Coronavirus/COVID-19, Thread 2

[Parliament10]

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[Captain_Caveman]

New Zealand isn’t just flattening the curve. It’s squashing it.

It has been less than two weeks since New Zealand imposed a coronavirus lockdown so strict that swimming at the beach and hunting in bushland were banned. They’re not essential activities, plus we have been told not to do anything that could divert emergency services’ resources.

People have been walking and biking strictly in their neighborhoods, lining up six feet apart outside grocery stores while waiting to go one-in-one-out, and joining swaths of the world in discovering the vagaries of home schooling.

It took only 10 days for signs that the approach here — “elimination” rather than the “containment” goal of the United States and other Western countries — is working.

The nascent slowdown reflected “a triumph of science and leadership,” said Michael Baker, a professor of public health at the University of Otago and one of the country’s top epidemiologists.

“Jacinda approached this decisively and unequivocally and faced the threat,” said Baker, who had been advocating for an “elimination” approach since reading a World Health Organization report from China in February.

“Other countries have had a gradual ramp-up, but our approach is exactly the opposite,” he said. While other Western countries have tried to slow the disease and “flatten the curve,” New Zealand has tried to stamp it out entirely.

Some American doctors have urged the Trump administration to pursue the elimination approach.

In New Zealand’s case, being a small island nation makes it easy to shut borders. It also helps that the country often feels like a village where everyone knows everyone else, so messages can travel quickly.

New Zealand’s next challenge: Once the virus is eliminated, how to keep it that way.

https://www.msn.com/en-us/news/world/new-zealand-isnt-just-flattening-the-curve-its-squashing-it/ar-BB12gstI

Ehh... I've been there. A remote 2-island nation that is about the size of CA but with only 5 million people. One of the lowest population densities in the world. Parts of the South Island have like 50 sheep for every person, lol. Good for them and all, but not that transferable to... well... anywhere.

[Froob]

They keep saying these next few weeks will be bad, but surprised Maine seems to be in great shape minus Portland

[SuperDeluxe]

Some tips for DIY masks:

https://www.nytimes.com/article/coronavirus-homemade-mask-material-DIY-face-mask-ppe.html

[exculpatory]

https://www.nbcnews.com/politics/donald-trump/mayo-clinic-cardiologist-inexcusable-ignore-hydroxychloroquine-side-effects-n1178776

Listen up.
As many of u know, I am an endocrinologist, but I take pride in remaining reasonably well versed in the other subspecialties of internal medicine - including cardiology (used to teach ACLS years ago).
Pay attention to what this Mayo Clinic cardiologist wrote above.
Bottomline:
1. Absent the results of randomized, controlled studies (currently underway) & with nothing else in our medical armamentarium, it is totally reasonable for docs to prescribe the hydroxychloroquine-azithromycin combination off label with informed consent for the seriously ill COVID-19 patient - while the data from the clinical trials are being accrued & analyzed.
2. However, BOTH of those drugs may prolong the QTc interval, &, in a small but significant number of patients whose QTc interval is already longer than it should be (due to many different reasons) or in patients who develop acute renal failure, may precipitate lethal ventricular arrhythmias (in particular, a polymorphic ventricular tachycardia called ‘torsade de pointes’ (‘twisting of peaks’j
which may degenerate into ventricular fibrillation). It looks like this:
https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9GcS866Ct3e_I4zuW2NgZSE-z_azZL9genbFhJklr9S7Sg9l7mDzgWW_uBV-DuA&s
3. Therefore, it is absolutely mandatory to obtain a baseline EKG in any patient where this combination is being considered. All ICU patients will have had an EKG & their rhythms are continuously monitored - and that monitoring MUST be continued. I am just as concerned about outpatients or non-ICU inpatients who may not be receiving a baseline EKG before being treated with the above drug combination - perhaps in part because of poorly informed physicians (sad to say, there are plenty out there), & all of the ignorant, non-medical hype by Trump (& even by that publicity-hunting, douchebag, moron Dr. Oz) about “how perfectly safe hydroxychloroquine is.”
Also see this small study:
https://www.medrxiv.org/content/10.1101/2020.04.02.20047050v1

[zoyathedestroya]

Leave SuperDeluxe's and my favorite pastor alone!

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Spoiler:

I mean... if the Devil had a face...

[zoyathedestroya]

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Subway still operational?

[threrf23]

https://www.nbcnews.com/politics/donald-trump/mayo-clinic-cardiologist-inexcusable-ignore-hydroxychloroquine-side-effects-n1178776

Listen up.
As many of u know, I am an endocrinologist, but I take pride in remaining reasonably well versed in the other subspecialties of internal medicine - including cardiology (used to teach ACLS years ago).
Pay attention to what this Mayo Clinic cardiologist wrote above.

Do you have any input regarding the use of hydroxychloroquine without Zithromax?

Based on what I have read about it in the past, to a lesser extent based on a brief experience with it, I have a high opinion of hydroxychloroquine. I suspect that it is more likely to help than hurt. And we have a doctor in Los Angeles claiming that he is seeing great results with a hydroxychloroquine/zinc combo (no mention of azithromycin).

I know enough to say that a hydroxychloroquine/Zithromax combo is known to be pretty potent against bacteria. And while I guess that could have value where certain underlying conditions are present, we are fighting a virus, and bacteria die off in and of itself can present bothersome side effects. So I'm not sure it makes good sense to begin with.

[exculpatory]

https://www.nbcnews.com/politics/donald-trump/mayo-clinic-cardiologist-inexcusable-ignore-hydroxychloroquine-side-effects-n1178776

Listen up.
As many of u know, I am an endocrinologist, but I take pride in remaining reasonably well versed in the other subspecialties of internal medicine - including cardiology (used to teach ACLS years ago).
Pay attention to what this Mayo Clinic cardiologist wrote above.

Do you have any input regarding the use of hydroxychloroquine without Zithromax?

Based on what I have read about it in the past, to a lesser extent based on a brief experience with it, I have a high opinion of hydroxychloroquine. I suspect that it is more likely to help than hurt. And we have a doctor in Los Angeles claiming that he is seeing great results with a hydroxychloroquine/zinc combo (no mention of azithromycin).

I know enough to say that a hydroxychloroquine/Zithromax combo is known to be pretty potent against bacteria. And while I guess that could have value where certain underlying conditions are present, we are fighting a virus, and bacteria die off in and of itself can present bothersome side effects. So I'm not sure it makes good sense to begin with.

1. As far as I am concerned, everything I wrote above about the cardiac safety of the hydroxychloroquine-azithromycin combination applies to combining it with zinc or using it alone. Every word of it. Read it again.
2. The anecdotal experiences of the rheumatologist in LA ‘safely’ treating lupus patients with hydroxychloroquine alone for many years & the LA doc using hydroxychloroquine-zinc in COVID patients are good to know - but do not at all in any freaking way establish the safety of the hydroxychloroquine-azithromycin combination given to sick COVID-19 patients. The definitive studies currently underway matter much MUCH more.
3. Your last paragraph, with all due respect, is uninformed nonsense & means absolutely nothing.
I suggest that you ‘stay in your lane’. I am not going to discuss what you wrote any further.
4. Regarding one of your earlier posts: I strongly advise you NOT to ingest something because you ‘like what you read’ about some of the ingredients. Get a doc you trust & take what he/she prescribes. If you ingested hydroxychloroquine in the past for something other than lupus, rheumatoid arthritis or related to malaria - you played with fire. Very very unwise.

[KGtabake]

Leave SuperDeluxe's and my favorite pastor alone!

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Spoiler:

I mean... if the Devil had a face...

Priests in Greece are rich as well.
Easter is next week. I'm terrified that people will go out and fluke the churches if some of these guys say it.

[Parliament10]

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[zoyathedestroya]

The numbers being reported by our health department are kinda dubious but it's a minor miracle that our death count has yet to reach 200 almost a month into our lockdown and more than two months after our first recorded covid case (currently at 3,870 cases). That's 2 deaths per 1M of population. Spain is at 311. USA at 39.

[Parliament10]

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[SuperDeluxe]

If this app does what it says it does, it may become a critical tool to keep healthcare workers safe(r) and also contagion in hospitals down. Hopefully it will be implemented in hospitals worldwide.

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[exculpatory]

If this app does what it says it does, it may become a critical took to keep healthcare workers safe(r) and also contagion in hospitals down. Hopefully it will be implemented in hospitals worldwide.

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Technology is incredible!

[Green89]

If this app does what it says it does, it may become a critical took to keep healthcare workers safe(r) and also contagion in hospitals down. Hopefully it will be implemented in hospitals worldwide.

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Technology is incredible!

I always wondered when the Star Trek Tricorder would become a reality. It's here, in the form of a phone!

[claycarver]

They're starting to revise the predicted deaths downward. The newest model from IHME predicts about 60,000 deaths by August, which represents about 25% fewer deaths than they projected on Sunday:

https://thehill.com/policy/healthcare/491715-key-coronavirus-model-revised-downward-predicts-60k-deaths-in-us-by-august

61,000 people died from the flu in the 2017-2018 season. If these models hold up, or even continue to drop, that's extraordinary.

[SuperDeluxe]

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[Parliament10]

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This is good news. Let's hope that he keeps getting better.

[sam_I_am]

They're starting to revise the predicted deaths downward. The newest model from IHME predicts about 60,000 deaths by August, which represents about 25% fewer deaths than they projected on Sunday:

https://thehill.com/policy/healthcare/491715-key-coronavirus-model-revised-downward-predicts-60k-deaths-in-us-by-august

61,000 people died from the flu in the 2017-2018 season. If these models hold up, or even continue to drop, that's extraordinary.

Realize that when 60,000 people died of the flu in 2017, there weren’t 300,000 people needing 2-3 weeks on a ventilator in an ICU to survive and there weren’t another 900,000 needing hospitalization for oxygen therapy. If you can’t understand the difference by now.....wow!