OtherGround Forums OG doc. AMA on COVID-19

3/15/20 11:48 AM
10/23/05
Posts: 2902
BZtown10 - 

What do you think about this video?  From 2018 


Hey BZ, good to see you on the thread. I already know your stance on vaccinations :)

I've read the paper and I actually know some of the authors. Don't want to derail the thread but here's an anwser.

Here's the link for full pdf: https://kopernio.com/viewer?doi=10.1371%2Fjournal.pmed.1000258&token=WzIxMzYzNSwiMTAuMTM3MS9qb3VybmFsLnBtZWQuMTAwMDI1OCJd.oOjFXf3YseAd6ie1EX3yeq3Bw4k

To be fair, there are 2 things here:
-Vaccination was protective against influenza (OR 0.4)
-Vaccination was associated with more medically attended H1N1 (OR 2.0)

H1N1 was a particularly virulent strain. Interesting data but subsequent studies did NOT show this association. And it's a far cry (if you read the paper) to suggest that vaccination may lead to an epidemic...

We can talk about it on the vaccination thread if the insults have stopped flying over there.

3/15/20 11:50 AM
10/23/05
Posts: 2903
emu67 - 

How about viral dose versus severity of symptoms? Is there any information in this - the thinking is that if you’re exposed to a large number of corona virus at the same time, you’ll be sicker than if you were exposed to a smidgen but just enough to infect you. Any truth to that?


Answered this earlier but yes:
large exposure = higher virus load = overwhelming of defense mechanisms = more severe symptoms and shorter incubation

3/15/20 12:01 PM
1/11/06
Posts: 7020
mataleo1 -
emu67 - 

How about viral dose versus severity of symptoms? Is there any information in this - the thinking is that if you’re exposed to a large number of corona virus at the same time, you’ll be sicker than if you were exposed to a smidgen but just enough to infect you. Any truth to that?


Answered this earlier but yes:
large exposure = higher virus load = overwhelming of defense mechanisms = more severe symptoms and shorter incubation

Thanks, sorry about missing the info. earlier. Stay healthy.

3/15/20 12:07 PM
7/22/15
Posts: 5294
mataleo1 -
trobinson21 - 
mataleo1 -
trobinson21 - 

Why aren’t you treating patients and searching for answers instead of playing politics and arguing on here all day?


Fuck off buddy: I've been on call for the last 16 days straight.

I'm still on call now covering the ICU. Fortunately, I have residents and fellow to help out. Happy?

Lol you’re full of shit.


I've been on this forum awhile. I practice as an internist, intensivist, nephrologist and clinical toxicologist.

If you're here to derail the thread, go play somewhere else.

Sorry you have to put up with asswipes like trobinson21, he's one of the everyday idiots on here.

He's probably taking note on all your advice though. 

3/15/20 12:08 PM
2/14/11
Posts: 35478

Intersting thread, thanks for taking the time, OP. 

Edited: 3/15/20 12:14 PM
3/17/02
Posts: 624
Kirik -

Thank you for the thread of the year.

Apologies for the trobinson troll. He was of course shown the door.

I do have a question that for me is huge. I am based in Western Massachusetts. Just yesterday we had the first presumptive cases in the county. I have a fight gym, and am trying to figure out whether to close or not. We have reached out to the town board of health repeatedly for some direction, without a response so far.

Do you think fight gyms should close down? Should they move to stand up only? Stand up only with a limited size and instruction to try to maintain social distancing? Follow the lead of school officials, and close down or limit size and/or programming if K-12 are closed down in the town?

I know it's impossible to answer anything definitively, but any feedback whatsoever would be very gratefully received.

And again, sincerest apologies for the troll. He obviously leads a very miserable life, at the least internally.

I’m in the same boat Kirik. Don’t know what to do with my gym. Others in the area are adding more to spite current events. We are supposed to have a big kids party tomorrow. This whole ordeal is ridiculous. 
 

I think it’s inevitable we will have to close. But when? How long do you wait? 

3/15/20 12:18 PM
10/23/05
Posts: 2904
jotabrav0 - 
Kirik -

Thank you for the thread of the year.

Apologies for the trobinson troll. He was of course shown the door.

I do have a question that for me is huge. I am based in Western Massachusetts. Just yesterday we had the first presumptive cases in the county. I have a fight gym, and am trying to figure out whether to close or not. We have reached out to the town board of health repeatedly for some direction, without a response so far.

Do you think fight gyms should close down? Should they move to stand up only? Stand up only with a limited size and instruction to try to maintain social distancing? Follow the lead of school officials, and close down or limit size and/or programming if K-12 are closed down in the town?

I know it's impossible to answer anything definitively, but any feedback whatsoever would be very gratefully received.

And again, sincerest apologies for the troll. He obviously leads a very miserable life, at the least internally.

I’m in the same boat Kirik. Don’t know what to do with my gym. Others in the area are adding more to spite current events. We are supposed to have a big kids party tomorrow. This whole ordeal is ridiculous. 
 

I think it’s inevitable we will have to close. But when? How long do you wait? 


No reason to wait. Everything else is closing for a reason. Better be safe. I'd think at the minimum 1 month, possibly 2 or more.

It sucks, I know most of you will lose money. For a threat that may never materialize. But this is serious.

Some of my mentors in medicine (those I trust and respect) have said this is what we should do. I defer to them for matters like this.

Edited: 3/15/20 12:24 PM
3/23/12
Posts: 25155
jotabrav0 -
Kirik -

Thank you for the thread of the year.

Apologies for the trobinson troll. He was of course shown the door.

I do have a question that for me is huge. I am based in Western Massachusetts. Just yesterday we had the first presumptive cases in the county. I have a fight gym, and am trying to figure out whether to close or not. We have reached out to the town board of health repeatedly for some direction, without a response so far.

Do you think fight gyms should close down? Should they move to stand up only? Stand up only with a limited size and instruction to try to maintain social distancing? Follow the lead of school officials, and close down or limit size and/or programming if K-12 are closed down in the town?

I know it's impossible to answer anything definitively, but any feedback whatsoever would be very gratefully received.

And again, sincerest apologies for the troll. He obviously leads a very miserable life, at the least internally.

I’m in the same boat Kirik. Don’t know what to do with my gym. Others in the area are adding more to spite current events. We are supposed to have a big kids party tomorrow. This whole ordeal is ridiculous. 
 

I think it’s inevitable we will have to close. But when? How long do you wait? 

Might I recommend that fight gyms forgo sparring and partnered technique drills and instead move to sport specific strength and conditioning training, bag and pad work?  Even pad work I might elect to only use the long isolation pads rather than pads that are held closer to the body.  You might even take time to, as a group review fight videos in a “gracie breakdown” manner.

3/15/20 12:24 PM
10/16/10
Posts: 29867
mataleo1 - 
Kimbos Lice - 

The last 2 days I've experienced fatigue, headache, and chills.

No fever, coughing, difficulty of breathing

 

Think I just might have a cold? 


No fever, No cough, No difficulty = VERY UNLIKELY THIS IS COVID


Probably just teh bad aids
3/15/20 12:26 PM
1/13/10
Posts: 47333

In late, thanks for the great Info.. Mataleo I’m more concerned for my daughter who will be two in June. I work in health care and she goes to the day care across from my job. What are the concerns I should have with toddlers and day cares etc? Not like my wife and I can just take time from work and keep her home. 

3/15/20 12:34 PM
10/23/05
Posts: 2905
youarewhatiswrong - 
jotabrav0 -
Kirik -

Thank you for the thread of the year.

Apologies for the trobinson troll. He was of course shown the door.

I do have a question that for me is huge. I am based in Western Massachusetts. Just yesterday we had the first presumptive cases in the county. I have a fight gym, and am trying to figure out whether to close or not. We have reached out to the town board of health repeatedly for some direction, without a response so far.

Do you think fight gyms should close down? Should they move to stand up only? Stand up only with a limited size and instruction to try to maintain social distancing? Follow the lead of school officials, and close down or limit size and/or programming if K-12 are closed down in the town?

I know it's impossible to answer anything definitively, but any feedback whatsoever would be very gratefully received.

And again, sincerest apologies for the troll. He obviously leads a very miserable life, at the least internally.

I’m in the same boat Kirik. Don’t know what to do with my gym. Others in the area are adding more to spite current events. We are supposed to have a big kids party tomorrow. This whole ordeal is ridiculous. 
 

I think it’s inevitable we will have to close. But when? How long do you wait? 

Might I recommend that fight gyms forgo sparring and partnered technique drills and instead move to sport specific strength and conditioning training, bag and pad work?  Even pad work I might elect to only use the long isolation pads rather than pads that are held closer to the body.  You might even take time to, as a group review fight videos in a “gracie breakdown” manner.


We're all guessing here, but just consider: It's a gym; there's sweat, saliva, droplets everywhere. Air is moist. People stay close. It's a germ pool. Movie theaters are closing up, many restaurants too. Take notice people, especially if you are potentially liable here.

3/15/20 12:36 PM
2/2/15
Posts: 8944
Kimbos Lice -

The last 2 days I've experienced fatigue, headache, and chills.

No fever, coughing, difficulty of breathing

 

Think I just might have a cold? 

Are your chills multiplying? Are you losing control?

3/15/20 12:38 PM
10/23/05
Posts: 2906
Barry_BondsMVP - 

In late, thanks for the great Info.. Mataleo I’m more concerned for my daughter who will be two in June. I work in health care and she goes to the day care across from my job. What are the concerns I should have with toddlers and day cares etc? Not like my wife and I can just take time from work and keep her home. 


June is really far away (in terms of a pandemic), so i'd rather not say too much here but wait and see. Kids are almost never critically ill. I'm more nervous for elderly patients with comorbid conditions.

3/15/20 12:41 PM
1/13/10
Posts: 47334
mataleo1 -
Barry_BondsMVP - 

In late, thanks for the great Info.. Mataleo I’m more concerned for my daughter who will be two in June. I work in health care and she goes to the day care across from my job. What are the concerns I should have with toddlers and day cares etc? Not like my wife and I can just take time from work and keep her home. 


June is really far away (in terms of a pandemic), so i'd rather not say too much here but wait and see. Kids are almost never critically ill. I'm more nervous for elderly patients with comorbid conditions.

Thank you sir 

3/15/20 12:43 PM
11/4/11
Posts: 6457
Barry_BondsMVP -

In late, thanks for the great Info.. Mataleo I’m more concerned for my daughter who will be two in June. I work in health care and she goes to the day care across from my job. What are the concerns I should have with toddlers and day cares etc? Not like my wife and I can just take time from work and keep her home. 

This is a good question, and currently it does not look like there is a clear answer. As has been stated before, it looks like minors (young healthy kids in particular) have a low risk of serious problems from this infection. They could potentially be a source of spread to more vulnerable populations. Our hospital has expanded is employee daycare since some schools (possibly all later today) are closing and staff need to be able to have their kid’s supervised so they can work. For the time being I would continue to use daycare/childcare, but I would try to minimize contact between your kids and older relatives or any family members with significant pre-existing conditions

3/15/20 12:53 PM
1/13/10
Posts: 47335
SC MMA MD -
Barry_BondsMVP -

In late, thanks for the great Info.. Mataleo I’m more concerned for my daughter who will be two in June. I work in health care and she goes to the day care across from my job. What are the concerns I should have with toddlers and day cares etc? Not like my wife and I can just take time from work and keep her home. 

This is a good question, and currently it does not look like there is a clear answer. As has been stated before, it looks like minors (young healthy kids in particular) have a low risk of serious problems from this infection. They could potentially be a source of spread to more vulnerable populations. Our hospital has expanded is employee daycare since some schools (possibly all later today) are closing and staff need to be able to have their kid’s supervised so they can work. For the time being I would continue to use daycare/childcare, but I would try to minimize contact between your kids and older relatives or any family members with significant pre-existing conditions

Yea the hospital’s day care hasn’t said anything about it or what they plan to do. Like you mentioned, doctors, nurses etc all have to work and our kids need to be watched. 
 

we will try and keep her away from my grandma etc, thanks for your input as well.

3/15/20 1:01 PM
1/27/20
Posts: 195

Thank you for taking the time to help us OP.

3/15/20 1:05 PM
10/12/11
Posts: 157

Thanks for the AMA Matleo1

In your opinion what are the best practices we can do if we have to go to work? Obviously working from home is ideal but a lot of us don’t have that option.

What I’m doing is wiping my work station down with a Clorox wipe (throughout the day), wearing gloves, and practicing social distancing.  When I get home I change into clothes I have in the garage and place my work clothes in a plastic garbage bag, before I get in the house.  I then jump into the shower as soon as possible.  I work in a fairly high risk environment (corrections) but I don’t have to interact with a large number of people.
 

Do you have any other recommendations?

 

Thanks again

3/15/20 1:10 PM
5/7/08
Posts: 22915

Hey Mata I'm also in Montreal. I'm immunosuppressed with infliximab and work in a job where we share a workstation (rotating shifts using the same mouses and keyboards, phones, etc..) so I've told my bosses I'm isolating. They're checking with occupational health services so I'm waiting for their response, but how long do you estimate before I can safely return to work and not worry about this virus? 2 weeks? More?

 

Thanks

3/15/20 1:14 PM
10/23/05
Posts: 2907
kappakeen - 

Thanks for the AMA Matleo1

In your opinion what are the best practices we can do if we have to go to work? Obviously working from home is ideal but a lot of us don’t have that option.

What I’m doing is wiping my work station down with a Clorox wipe (throughout the day), wearing gloves, and practicing social distancing.  When I get home I change into clothes I have in the garage and place my work clothes in a plastic garbage bag, before I get in the house.  I then jump into the shower as soon as possible.  I work in a fairly high risk environment (corrections) but I don’t have to interact with a large number of people.
 

Do you have any other recommendations?

 

Thanks again


I'm not an expert on infectious control but from what I've read:

-Keep a safe distance from co-workers
-Wash hands often (or sanitizer)
-Don't go in if you're sick
-Don't go in if anyone else is sick
-Gloves will eventually have droplets if you keep them long enough.
-Limit contact (hand shaking)

You seem to be doing your best!

3/15/20 1:15 PM
10/23/05
Posts: 2908
MayorPirkle - 

Hey Mata I'm also in Montreal. I'm immunosuppressed with infliximab and work in a job where we share a workstation (rotating shifts using the same mouses and keyboards, phones, etc..) so I've told my bosses I'm isolating. They're checking with occupational health services so I'm waiting for their response, but how long do you estimate before I can safely return to work and not worry about this virus? 2 weeks? More?

 

Thanks


At the very least: 1 month, but it may be longer. Hotter months ahead may limit the incidence and spread, but too early to know.

3/15/20 1:28 PM
1/17/20
Posts: 10

What about this treatment? Any validity to this?

3/15/20 1:28 PM
1/1/01
Posts: 19177

Great thread. Thank you.

3/15/20 1:37 PM
1/1/01
Posts: 20295

Cliffs?

3/15/20 1:39 PM
10/23/05
Posts: 2909
King Vinny - 

What about this treatment? Any validity to this?


Don't have time to watch the whole thing.

I like to consider myself evidence-based. There are so many treatments out there that make sense. "There's a cystine molecule on the surface", "Anti-oxydants", "Anti-virals"...

That's not enough. Corticoids make a lot of sense but preliminary data is that they're bad. Chloroquine has a shitty safety profile. Quinine? Well, look up immune thrombopenia and blindness. The medical community has been accused of pushing drugs without proper safety and efficacy trials and I agree.

We need robust and transparent longitudinal studies with 2 groups comparing hard outcomes and side-effects (mortality, not length of hospitalization). It is particularly challenging to do these studies but, fortunately, there are so many incident patients that we actually can perform trials with results available in the matter of weeks.

We should get news from China soon. I have a lot to say about that (I have many Chinese colleagues working on guideline panels with me).