Coronavirus: What questions do you have?

The requirement to see an ophthalmologist to check for eye damage should be enough to scare off anyone considering hydroxychloroquine, that's if the hours of bathroom time haven't already. This drug has some powerful side effects for some people for sure. Just working every day to be strong and healthy is my strategy because SOMETHING is going to attack and being healthy is our best defense.

I was shopping for a respirator for painting and sanding but see that there has been a run on everything in that category. Oh well, there will probably be a ton available in a couple months. Hope you can keep supplied at work, we need you to be healthy to help win this war.

cwbullet said:

Hydroxycholorquine does not provide immunity or at least there is no proof of that today. So far, the indication to treat only the severest of infections. To be honest, the mechanism is known but is theorized to suppress the immune system which might be causing the damage to the body in these severe infections. The evidence is very limited and the researcher who hypothesized it has been debunk in the past for outlandish claims. I have treated on patient with it and we have have had 100% positive results. That could be a coincidence. Time will tell with more data.

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Thanks for sharing a true medical (vs journalistic) update Chuck!

Speaknoevil said:

Thanks for sharing a true medical (vs journalistic) update Chuck!

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I think it is important to moderate expectations. If all people expect to get hydroxychloroquinone, they will be upset with their medical visits / requests.

My understanding from the last SARS thing (and I'm nowhere near an MD, so....) is that it was afflicting younger strong men because their immune ssytem went into overdrive, so suppressing immunity in those patients actually helped. But that may be the same debunked fellow Dr. Chuck is referring to above. I defer to the expert. (My sister is on that stuff for Lupus.)

The stuff is toxic to malaria parasites, hence its function there. It's also toxic to humans, but we can tolerate it, mostly, for a while, or longer in some cases like LUPUS. But it has significant drug interactions. Beware.

Lots of people were hoarding it based on initial reports and interest by the president. Now some patients that need it (Like for lupus) are having trouble finding it, while it sits in the medicine cabinet of the hoarders.

A doctor's experience contracting COVID-19. She is only 33 and they administered hydroxychloroquinone. https://time.com/5812495/doctor-covid-19-coronavirus/

Chuck I had a question about all the "home-made" or "alternate provider" PPE. Are hospital staff actually allowed to use them? I'm hearing in my locality (in Canada), they'll likely get dumped as they're not on the "approved materials" purchase list...

We aren't allowed to use most homemade masks. The hospital is sewing masks in the basement out of surgical sheets and has prepared kits and given them out to volunteers to sew and return. We still have our supply of N95s for 1 mask per shift.

They are distributing other homemade masks to other clinics and nursing homes, so they won't go to waste. Everything helps right now.

Dipstick said:

Chuck I had a question about all the "home-made" or "alternate provider" PPE. Are hospital staff actually allowed to use them? I'm hearing in my locality (in Canada), they'll likely get dumped as they're not on the "approved materials" purchase list...

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We are allowed to use some. I 3d printed on and used it. I trust it.

Most of our docs are upgrading to PAPRs in the OR, ICU, and ERs.

I don't want anyone to think I am a naysayer. I think time will tell on Hydroxyquinone. If I were sick enough to take it, I would. I am just warning not to take it on your own or hoarding it. This medication should be used with specific patients.

The evidence needs some beefing up. I certainly would not take it for prophylaxis, yet.

All I’ve heard is that they give it to really extreme cases but it seems as if some states are stock piling it. Our governor admitted to that this afternoon.

timbucktoo said:

All I’ve heard is that they give it to really extreme cases but it seems as if some states are stock piling it. Our governor admitted to that this afternoon.

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We have 10K tablets in the pharmacy. We have audited every prescription to prevent scripts for friends.

From what I've read it acts as an ionophore for Zn+2 ions. It allows the ions to move from extracellular space to intracellular space. Once there, the Zn+2 ions block select DNA/RNA replication processes and it turns out that it is very effective at blocking the RNA that the Corona virus has. Basically it's the zinc doing the work but the zinc can't get there on its own.

I'd want some randomized blind trials for this but in the non-blind stuff that's been done, it's been very effective after only a few days.

cwbullet said:

Most of our docs are upgrading to PAPRs in the OR, ICU, and ERs.

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Are your docs buying their own or did you manage to keep a supply of PAPR hoods? Some of our ED docs bought their own. We started to run low on PAPR hoods before we ran low on N95 . I think people were using them despite being fit tested for masks.

We had one in the helicopter in case someone couldn't pass a fit test, but it is impossible to use with our helmets. It was taken back by the infectious disease folks as soon as we had our first suspected case.

We have 40-50 we use for Chem-Bio exposures. We are just repurposing them.

Back at work today, more Coronavirus rule outs. We have tested hundreds and have less than 6 positives. Everyone thinks they have the virus yet so few test positive. We are using the CDC guidelines. It sure throws a wide net to find so few positives.

cwbullet said:

Back at work today, more Coronavirus rule outs. We have tested hundreds and have less than 6 positives. Everyone thinks they have the virus yet so few test positive. We are using the CDC guidelines. It sure throws a wide net to find so few positives.

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I've seen social media posts circulating with screenshots of people claiming to be in medical jobs stating how they've seen death certificates for people with pneumonia, or other respiratory problems as cause of death being changed to COVID-19/novel coronavirus. Some even went on to say they knew the test results for those cases were pending or hadn't come in yet.

Do you have any procedural insight that may explain such occurrences, or are these just cries for attention using a difficult to verify platform?
(admittedly, I went back looking for the screenshots to add here, but am not having luck finding them again. Perhaps that's enough evidence of their credibility or lack thereof)

Chuck, the choloroquin / hyrdoxychloroquinone thing turned divisive on a different (non-TRF) forum I'm on. One faction advocated stocking up just in case before it's gone, and railed against restrictions on scripts for it by the pharmaceutical association. Another faction supported the restrictions because a) drug sitting in someone's prepper hoard doesn't help anybody and b) in the US these drugs are mostly used for LUPUS/SLE and a few other things and very much needed for those people. There are doses out there stockpiled but not enough to support a toliet-paper-frenzy like run on stocks.

In your experience as a doctor, and having seen the initial evidence and being well read on ongoing trials, at what point do you think we should expect to see worthwhile data come out on its use for 1) severe cases 2) moderate cases 3) mild cases to prevent them getting worse? Weeks? Months? Just curious.

Thanks for all you do. You represent the best in us.

Chuck, If you have time to watch these, I was wondering how accurate they are. This guy is a bariatric surgeon in Texas, explains this is a respiratory illness (out of his specific field) but he explains in great detail how the virus attacks the lungs and how people get into trouble.

The second video he brings it closer to his expertise and explains that obese people are one of the groups with a much higher risk for death from the virus. High blood pressure appears to be a factor as well. If this is accurate, it could end up cutting a swath through the rocketry community. We as a group skew older and seem to run a bit on the hefty side.

cwbullet said:

We have tested hundreds and have less than 6 positives. Everyone thinks they have the virus yet so few test positive. We are using the CDC guidelines. It sure throws a wide net to find so few positives.

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This sounds like the (I assume single use) tests that are in such limited supply are being squandered. What do you think?
Are the tests being used with discretion or available to anybody with the sniffles armed with the latest Breaking News?
I've seen footage of lines of cars that resemble the 1978 gas crisis.

I've had a question that maybe you could answer.
How did this current form of corona virus become so much more wide spread than the several recent past examples?
Basics such as travel, weather/climate or world economy are basically the same.

The video shows how the virus kills you by attacking your lungs. I wonder if there's a significant difference in death rates between smokers and non-smokers? Surely if your lungs are already damaged as much as smokers lungs are they've got to be at a huge disadvantage in something like this.

Just like his next video saying how obese people are at greater risk.

Exactimator said:

Chuck, If you have time to watch these, I was wondering how accurate they are. This guy is a bariatric surgeon in Texas, explains this is a respiratory illness (out of his specific field) but he explains in great detail how the virus attacks the lungs and how people get into trouble.

The second video he brings it closer to his expertise and explains that obese people are one of the groups with a much higher risk for death from the virus. High blood pressure appears to be a factor as well. If this is accurate, it could end up cutting a swath through the rocketry community. We as a group skew older and seem to run a bit on the hefty side.

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The mechanism is sort fo correct. Yes, they cause damage to the lungs. A significant portion is cause by own inflammatory response to the virus.

Yes, age and quiet a few of diseases increase patient risk and one of those is high blood pressure. There is also evidence that some blood pressure meds lower your risk.

What type of high blood pressure meds?

Mushtang said:

The video shows how the virus kills you by attacking your lungs. I wonder if there's a significant difference in death rates between smokers and non-smokers? Surely if your lungs are already damaged as much as smokers lungs are they've got to be at a huge disadvantage in something like this.

Just like his next video saying how obese people are at greater risk.

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Yes and Vapers and any other forms of inhalants.

Mushtang said:

The video shows how the virus kills you by attacking your lungs. I wonder if there's a significant difference in death rates between smokers and non-smokers? Surely if your lungs are already damaged as much as smokers lungs are they've got to be at a huge disadvantage in something like this.

Just like his next video saying how obese people are at greater risk.

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I'm certainly not a doctor and haven't seen anything regarding smoking (other than what Chuck just posted (thanks)). Anecdotally, based on ONE person: my mother in law smoked two packs a day for ten years when she was in her 40's/50's. She was diagnosed with emphysema and takes regular prescription meds by inhaler. She's in her mid 70's. Her pulmanologist told her if she gets Covid-19 and it doesn't kill her, she'll most likely be on oxygen for the rest of her life.

Back several years ago when her doctor was diagnosing her emphysema, he was examining her and asked "did you smoke a lot about 20-30 years ago? You have a bunch of old scar tissue in your lungs." He pretty much nailed it.

Exactimator said:

I'm certainly not a doctor and haven't seen anything regarding smoking (other than what Chuck just posted (thanks)). Anecdotally, based on ONE person: my mother in law smoked two packs a day for ten years when she was in her 40's/50's. She was diagnosed with emphysema and takes regular prescription meds by inhaler. She's in her mid 70's. Her pulmanologist told her if she gets Covid-19 and it doesn't kill her, she'll most likely be on oxygen for the rest of her life.

Back several years ago when her doctor was diagnosing her emphysema, he was examining her and asked "did you smoke a lot about 20-30 years ago? You have a bunch of old scar tissue in your lungs." He pretty much nailed it.

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You are 200% correct! COVID and the future COVIDs are one heck fo a reason not to smoke or inhale anything other than air.

boatgeek said:

I've put in an offer to donate the unopened half-mask respirator and will report back on if they want it.

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Turns out they did want it and will pick it up later today.

boatgeek said:

Turns out they did want it and will pick it up later today.

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Thank you very much for your donation!

Exactimator said:

Back several years ago when her doctor was diagnosing her emphysema, he was examining her and asked "did you smoke a lot about 20-30 years ago? You have a bunch of old scar tissue in your lungs." He pretty much nailed it.

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This is kind of an aside, but I just want to add that over the years I have treated a number of people with serious respiratory complications who worked with fiberglass in an industrial setting. These weren't hobbies, but still be careful working with any fine dust.

Exactimator said:

Chuck, If you have time to watch these, I was wondering how accurate they are. This guy is a bariatric surgeon in Texas, explains this is a respiratory illness (out of his specific field) but he explains in great detail how the virus attacks the lungs and how people get into trouble.

The second video he brings it closer to his expertise and explains that obese people are one of the groups with a much higher risk for death from the virus. High blood pressure appears to be a factor as well. If this is accurate, it could end up cutting a swath through the rocketry community. We as a group skew older and seem to run a bit on the hefty side.

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Those who suffer from obesity are at increased risk for diabetes, hypertension, kidney failure, liver failure, and heart failure.

The volume of adipose tissue itself takes up space even inside the chest.

The volume in the abdomen makes diaphragmatic movement more difficult.

Think of a severe viral infection that compromises 50% of lung capacity. In someone who starts at 100%, they may do fine, they have a full 50% reserve

For those who have one or more of the above, you can see how they aren’t starting at the same “100%”.