Coronavirus/COVID-19, Thread 3 (Omicron & Delta Variants)

[Curmudgeon]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

[Dangit]

Because it probably started in a lab where gain of function research was taking place . And I want to know if who was funding it , what purpose it was serving , if it was possibly a bio weapon ,If it was a mistake, if it was on purpose.... I want to know everything

I don't believe for a second thar both sides of our government are being completely truthful about this ..
Conspiracy theorist or not .... I think anytime money and politics are involved we are probably not getting the whole story .

Dismissing anyone with questions
Shutting up up certain scientists or medical personnel with different views ... and changing dictionary definition s so people won't use them against you... doesn't lead me to be very confident in what the government is telling me honestly.

Ok, why probably though? What is the evidence that would lead you to believe this?

https://www.msn.com/en-us/health/medical/theres-more-evidence-that-covid-19-started-in-a-lab-expert-says/ar-AAKnEqd

Also people from the lab that have spoken out ...
I'm not saying it's impossible it wasn't from a wet market, but I'm inclined to believe the lab leak and the fact that the w.h.o tried to cover for them are more likely

[exculpatory]

1. What anticoagulation protocol?
Just straight prophylactic lovenox. If the ddimer goes sky high, then looks for clots. Previously we would fully anticoagulate if the ddimer rose above a certain threshold, but after too many bleeding events cut that out

2. How does COVID COAGULOPATHY c/w DIC - I have read/heard more clotting & less bleeding?
They don't seem to develop DIC lab-wise, but have a markedly increased risk/rate of clotting. And all the negative conequences (VTE, stroke, MI...)

3. Does COVID ARDS behave differently than sepsis-related ARDS - vent wise?
TImeframe is the biggest thing imo. WIth covid, once you are on the vent plan on 3-8 weeks before you declare yourself (stable enough for trach or death are the two usual pathways. maybe 1% extubate). WIth traditional Ards, usually you would have an endpoint by 2-3 weeks.

4. How do you separate out cytokine storm? How frequently do you see it?
Usually time frame. around 10-14 days you see things backslide: super high fevers, marked rise in CRP, shock and usually arrest pretty quickly. Early on, we saw it more often but lately not that much. I think its been at leat 4-6 months since we had a cytokine storm patients. I think its becaue earlyu on we thought steroids were bad (promote viral shedding) whereas now it a mainstay of treatment

5. Lots of diabetes? Exacerbation of pre-existing DM and/or de novo?
Lots of diabetes. Both de novo and exacerbation. Covid itself seems to spike the sugars, then the steroid doses don't help. Its not uncommon to have them on doses of 40-50 units of nph q6-8h

6. Which glucocorticoid & how much & usually what duration?
hospital protocol is to start with decadron 6mg iv q12h for 7 days then switch to qd for 7 day, but since there is no standard dose/duration most of us go up with the crp rises. I think 40-80mg solumedrol q6h is a typical doe for someone on the vent


7. FYI: If & when they can be weaned off steroids, be very careful distinguishing an exogenously suppressed HPA axis w secondary adrenal atrophy which will take varying time to come back VS permanent primary hypoadrenalism 2/2 COVID-induced adrenalitis. (ASIDE: I have always had a special interest in adrenal & pituitary disease - as well as ANY hyper or hypo electrolyte [NA/K/CA & the WAY too often underdiagnosed hypomagnesemic & hypophosphatemic patient]. In that regard, I have always overlapped with the nephrons everywhere I practiced.)
I just saw that (or rather a colleague told me about it). We also cover the local LTACH, so was good to know

hey ex, embedded answers in blue

Thanks very much.

Great answers.

In my experience, that kind of TRULY MASSIVE cumulative glucocorticoid exposure will almost certainly result in a very large percentage of survivors w HPA axis suppression & secondary adrenal atrophy (beyond the possibility of adrenalitis & permanent primary hypoadrenalism). I hope your group is frequently consulting your endocrine colleagues (& my endocrine alter egos) regarding tapering protocols/serial AM cortisols/ACTH stimulation tests if & when their underlying profound pulmonary pathology permits steroid weaning from pharmacologic to physiologic dosing, & they are eventually transferred to the LTACH. There is A LOT of individual variation in how fast the HPA axis recovers. In addition, you must be seeing a ton of opportunistic infection (I recently saw a mucormycosis case report) while these patients are on these elephant doses of Solumedrol for a protracted period of time. And then there is the inevitable & profound secondary osteoporosis 2/2 to the steroids combined with disuse which MUST be occurring - albeit that is the least of their problems.

If you run into anything weird endocrine-wise or electrolyte-wise, please feel free to run it past me as u wish.

[Bad-Thoma]

Because it probably started in a lab where gain of function research was taking place . And I want to know if who was funding it , what purpose it was serving , if it was possibly a bio weapon ,If it was a mistake, if it was on purpose.... I want to know everything

I don't believe for a second thar both sides of our government are being completely truthful about this ..
Conspiracy theorist or not .... I think anytime money and politics are involved we are probably not getting the whole story .

Dismissing anyone with questions
Shutting up up certain scientists or medical personnel with different views ... and changing dictionary definition s so people won't use them against you... doesn't lead me to be very confident in what the government is telling me honestly.

Ok, why probably though? What is the evidence that would lead you to believe this?

https://www.msn.com/en-us/health/medical/theres-more-evidence-that-covid-19-started-in-a-lab-expert-says/ar-AAKnEqd

Also people from the lab that have spoken out ...
I'm not saying it's impossible it wasn't from a wet market, but I'm inclined to believe the lab leak and the fact that the w.h.o tried to cover for them are more likely

Thank you for the link and I'm not saying it's impossible it came from a lab either. I still tend to think it's a disease like many, many before it that evolved naturally but I'll continue to read about it as more things come out.

[theman]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

[theman]

Watch on YouTube

[theman]

When are we starting the climate control thread? Also, I suggest we start a thread on religion & politics. Maybe even a dogs VS cats thread. All good topics for a basketball forum.

Cats > Dogs. There is no need for discussion.

[Dangit]

When are we starting the climate control thread? Also, I suggest we start a thread on religion & politics. Maybe even a dogs VS cats thread. All good topics for a basketball forum.

Cats > Dogs. There is no need for discussion.

Freaking conspiracy theory bs...
I hate your political crap

Dogs over cats .... Trust the science

[AlCelticFan]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

Also, if an accidental leak, of course we'd want to tighten up controls to prevent any future leaks of this type.

[Curmudgeon]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

Also, if an accidental leak, of course we'd want to tighten up controls to prevent any future leaks of this type.

If it was an accidental leak in Wuhan, the U.S. has nothing to say about the controls. It's a Chinese facility. If the leak was intentional, it's not clear to me why the Chinese would want to put a billion of their own citizens at risk.

It is what it is. Stop trying to trace conspiracies. If China is really engaged in genocide, I challenge Alex Jones and Qanon to do something about it.

[djFan71]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

Also, if an accidental leak, of course we'd want to tighten up controls to prevent any future leaks of this type.

Agreed, but It really doesn't matter in the what do we do now / how do we swear at each other in this thread kind of way.

[Jaqua92]

I have seen GBS a few times.
That must have been horrible for you.

Was a **** nightmare man

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[Jaqua92]

Well, I got the variant this week.

Tested positive the day I was supposed to be boostered, obviously I stayed home. Will need to be rescheduled.

In terms of non-urgent/Emergency illness, it is a top 3 most sick I've ever been.

The peak was only a day or two, a bit worse than my worst case of bronchitis. Nonstop coughing, sorry throat, productive cough. Shortness of breath, tired lungs and sore chest from all the coughing. Tuesday, I don't think 4 minutes passed without coughing. It was rough.

Feeling a bit better now, still some congestion, on the mend.

Somehow, my fiance remained negative during all of this. Somehow.

It isn't fun. I don't feel great. I'm still tired. My breathing feels normal, but it's moved to my sinuses now.

Get your boosters people.

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[exculpatory]

Well, I got the variant this week.

Tested positive the day I was supposed to be boostered, obviously I stayed home. Will need to be rescheduled.

In terms of non-urgent/Emergency illness, it is a top 3 most sick I've ever been.

The peak was only a day or two, a bit worse than my worst case of bronchitis. Nonstop coughing, sorry throat, productive cough. Shortness of breath, tired lungs and sore chest from all the coughing. Tuesday, I don't think 4 minutes passed without coughing. It was rough.

Feeling a bit better now, still some congestion, on the mend.

Somehow, my fiance remained negative during all of this. Somehow.

It isn't fun. I don't feel great. I'm still tired. My breathing feels normal, but it's moved to my sinuses now.

Get your boosters people.

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Sorry to hear this.
Glad you are mending.
If you had received the booster, it would have been much less severe.
The reason you did not end up hospitalized was 1) your youth & 2) memory T cells & memory B cells from your double vax.
I hope you do not develop long Covid.
Think positive & keep your chin up!

[Bad-Thoma]

Well, I got the variant this week.

Tested positive the day I was supposed to be boostered, obviously I stayed home. Will need to be rescheduled.

In terms of non-urgent/Emergency illness, it is a top 3 most sick I've ever been.

The peak was only a day or two, a bit worse than my worst case of bronchitis. Nonstop coughing, sorry throat, productive cough. Shortness of breath, tired lungs and sore chest from all the coughing. Tuesday, I don't think 4 minutes passed without coughing. It was rough.

Feeling a bit better now, still some congestion, on the mend.

Somehow, my fiance remained negative during all of this. Somehow.

It isn't fun. I don't feel great. I'm still tired. My breathing feels normal, but it's moved to my sinuses now.

Get your boosters people.

Sent from my SM-G975U using Tapatalk

I'm glad to hear you're doing better and thanks for sharing your experience with it. I think it helps people to remember that even if you're personal chance of dying is low it can still be a really **** time. Get well soon.

[Captain_Caveman]

Who cares if it was a lab leak? Doesn't matter now. Even if it was intentional, it would be impossible to prove.

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

Also, if an accidental leak, of course we'd want to tighten up controls to prevent any future leaks of this type.

In a country we don't govern, at the same time people are railing about government overreach in our own?

[Bad-Thoma]

I think if it were "leaked" intentionally that would be a big deal. It would basically equate to genocide.

Also, if an accidental leak, of course we'd want to tighten up controls to prevent any future leaks of this type.

In a country we don't govern, at the same time people are railing about government overreach in our own?

Hey, China loves nothing more than a little constructive criticism.

[Captain_Caveman]

Read on Twitter

[exculpatory]

Read on Twitter

Thanks for posting this, Cave!

Overwhelming data added to the mega-mega-mega-Mega-Overwhelming data which already has accrued in countless peer reviewed publications during the last year.
The vaccines in general have been beyond incredibly successful - literally mindblowingly successful - at least 1 million more Americans are not dead today because of them.
So so so so awful that the willfully, despicably & irresponsibly ignorant unvaccinated (as the primary spreaders & the reason Delta, Omicron & future variants have developed & will develop, respectively) are the primary reasons that more than 800,000 Americans are, in fact, dead today (& are still dying).
People like you, Thom, SD, myself & multiple others (w perhaps varied opinions on some other matters) are as one on Covid. This is ONLY about the public health & the best medicine possible - & NOT A **** POWER GRAB. It is so so so so sad & profoundly tragic that our country has tens of millions of anti-science abject morons. This was in large part preventable had even ~80% of the country double vaxxed during the first half of 2021 & boosted during the second half of 2021 (VS the approximately 60% & 30%, respectively, who did), & the many millions of infected survivors had received even ONE F/U vaccination.

God bless us in 2022.

[Jaqua92]

Read on Twitter

Thanks for posting this, Cave!

Overwhelming data added to the mega-mega-mega-Mega-Overwhelming data which already has accrued in countless peer reviewed publications during the last year.
The vaccines in general have been beyond incredibly successful - literally mindblowingly successful - at least 1 million more Americans are not dead today because of them.
So so so so awful that the willfully, despicably & irresponsibly ignorant unvaccinated (as the primary spreaders & the reason Delta, Omicron & future variants have developed & will develop, respectively) are the primary reasons that more than 800,000 Americans are, in fact, dead today (& are still dying).
People like you, Thom, SD, myself & multiple others (w perhaps varied opinions on some other matters) are as one on Covid. This is ONLY about the public health & the best medicine possible - & NOT A **** POWER GRAB. It is so so so so sad & profoundly tragic that our country has tens of millions of anti-science abject morons. This was in large part preventable had even ~80% of the country double vaxxed during the first half of 2021 & boosted during the second half of 2021 (VS the approximately 60% & 30%, respectively, who did), & the many millions of infected survivors had received even ONE F/U vaccination.

God bless us in 2022.

16% of people unvaccinated per 100,000 cases are hospitalized? That's wild.


Ex, question for you. Would people who have developed natural immunity from the original covid be immune to this variant.

My fiance thinks she had COVID in February of 2020, right before things got crazy. Didn't get tested because it was before it became a thing. She had all of the classic symptoms.

Since then, she's been exposed at work. Exposed to people who have tested positive, family, etc. Now, she was exposed to me for quite a few days before I became symptomatic, etc. And she still has never tested positive.

Is she just lucky? Or is there a possibility she may have had it at some point?

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