Coronavirus: What questions do you have?

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cwbullet

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In a trauma unit we used to have a pool to predict the first date that a motorcycle accident victim is brought in. It was a sure sign of spring. One of my compatriots said they should put organ donor cards in all motorcycle shops. He also called them "graveyard ponies".

I agree that with the lockdown, flu cases are less and at the prison in town here they were on lockdown for flu prevention before the governor ordered a lockdown for the general population due to Covid. As a result, there haven't been any Covid cases in the local prison yet. Have only had a total of three cases
in the county I live in so that might have something to do with it. Yes there isn't widespread testing because we don't have many tests available but the local hospital is not being inundated with Covid sick people either so that indirectly supports the low number (3) of Covid cases.

I've joked with associates and patients that in Fulton County, we're a bunch of "hicks" that don't go anywhere! That in and of itself I think is protective along with the other features of good hygiene and masks. Kurt
We call them Donorcycles.
 

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Chuck...I'm intersted to hear your opinion about the Kawasaki-like symptoms that have been observed in children in NYC who have coronavirus antibodies:

https://www.cbsnews.com/news/kawasaki-disease-children-hospitalized-new-york-city-coronavirus-link/

Thanks so much for taking the time to manage this thread. Now more than ever, It's incredibly valuable to get answers from a trustworthy source.
Wow, that's interesting. I wonder if they are treating it like Kawasaki's with aspirin and gamma globulin. Kurt
I'm very interested by this. I saw articles linking "Kawasaki-like" symptoms and COVID-19 yesterday and sent them to a colleague of mine. Her son (18 months at the time) was struggling over Christmas with intermittent fever and inflammation symptoms. They live in the greater NYC/NJ metro area. Eventually it was diagnosed as Kawasaki. Then, later, when treatment didn't work and it didn't go away, diagnosis changed to juvenile idiopathic arthritis. First biologic treatment didn't work for that; the next one (I forget which drug) does seem to be working. Steroids were effective before the second biologic was engaged.
Several bouts of hospitalization occurred over several months. The little boy seems to be doing OK now, on the second biologic.

I wonder if my colleague's son could be part of this; she is now aware and investigating in case it has any treatment implications.
 

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I'm very interested by this. I saw articles linking "Kawasaki-like" symptoms and COVID-19 yesterday and sent them to a colleague of mine. Her son (18 months at the time) was struggling over Christmas with intermittent fever and inflammation symptoms. They live in the greater NYC/NJ metro area. Eventually it was diagnosed as Kawasaki. Then, later, when treatment didn't work and it didn't go away, diagnosis changed to juvenile idiopathic arthritis. First biologic treatment didn't work for that; the next one (I forget which drug) does seem to be working. Steroids were effective before the second biologic was engaged.
Several bouts of hospitalization occurred over several months. The little boy seems to be doing OK now, on the second biologic.

I wonder if my colleague's son could be part of this; she is now aware and investigating in case it has any treatment implications.

Yes very interesting. I hope the kid fully recovers.
 

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Another tidbit. Autopsies of deaths across the country appear to show a high number of life threatening clots. Now we need to figure out how significant this is and why they are occurring.
 
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ksaves2

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Yes very interesting. I hope the kid fully recovers.
Another wow, I know the medicos on this thread know that long term rhhoids on a kid is fraught with issues
and hope they can taper soon. Undoubtedly, specialist folks are involved who know more than me and what they can get away with. Kurt
 

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Chuck,

I read an interesting blog post on Coronavirus risks: https://erinbromage.wixsite.com/cov...14Z_426FOfa5DZEydvRkTy8WhrX-hKz0scxhSKT6XgxnU The author is a Ph.D. Biology, on faculty at UMass Dartmouth, teaching microbiology and immunology. (Checked the school's website - https://www.umassd.edu/directory/ebromage/)

The central premise is this: Successful Infection = Exposure to Virus x Time

There is a mixture of research and anecdotal evidence used as examples. It seems to make sense, but before I rely on it would like a more educated opinion.
 

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Chuck,

I read an interesting blog post on Coronavirus risks: https://erinbromage.wixsite.com/cov...14Z_426FOfa5DZEydvRkTy8WhrX-hKz0scxhSKT6XgxnU The author is a Ph.D. Biology, on faculty at UMass Dartmouth, teaching microbiology and immunology. (Checked the school's website - https://www.umassd.edu/directory/ebromage/)

The central premise is this: Successful Infection = Exposure to Virus x Time

There is a mixture of research and anecdotal evidence used as examples. It seems to make sense, but before I rely on it would like a more educated opinion.
In general, this is a education blogger and is mostly correct. Pandemics that time for two reasons. 1. COVID passes from person person at a rate of 2-3 people or even up to 6 fold increase per week depending on what you read. 2. It also takes time to become symptomatic.
 

75Grandville

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In general, this is a education blogger and is mostly correct. Pandemics that time for two reasons. 1. COVID passes from person person at a rate of 2-3 people or even up to 6 fold increase per week depending on what you read. 2. It also takes time to become symptomatic.
Thank you! So, my take away is that brief interactions (shopping, etc.) are relatively safe for the general population. To me, this is part of trying to figure out what the "new normal" looks like. It helped that this person laid things out in a very straightforward way.

To be clear, I'm trying to gather information so that I can make my own informed decisions.

So, I will consider occasional brief shopping trips in person rather than curbside pickup. After eight weeks of complying with "Stay Home, Stay Safe" going to a convenience store for a donut was a great adventure! Maybe even take my daughter's boots to a cobbler to be repaired! Oh, I can barely stand the excitement!

Still planning to stay home/stay safe to the largest extent possible.

In all seriousness, grateful to have a job, a job that allows me to work from home, a home from which to work, ability to support my family and try to keep them safe, etc.
 

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Thank you! So, my take away is that brief interactions (shopping, etc.) are relatively safe for the general population. To me, this is part of trying to figure out what the "new normal" looks like. It helped that this person laid things out in a very straightforward way.

To be clear, I'm trying to gather information so that I can make my own informed decisions.

So, I will consider occasional brief shopping trips in person rather than curbside pickup. After eight weeks of complying with "Stay Home, Stay Safe" going to a convenience store for a donut was a great adventure! Maybe even take my daughter's boots to a cobbler to be repaired! Oh, I can barely stand the excitement!

Still planning to stay home/stay safe to the largest extent possible.

In all seriousness, grateful to have a job, a job that allows me to work from home, a home from which to work, ability to support my family and try to keep them safe, etc.
Enjoy the doughnut.
 

Reinhard

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Thank you! So, my take away is that brief interactions (shopping, etc.) are relatively safe for the general population. To me, this is part of trying to figure out what the "new normal" looks like. It helped that this person laid things out in a very straightforward way.

To be clear, I'm trying to gather information so that I can make my own informed decisions.

So, I will consider occasional brief shopping trips in person rather than curbside pickup. After eight weeks of complying with "Stay Home, Stay Safe" going to a convenience store for a donut was a great adventure! Maybe even take my daughter's boots to a cobbler to be repaired! Oh, I can barely stand the excitement!

Still planning to stay home/stay safe to the largest extent possible.

In all seriousness, grateful to have a job, a job that allows me to work from home, a home from which to work, ability to support my family and try to keep them safe, etc.
Two days ago, some data from a local cluster study got released. Clusters are groups of infections associated with a common geographical area and time frame, which often means they have a common source.
The biggest groups of clusters were associated with care facilities, followed by families and recreational activities. Not a single cluster could be identified that was either associated with shopping or public transport, although one has to keep in mind that these clusters are much harder to identify (nobody can name whom they met in the subway or in the store). So those brief interactions at the store can probably be considered lower risk compared to other activities.

Reinhard
 

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Two days ago, some data from a local cluster study got released. Clusters are groups of infections associated with a common geographical area and time frame, which often means they have a common source.
The biggest groups of clusters were associated with care facilities, followed by families and recreational activities. Not a single cluster could be identified that was either associated with shopping or public transport, although one has to keep in mind that these clusters are much harder to identify (nobody can name whom they met in the subway or in the store). So those brief interactions at the store can probably be considered lower risk compared to other activities.

Reinhard
Super interesting. Do you have a link?

If a contact tracing app becomes available I will sign up for it. That's the only way to definitively catch that kind of cluster. Been thinking a lot about this lately. Appreciate your post!
 

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Two days ago, some data from a local cluster study got released. Clusters are groups of infections associated with a common geographical area and time frame, which often means they have a common source.
The biggest groups of clusters were associated with care facilities, followed by families and recreational activities. Not a single cluster could be identified that was either associated with shopping or public transport, although one has to keep in mind that these clusters are much harder to identify (nobody can name whom they met in the subway or in the store). So those brief interactions at the store can probably be considered lower risk compared to other activities.
That is pretty important. Out of all of the tracings we have done, only one cluster was associated with a business and it was a filling station.
 

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Super interesting. Do you have a link?

If a contact tracing app becomes available I will sign up for it. That's the only way to definitively catch that kind of cluster. Been thinking a lot about this lately. Appreciate your post!
Unfortunately the original is in German, so here is - buyer beware - the Google Translate version:

For whatever reasons, Google misinterpreted some of the numbers in the tables 2 and 3. For example, the number "19" got changed into "19th", but it's not a rank, it's just the number of clusters. So whenever you see "st", "nd", "rd" or "th", in those tables disregard that.

This is also only the abbreviated press release version. For example, the biggest clusters in Austria are associated with alpine resorts (especially night life) but here they hide in the line item "Leisure activity and household". I don't think the full study is publicly available.

Reinhard
 

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Unfortunately the original is in German, so here is - buyer beware - the Google Translate version:

For whatever reasons, Google misinterpreted some of the numbers in the tables 2 and 3. For example, the number "19" got changed into "19th", but it's not a rank, it's just the number of clusters. So whenever you see "st", "nd", "rd" or "th", in those tables disregard that.

This is also only the abbreviated press release version. For example, the biggest clusters in Austria are associated with alpine resorts (especially night life) but here they hide in the line item "Leisure activity and household". I don't think the full study is publicly available.

Reinhard
This is very similar to my experience. My findings is that rarely is it a chance encounter. It is 20-30 minutes encounters that get you. You drop you guard and get infected.
 

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BABAR

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Problem: Low availability.
ProblemS

Perhaps biggest applies even to a theoretically perfect test, with 100% sensitivity, specificity, positive and negative predictive values (not that such exists, but Abbott Architect SARS-CoV-2 IgG
Test in the link above comes close.)


Does getting the virus once mean permanent or temporary or zero immunity? I.e., can you get it again, and if so how soon? This may not be “one and done” like chicken pox.

Also, in an asymptomatic patient, positive test could mean
1. PreSymptomatic and possibly actively shedding virus/infectious
2. True Asymptomatic carrier, again possibly actively shedding virus (aka Typhoid Mary)
3. Marker of previous infection now cleared and no longer infectious.
4. False positive. (Even if the test is 99% specific [and few of ANY medical tests are THAT good] when used for SCREENING EVERYONE in a predominantly healthy population Some of your positives are false positives.)

False positive and false negative rates
 

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ProblemS

Perhaps biggest applies even to a theoretically perfect test, with 100% sensitivity, specificity, positive and negative predictive values (not that such exists, but Abbott Architect SARS-CoV-2 IgG
Test in the link above comes close.)


Does getting the virus once mean permanent or temporary or zero immunity? I.e., can you get it again, and if so how soon? This may not be “one and done” like chicken pox.

Also, in an asymptomatic patient, positive test could mean
1. PreSymptomatic and possibly actively shedding virus/infectious
2. True Asymptomatic carrier, again possibly actively shedding virus (aka Typhoid Mary)
3. Marker of previous infection now cleared and no longer infectious.
4. False positive. (Even if the test is 99% specific [and few of ANY medical tests are THAT good] when used for SCREENING EVERYONE in a predominantly healthy population Some of your positives are false positives.)

False positive and false negative rates
Good points. The Abbot test quotes 100%, we have to see what reality is in the field. Most importantly, what does the positive IgG mean? It might mean immunity or just exposure.
 

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Just an FYI - a TN nursing home my mom is in called Friday. They were informing me that all employees and residents have to have the test for Covid-19. It is a TN requirement. I asked when I might be able to see Mom again (March 13th last day I saw her in person). They think maybe June.
 

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Just an FYI - a TN nursing home my mom is in called Friday. They were informing me that all employees and residents have to have the test for Covid-19. It is a TN requirement. I asked when I might be able to see Mom again (March 13th last day I saw her in person). They think maybe June.
I hope she and her fellow inmates (I mean residents.... sorry, my Dad is in an independent retirement community in CA and even though less restrictive, he says it FEELS like prison) continue to do well physically and emotionally. The isolation caused by these restrictions certainly is not negligible.
 

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Just an FYI - a TN nursing home my mom is in called Friday. They were informing me that all employees and residents have to have the test for Covid-19. It is a TN requirement. I asked when I might be able to see Mom again (March 13th last day I saw her in person). They think maybe June.
It must be tough. Just keep in mind, they are trying to protect both you and the patients. Unfortunately, nursing homes have been a huge source of infections.

I hope she and her fellow inmates (I mean residents.... sorry, my Dad is in an independent retirement community in CA and even though less restrictive, he says it FEELS like prison) continue to do well physically and emotionally. The isolation caused by these restrictions certainly is not negligible.
I often felt the same way about camps during deployments. Isolation is terrible. It really is draining on the psyche. I would ask myself often if the fences and guard posts were there to keep to locals out or us inside.
 

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Just an FYI - a TN nursing home my mom is in called Friday. They were informing me that all employees and residents have to have the test for Covid-19. It is a TN requirement. I asked when I might be able to see Mom again (March 13th last day I saw her in person). They think maybe June.
My Mom (age 91) is a resident in a facility that now has 40 or 50 residents test positive (including my mom) as well as 10 staff members. After the first two positive cases, they tested *everyone*. They are still waiting on the results for 70+ tests. The entire community is locked down with a guard at the end of the driveway asking what business you have there and Mom's hallway is now a sealed off COVID ward and everyone, patients and staff alike wear masks (staff also wears PPE, of course). Our daughter works for a medical staffing agency so even though she did not work in the COVID ward, she was able to get on site for two days (working) and ended each day on the phone with Mom with a "window visit."

The part I don't understand, is that we can't send mail, or packages, or even have our daughter hand deliver a care package (my wife sewed Mom some masks). I can understand why sending things OUT from the lockdown ward would be an issue, but why would they stop things from going IN?

[edit: Mom, so far, seems to be recovering okay but there have been several deaths so far.]
 
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cwbullet

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My Mom (age 91) is a resident in a facility that now has 40 or 50 residents test positive (including my mom) as well as 10 staff members. After the first two positive cases, they tested *everyone*. They are still waiting on the results for 70+ tests. The entire community is locked down with a guard at the end of the driveway asking what business you have there and Mom's hallway is now a sealed off COVID ward and everyone, patients and staff alike wear masks (staff also wears PPE, of course). Our daughter works for a medical staffing agency so even though she did not work in the COVID ward, she was able to get on site for two days (working) and ended each day on the phone with Mom with a "window visit."

The part I don't understand, is that we can't send mail, or packages, or even have our daughter hand deliver a care package (my wife sewed Mom some masks). I can understand why sending things OUT from the lockdown ward would be an issue, but why would they stop things from going IN?

[edit: Mom, so far, seems to be recovering okay but there have been several deaths so far.]
I cannot explain the policy on things coming in in less they are issuing masks and want to avoid the false perception of protection with homemade masks. It seems draconian.
 

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Thanks for the comments, and Peartree sorry you cannot send anything into your Mom. I'm pretty sure that Mom can receive mail. I know family sent her some Mother's Day mail. So far, at this place no one has it or symptoms. And I understand that a nursing home is a prime killing field due to all the old persons ailment issues. They have been playing hall bingo by having people outside their doors but not in one room together, and music and Mom says they are ALWAYS cleaning. Staff wears masks, but I'm not sure she does. She seems very okay with how things are going. She doesn't like to get out with others anyway. Perfect candidate for being in a quarantine status.
 

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I cannot explain the policy on things coming in in less they are issuing masks and want to avoid the false perception of protection with homemade masks. It seems draconian.
I would also like to add to my comment that you Mom and family will remain in my thoughts an prayers for a quick recover. Compassion seems to go out the door during this rough time.
 

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I cannot explain the policy on things coming in in less they are issuing masks and want to avoid the false perception of protection with homemade masks. It seems draconian.
Yeah, it's a mystery to us. We didn't even mention masks, specifically. My brothers mentioned to me first in our group chat that Mom's facility was holding all of her mail and she hadn't received things that they'd sent in the last few weeks. That's why I had our daughter ask if she could hand it to a nurse that worked there so they could just carry it down the call, but they still said "no." I have no idea why. Thanks everyone for all your kind thoughts and prayers for Mom. Oh, and no, they aren't issuing masks. Mom has been wearing a bandanna like a wild-West outlaw. :)
 

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Yeah, it's a mystery to us. We didn't even mention masks, specifically. My brothers mentioned to me first in our group chat that Mom's facility was holding all of her mail and she hadn't received things that they'd sent in the last few weeks. That's why I had our daughter ask if she could hand it to a nurse that worked there so they could just carry it down the call, but they still said "no." I have no idea why. Thanks everyone for all your kind thoughts and prayers for Mom. Oh, and no, they aren't issuing masks. Mom has been wearing a bandanna like a wild-West outlaw. :)
A bandana is better than no-dana. In all seriousness, I talked to my public health officer, infectious disease, and infection control experts and they struggled their shoulders. I would call and ask in a non-confrontational manner. They will either rethink the policy or explain it.
 

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This morning, my team begins to focus on planning to return to "normal" and whatever that means. Most of the medical staff have been teleworking and will be required to slowly file back into the clinical areas over 6 weeks. I have never done this sort fo planning. The question is how many of them will decide to retire instead. The thought has hit my mind. Two more years or less and that will be a reality.
 
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