID-19 and people admitted for influenza.
With that in mind, amongst people sick enough to be admitted to the hospital, the 18-49 age group generally makes about 13% of influenza patients who require admission compared to 38% for COVID. That is a big difference.
The 50-65 age group accounts for about 20% of influenza admissions compared to around 17% for COVID-19 thus far.
The 65 and older age group accounts for ~57% of the people who required admission for influenza compared to only 45% of the COVID-19 patients requiring admission thus far.
If you are confused, do the math- note that the 38% + 17% + 45% for COVID patients as noted above = 100%. In the influenza group, 13% + 20% +57% = 90%, where did that 10% go?
Well interestingly, while that middle age group accounts for a much higher percentage of the hospitalized COVID patients compared to hospitalized influenza patients, about 10% of people who require admission for influenza are less than 18 whereas the US has yet to see hardly any patients admitted for COVID-19 who are less than 18.
Sources below:
www.cdc.gov
www.cdc.gov
Ultimately, if you consider the possibility that, based on this limited information, COVID-19 could more severely affect the working class person, college student, father/mother, etc compared to other illnesses like influenza, the burden of COVID-19 in our communities could have a far greater impact even if, in the best case scenario, the overall mortality rates end up being similar.
Physicians around the country and in other countries are seeing younger people being affected, and seeing what appears to be drastic increase in the number of people who are needing to be intubated and on ventilators compared to influenza or other typical viral infections. We don't have all the numbers, but between what we are seeing and what we do have, the idea that you are otherwise healthy and have a great immune system may turn out to NOT to keep you from getting very sick with this.
4) Regardless of the numbers and the whys, COVID-19 has led to extreme shortages of supplies, putting physicians, nurses, housekeepers, etc at risk unlike other epidemics/pandemics that we have seen in our lifetimes
This is likely multifactorial, but the reality is, globally, we got way behind the 8-ball with this. On a day to day, moment to moment, literally second to second basis at times in the ED, I have found every decision I am making being altered in some way by COVID-19 and its downstream effects. As we continue to learn about the disease itself, we need to be able to adequately protect the people keeping the system afloat.
Its somewhat hard to describe this circumstance of things in the emergency department right now, but you know that scene from the movie "Apollo 13" where they have to figure out how to fix the carbon dioxide filter and need to fit a square peg into a round hole... that kinda feels like where we are at right now for a whole city/country/world instead of a spaceship.
At the end of the day, the headlines, stock market, and social media feeds seem to portray the idea that some top down answer is going to fall into everyone's lap in the form of an economic stimulus package, a clear treatment or vaccine, more testing availability, more masks, more toilet paper (joke... kind of), etc. However, while all of this NEEDS to happen, I realize more and more every day that the solution for this comes down to every individual in our communities doing their part to help our communities climb out of this crisis from the ground up.
I'm a numbers person, I like statistics, but the truth is, on a day to day basis, we are seeing more sick people, more positive cases, cases that break the norm, and people who normally wouldn't be sick from a typical virus getting extremely sick.
Waiting for a stimulus package, more tests, a treatment, more masks, etc, means that we get more and more and more behind. The ONLY way to slow this right now is to have people wise up, to be smart, to stay home, to socially distance, to be fiscally responsible and to be responsible consumers, neighbors, and community members. The average American isn't used to truly rationing, to not getting a test that they need, to dealing with the fact that they need to share.
We all need to change our frame of mind.
All that said, I have watched our community unite and make huge steps forward with this. I go to work feeling proud to be there and I have watched our medical community morph and unite to work together and I feel more connected with my colleagues, consultants, nurses, techs, housekeepers, etc than I ever have before.
But that said, I also feel a significant sense of sadness, humility, fear, and somberness knowing that this is real and we are behind the curve. Everyone needs to realize that what we are doing in our communities is not enough. We need to do whatever we can to slow that down at the community level.
Take this seriously, don't be ignorant, oblivious, or say it is overstated.
For now, assume that you have this even if you don't have symptoms. Be around the people you have to be around, and do your best to not be around people you don't have to be around.
Give us time to get supplies, to get tests, to do all the things that need to get done. If we all do this and the disaster that feels on the horizon never happens, then we won.
If we don't do this, that's on all of us.
The takeaway is this: At this point, we should behave as though we each have the virus already.
**********
From Nathan Ansbaugh:
Hi all,
I'm home from the hospital today, navigating a thousand emotions and thoughts over what has happened over the past 10 days with COVID-19 and, more so, trying to wrap my head around what is ahead of us. I don't necessarily want to spend time when I'm home from the hospital writing about COVID-19, but amidst all of the headlines I read, all of the conversations I see on social media, etc, I continue to feel that doctors in our communities share a responsibility to communicate with our friends, family, and communities the behind the scenes issues that are affecting patients, us as providers, and are rapidly trickling down to our communities locally and around the country/world.
First off, if this post was shared with and you don't know me, I am no COVID-19 expert, but I am an emergency physician at the major referral center here in Bend, Oregon. I have a masters in public health in epidemiology and biostatistics and a background working with the Oregon Health Authority and CDC in emerging infectious disease epidemiology. Turns out, I'm also human and I'm working through this like everyone is. If nothing else, I hope that little intro is enough of a disclaimer to allow me to be honest, imperfect, and transparent while doing my best to stay objective and level headed while I try to pass along some information and thoughts.
A lot has changed over the past week, and I think the biggest change for me personally has been a transition from an academically driven practical understanding of the potential severity of COVID-19 to a more somber, emotional, and a more in-my-face acquainted realization of the extreme obstacle in front of us.
I want to take this opportunity to address what I think is the biggest question- are we doing the right thing by social distancing, shutting down schools, restaurants, putting businesses at risk, etc? Is it worth people losing jobs, kids being hungry when their folks rely on school meals and are strapped for cash without any income currently, is it worth an economic collapse, is it worth the psychological consequences that we are all experiencing in our own way? If it is worth it, that why now? Why not with H1N1 or west nile or Zika or ebola or any of the other recent global pandemics? If it is worth it, when does this end and when does life begin to look normal again? Let me start where I will end. I wish it wasn't, but it is worth it.
In my last post, I mentioned how important it is to understand the numbers you see online or in the news. I mentioned the importance of asking, "What is the denominator?" Initially, the big question on the table was, what is the mortality rate? If 1000 people get the disease, how many are expected to die? We talked about the importance of knowing different characteristics about those 1000 people, such as age, comorbidities, etc? When we hear numbers like 3% mortality, we need to understand who those people are in the denominator who were tested, why were they tested, and how does this affect the numbers we are seeing?
The truth is, I thought we would be a lot further down the road to having real numbers, ideally having at least rough estimates of prevalence and incidence of COVID-19 in our communities (meaning the actual burden of disease in our communities- how many people actually have COVID-19 currently, and how many new cases we are seeing on a daily basis). I thought we would have more accurate and representative mortality data, data about the probability of significant complications like requiring intubation (a breathing tube with mechanical ventilation), having heart failure, or having other serious complications because of the illness. In reality, we are, for all practical purposes, no closer to answering those above questions in our local community let alone nationally than we were a week ago. Amidst this, in the past week, our group of emergency physicians have cared for dozens of people in the emergency department who we strongly suspect have COVID-19, but we have sent only a handful of tests to confirm the diagnosis because we simply do not have enough tests. The extremely limited number of tests and supplies that do exist are currently reserved for the sickest of the sick being admitted to the hospital or reserved for providers who are sick who need to be tested to ensure they can keep on working even if they feel like crap. Despite having more and more patients with suspected COVID-19, we still don't know when testing will be more readily available, and we are truly running out of supplies to protect ourselves in the hospital without a clear idea of whether more supplies will come any time soon.
So what makes this COVID-19 problem different from anything else?
1) We are WAY behind in our testing and data collection: we should be MUCH further down the pathway toward understanding the numbers than we are. Amongst sick people who are not in the hospital and are toughing it out at home, we really have no idea what percentage of people actually have COVID-19. We need to know these numbers before we can truly understand the mortality/morbidity numbers. When these numbers become more clear, only then can we more selectively target people who are at risk, clear people to go back to work, and know what resources we are actually going to need from a systems perspective.
Until testing happens more readily and more widespread, I'm afraid we are stuck.
2) We are beginning to doubt that we really know what this disease actually looks like: 10 days ago, we were pretty confident we could capture the vast majority of people by screening people for fevers or cough. Still, if you walk into our hospital, you get your temperature taken and they ask if you have cough or cold symptoms to screen out people with the disease. However, now we are hearing about/seeing impressive percentages of people who are tested for COVID-19 later in the course of their care because of other issues such as unexplained abdominal pain, low oxygen levels, confusion, etc, and we are seeing lots of people without cough or fever testing positive for COVID-19. This is not that unique for viruses as they can present in many ways. Influenza does this, rhinovirus does this, adenovirus does this, but these have predictable impacts on society and right now, COVID-19 does not. This makes triaging patients, mitigating the spread of infection, and protecting our community that much more difficult.
3) Younger/healthier people may be prone to more severe illness and death compared to their risk with other infections like influenza:
When comparing CDC data released on March 18, 2020 regarding COVID-19 and the CDC's most recent data for Influenza during 2018-2019, there appears to be an impressive difference in the percentage of younger people being hospitalized for COVID-19 compared to those with influenza. As we discussed, we currently have very limited data about the burden of COVID-19 in the population as a whole, but since we have been primarily testing people sick enough to be admitted to the hospital, we can make some loose comparisons between people admitted for COVID-19 and people admitted for influenza.
With that in mind, amongst people sick enough to be admitted to the hospital, the 18-49 age group generally makes about 13% of influenza patients who require admission compared to 38% for COVID. That is a big difference.
The 50-65 age group accounts for about 20% of influenza admissions compared to around 17% for COVID-19 thus far.
The 65 and older age group accounts for ~57% of the people who required admission for influenza compared to only 45% of the COVID-19 patients requiring admission thus far.
If you are confused, do the math- note that the 38% + 17% + 45% for COVID patients as noted above = 100%. In the influenza group, 13% + 20% +57% = 90%, where did that 10% go?
Well interestingly, while that middle age group accounts for a much higher percentage of the hospitalized COVID patients compared to hospitalized influenza patients, about 10% of people who require admission for influenza are less than 18 whereas the US has yet to see hardly any patients admitted for COVID-19 who are less than 18.
Sources below:
Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19
COVID-19 can result in severe disease, including hospitalization, admission to an intensive care unit, and death, especially among older adults. Everyone can take actions, such as social distancing...
www.cdc.gov
Estimated Flu-Related Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2018–2019 Flu Season | CDC
CDC calculates estimates of disease burden in the United States using surveillance data and modeling to adjust for sources of under-detection. Burden estimates for the 2018-2019 season found here.
www.cdc.gov
Physicians around the country and in other countries are seeing younger people being affected, and seeing what appears to be drastic increase in the number of people who are needing to be intubated and on ventilators compared to influenza or other typical viral infections. We don't have all the numbers, but between what we are seeing and what we do have, the idea that you are otherwise healthy and have a great immune system may turn out to NOT to keep you from getting very sick with this.
4) Regardless of the numbers and the whys, COVID-19 has led to extreme shortages of supplies, putting physicians, nurses, housekeepers, etc at risk unlike other epidemics/pandemics that we have seen in our lifetimes
This is likely multifactorial, but the reality is, globally, we got way behind the 8-ball with this. On a day to day, moment to moment, literally second to second basis at times in the ED, I have found every decision I am making being altered in some way by COVID-19 and its downstream effects. As we continue to learn about the disease itself, we need to be able to adequately protect the people keeping the system afloat.
Its somewhat hard to describe this circumstance of things in the emergency department right now, but you know that scene from the movie "Apollo 13" where they have to figure out how to fix the carbon dioxide filter and need to fit a square peg into a round hole... that kinda feels like where we are at right now for a whole city/country/world instead of a spaceship.
At the end of the day, the headlines, stock market, and social media feeds seem to portray the idea that some top down answer is going to fall into everyone's lap in the form of an economic stimulus package, a clear treatment or vaccine, more testing availability, more masks, more toilet paper (joke... kind of), etc. However, while all of this NEEDS to happen, I realize more and more every day that the solution for this comes down to every individual in our communities doing their part to help our communities climb out of this crisis from the ground up.
I'm a numbers person, I like statistics, but the truth is, on a day to day basis, we are seeing more sick people, more positive cases, cases that break the norm, and people who normally wouldn't be sick from a typical virus getting extremely sick.
Waiting for a stimulus package, more tests, a treatment, more masks, etc, means that we get more and more and more behind. The ONLY way to slow this right now is to have people wise up, to be smart, to stay home, to socially distance, to be fiscally responsible and to be responsible consumers, neighbors, and community members. The average American isn't used to truly rationing, to not getting a test that they need, to dealing with the fact that they need to share.
We all need to change our frame of mind.
All that said, I have watched our community unite and make huge steps forward with this. I go to work feeling proud to be there and I have watched our medical community morph and unite to work together and I feel more connected with my colleagues, consultants, nurses, techs, housekeepers, etc than I ever have before.
But that said, I also feel a significant sense of sadness, humility, fear, and somberness knowing that this is real and we are behind the curve. Everyone needs to realize that what we are doing in our communities is not enough. We need to do whatever we can to slow that down at the community level.
Take this seriously, don't be ignorant, oblivious, or say it is overstated.
For now, assume that you have this even if you don't have symptoms. Be around the people you have to be around, and do your best to not be around people you don't have to be around.
Give us time to get supplies, to get tests, to do all the things that need to get done. If we all do this and the disaster that feels on the horizon never happens, then we won.
If we don't do this, that's on all of us.
Last Edited:
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Parolee released early due to COVID-19 breaks into house, threatens woman with knife, police say
A man recently released from a halfway house early because of concerns over the spread of COVID-19 has been charged with breaking into a random home, tying up a woman at knifepoint and threatening to kill her.
www.ksl.com
The facts are pretty horrifying:
- Crook gets released early because of COVID-19.
- Breaks into woman's home, grabs knife, goes to her bedroom while she is sleeping, wakes her, demands money, cards, etc.
- When she starts screaming, ties her up with shoelaces and tells her he'll cut off her head.
- Her son downstairs hears the screaming, calls police.
- When the crook realizes police are there he gets in bed with her and claims to be her lover.
- Woman escapes and he is arrested at gunpoint.
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What did they expect him to do, get a job?Parolee released early due to COVID-19 breaks into house, threatens woman with knife, police say
A man recently released from a halfway house early because of concerns over the spread of COVID-19 has been charged with breaking into a random home, tying up a woman at knifepoint and threatening to kill her.
The facts are pretty horrifying:
- Crook gets released early because of COVID-19.
- Breaks into woman's home, grabs knife, goes to her bedroom while she is sleeping, wakes her, demands money, cards, etc.
- When she starts screaming, ties her up with shoelaces and tells her he'll cut off her head.
- Her son downstairs hears the screaming, calls police.
- When the crook realizes police are there he gets in bed with her and claims to be her lover.
- Woman escapes and he is arrested at gunpoint.
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- 1,744
He was broadcasting from the Javits Center, which is being set up as a 1,000 bed hospital for Covid-19 patients. Might be unwise to send it all elsewhere, when it will surely be needed there.
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31 years old.
"Dixon went to a St. Louis urgent care facility on March 17 with flu-like symptoms, Johnson said. Staff there told her to go to a hospital emergency room, where she was admitted, he said.
By Thursday, Dixon was put on a ventilator because her oxygen levels had dropped, and by Friday her test results came back positive for COVID-19, Johnson said. She died two days later. "
www.stltoday.com
"Dixon went to a St. Louis urgent care facility on March 17 with flu-like symptoms, Johnson said. Staff there told her to go to a hospital emergency room, where she was admitted, he said.
By Thursday, Dixon was put on a ventilator because her oxygen levels had dropped, and by Friday her test results came back positive for COVID-19, Johnson said. She died two days later. "
'Now it's our family,' cousin of St. Louis woman who died from coronavirus says
Less than a week ago Jazmond Dixon, 31, went to an urgent care for flu-like symptoms. She died Sunday.
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Way, way too many variables to put the blame on the malaria drugs is my first reaction.
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Yes. Yes, that CDC "study" has been thoroughly debunked. Many credible studies have concluded that that 4X BS is not true.
He probably reads thinkprogress or thetrace regularly, too...
Yep. Having a backyard pool is way more deadly than having a gun in your house.
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As long as increasing shareholder value is the goal, it won't happen.
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Britain's Prince Charles tests positive for new coronavirus
LONDON (AP) — Prince Charles, the heir to the British throne, has tested positive for the new coronavirus, royal officials confirmed Wednesday — touching off criticism over whether his wealth and status gave him priority in receiving a test. The 71-year-old is showing mild symptoms of COVID-19...
komonews.com
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NYC ? Self Quarantine
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yet...
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Yet yesterday he sat down with Bill Hemmer for an extended interview, who came from Fox's studios in, guess where.NYC ? Self Quarantine
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Personally, I can't tell if it's the Corona or a hangover but I think I'll start drinking again just to confirm one way or the other.
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Do it for Science!
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Do it for the children!
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