OtherGround Forums OG doc. AMA on COVID-19

3/15/20 5:43 PM
5/5/07
Posts: 11717
yusul -
mataleo1 -
androb - 
mataleo1 -
androb - 
mataleo1 -
Jacks Wasted Life - 

Thank you for this AMA.

 

1) Is it true that because it is aerosol based, we are all likely to get it?  Or will preventative measures like washing hands before eating or preparing food and not touching our nose, mouth, or eyes reduce our chances of getting infected?

2) I’ve heard rumors that some states are strongly considering 2-4 week quarantines for all residents.  Have you heard anything on this?

3) If a 2-4 week quarantine were implemented, how beneficial do you think it would it be in combating the virus?  Would it potentially prevent many cases or just delay them, essentially to give health care facilities more lead time to prepare for the inevitable?


1) There remains confusion here. It doesn't seem to be airborne but can still travel because of droplets. The main risk is contact with an infected host and then touching your face. So hand washing remains paramount.

2) I don't know about that, I'll ask my wife. At my hospital, they've put EVERY health care worker that comes back from outside the country in forced quarantine.

3) It really depends on how successful we are at enforcing the quarantine. They seem to have had success in China and South Korea with this.

Can you verify this 

250 000 test were given in SK (to those with symptoms) and only 2% of the tests came back positive 

are you seeing those types of numbers as well. That most people with symptoms that are getting tested are coming back negative?


I don't know what's going on in Saskatchawan but I can find out.

More patients have been tested in Montreal than NYC as of today. More than 90% have been negative so far.

Lots of RSV and influenza infections though (which can mimic COVID)

SK=South Korea. 
they seem to have the best handle on it. 
 

lol I don’t know if 250k people total live in Saskatchewan (jokes)


Ha!

Have you read their car drive-in system for detection? That was a brilliant idea. We should do this here. SK has done an amazing job of isolating people at risk, quick detection, and quick treatments. Hope we were as good here!

actually, why aren't we doing that in canada? what canadian agencies would be responsible for implementing it? ministry of health? individual hospitals? min of transport?

 

also, you are in nyc because of your wife? i thought you were in montreal (is there a connection with your hospitals?)

general curiousity, please don't divulge anything too personal of course, i just didn't know that canadian hospitals had direct contact with us hospitals outside of research collaborations. 

 

real question: what's your view on the idea that there's an S strain and an L strain? it seems quite plausible to me as there have been varying death rates. 

 

also, why would people who recovered catch again 45 days later? My assumption would be that they caught another strain (l and s maybe)? or that the COV19 could hide in the nervous system? is there another explanation as your body should have developed antibodies and a more reactive immune system?

 

cheers mate, if this virus is done, i hope to drop by montreal. 

Hes most likely dual credentialed.  A lot of docs that work close to border have this.

Im credentialed in canada but also have license to practice in ny and PA

In terms of testing positive again.   My suspicion is that is had moreso to do with the PCR testing they using and creating false positives.    Similar thing we see if patients treated for c. Diff with them still testing positive long after recovering from acute illness.

They are testing specifically for covid19 and not other coronavirus.  The normal viral swab is different test than the one for covid19.

Canada is just now getting better testing.   Some labs able get results back quickly but for confirmation still being sent to winnipeg.   This is what er doc told me today.  Again things keep changing day by day and faster methods will come now that we actually taking this seriously. 

 

3/15/20 5:45 PM
10/14/03
Posts: 30764

Great idea for a thread, but I just wish these were real doctors answering. I mean come on 15 pages and none of them have even mentioned toilet paper!!

JUST KIDDING, thanks for the info guys, Stay safe out there.

3/15/20 5:46 PM
2/4/09
Posts: 10463
GenErick -

Great idea for a thread, but I just wish these were real doctors answering. I mean come on 15 pages and none of them have even mentioned toilet paper!!

JUST KIDDING, thanks for the info guys, Stay safe out there.

Jokes on those suckers. The real treat is in baby wipes!

3/15/20 5:56 PM
2/27/11
Posts: 11196
Dragunov -
mataleo1 -

I'm going to take a break from the thread for a little while. But I'll answer questions tomorrow AM.

A lot of backlash (and now backtrack) on the Herd immunity approach of the UK.

Get some rest man. I’m in the UK. Not at all happy with the approach so far. It’s almost as if we’re waiting for it to really hit the fan before putting any significant measures in place.

I heard something about quarantining all the over 70 in UK, is it true? That would be a brilliant idea.

99% of the dead in Italy are > 70yo, in fact the average is 80.3, large majority with more than one preexisting condition (most common: hypertension, cardiopathies, diabetes), also most of them are in critical conditions in recovery units that are running out of space, which is the biggest problem at this time.

Plus in Italy you cant get the oldies to stay the fuck home, even in the evening you see a lot of bar full of granpas playing cards (this before the bars were closed down for the epidemic of course).

But even to this day, i see them out doing shopping in grocery stores or whatever, going out every fucking day.

 

 

 

 

 

3/15/20 5:57 PM
1/1/01
Posts: 26765
Rahjai MD -
yusul -
mataleo1 -
androb - 
mataleo1 -
androb - 
mataleo1 -
Jacks Wasted Life - 

Thank you for this AMA.

 

1) Is it true that because it is aerosol based, we are all likely to get it?  Or will preventative measures like washing hands before eating or preparing food and not touching our nose, mouth, or eyes reduce our chances of getting infected?

2) I’ve heard rumors that some states are strongly considering 2-4 week quarantines for all residents.  Have you heard anything on this?

3) If a 2-4 week quarantine were implemented, how beneficial do you think it would it be in combating the virus?  Would it potentially prevent many cases or just delay them, essentially to give health care facilities more lead time to prepare for the inevitable?


1) There remains confusion here. It doesn't seem to be airborne but can still travel because of droplets. The main risk is contact with an infected host and then touching your face. So hand washing remains paramount.

2) I don't know about that, I'll ask my wife. At my hospital, they've put EVERY health care worker that comes back from outside the country in forced quarantine.

3) It really depends on how successful we are at enforcing the quarantine. They seem to have had success in China and South Korea with this.

Can you verify this 

250 000 test were given in SK (to those with symptoms) and only 2% of the tests came back positive 

are you seeing those types of numbers as well. That most people with symptoms that are getting tested are coming back negative?


I don't know what's going on in Saskatchawan but I can find out.

More patients have been tested in Montreal than NYC as of today. More than 90% have been negative so far.

Lots of RSV and influenza infections though (which can mimic COVID)

SK=South Korea. 
they seem to have the best handle on it. 
 

lol I don’t know if 250k people total live in Saskatchewan (jokes)


Ha!

Have you read their car drive-in system for detection? That was a brilliant idea. We should do this here. SK has done an amazing job of isolating people at risk, quick detection, and quick treatments. Hope we were as good here!

actually, why aren't we doing that in canada? what canadian agencies would be responsible for implementing it? ministry of health? individual hospitals? min of transport?

 

also, you are in nyc because of your wife? i thought you were in montreal (is there a connection with your hospitals?)

general curiousity, please don't divulge anything too personal of course, i just didn't know that canadian hospitals had direct contact with us hospitals outside of research collaborations. 

 

real question: what's your view on the idea that there's an S strain and an L strain? it seems quite plausible to me as there have been varying death rates. 

 

also, why would people who recovered catch again 45 days later? My assumption would be that they caught another strain (l and s maybe)? or that the COV19 could hide in the nervous system? is there another explanation as your body should have developed antibodies and a more reactive immune system?

 

cheers mate, if this virus is done, i hope to drop by montreal. 

Hes most likely dual credentialed.  A lot of docs that work close to border have this.

Im credentialed in canada but also have license to practice in ny and PA

In terms of testing positive again.   My suspicion is that is had moreso to do with the PCR testing they using and creating false positives.    Similar thing we see if patients treated for c. Diff with them still testing positive long after recovering from acute illness.

They are testing specifically for covid19 and not other coronavirus.  The normal viral swab is different test than the one for covid19.

Canada is just now getting better testing.   Some labs able get results back quickly but for confirmation still being sent to winnipeg.   This is what er doc told me today.  Again things keep changing day by day and faster methods will come now that we actually taking this seriously. 

 

Thanks!

3/15/20 6:13 PM
11/23/10
Posts: 80
NoNeed4aScreenName -
GenErick -

Great idea for a thread, but I just wish these were real doctors answering. I mean come on 15 pages and none of them have even mentioned toilet paper!!

JUST KIDDING, thanks for the info guys, Stay safe out there.

Jokes on those suckers. The real treat is in baby wipes!

The secret to surviving this is hoarding coffee filters, bro!

Edited: 3/15/20 6:21 PM
2/4/09
Posts: 10467
Job Security -
NoNeed4aScreenName -
GenErick - Great idea for a thread, but I just wish these were real doctors answering. I mean come on 15 pages and none of them have even mentioned toilet paper!!

JUST KIDDING, thanks for the info guys, Stay safe out there.

Jokes on those suckers. The real treat is in baby wipes!

The secret to surviving this is hoarding coffee filters, bro!

Putting in an Amazon order right now for 17K boxes, make a couple bucks while surviving. What's the worst that could happen?

 

 

3/15/20 6:41 PM
1/1/01
Posts: 1274

Friends of mine say that the lockdown that is happening in some places (you don't leave your home) only hurts the economy and is pointless because it may work for a few days or a week and then people will go out anyway and meet people because that's just what we do. What are your opinions on that?

3/15/20 6:54 PM
11/4/11
Posts: 6458
per -

Friends of mine say that the lockdown that is happening in some places (you don't leave your home) only hurts the economy and is pointless because it may work for a few days or a week and then people will go out anyway and meet people because that's just what we do. What are your opinions on that?

It probably helps the overall effort of increasing social distancing, even though people will sometimes not comply. We already have reports of individuals who were under quarantine for possible exposure breaking the quarantine, in one case to bring a teen to a dance. Some people just refuse to take steps that are restrictive for them but may benefit the greater population. Remember the woman who decided to walk out of quarantine during the Ebola scare? 

3/15/20 7:16 PM
1/7/09
Posts: 15799

Have you seen a more detailed breakdown of any of the statistics of hypertensive cases? 

 

We see that hypertension increases the risk of a severe outcome, but what does that mean really?  Are these people who have untreated high blood pressure?  Are they people who had hypertension but are treated and present with normal blood pressure?  If they are treated, what medications are they on?  I saw some statistic that only 13% of people with high blood pressure in China are medicated.

3/15/20 7:21 PM
1/7/09
Posts: 15800
per -

Friends of mine say that the lockdown that is happening in some places (you don't leave your home) only hurts the economy and is pointless because it may work for a few days or a week and then people will go out anyway and meet people because that's just what we do. What are your opinions on that?

The more people comply, the more effective it is. It's not all or nothing. The goal is to flatten the curve, meaning reduce the overall number of infected and spread out the time frame over which they get infected(so that we dont exceed the capacity of our healthcare systems like what is happening in Italy).

 

Flattening the curve is the best we can do in part because of selfish assholes such as those people you mention(and also because 100% population isolation isn't really practical).  If we were all 100% compliant for X number of weeks we would literally wipe out the virus completely as it would have nowhere to spread with everyone infected either recovering or dying.

3/15/20 7:23 PM
3/4/03
Posts: 9229

Is it better to have cash on hand right now or will that potentially be seen as too much of a contagious vehicle?

3/15/20 7:23 PM
7/30/14
Posts: 5123
pidgey -
Dragunov -
mataleo1 -

I'm going to take a break from the thread for a little while. But I'll answer questions tomorrow AM.

A lot of backlash (and now backtrack) on the Herd immunity approach of the UK.

Get some rest man. I’m in the UK. Not at all happy with the approach so far. It’s almost as if we’re waiting for it to really hit the fan before putting any significant measures in place.

I heard something about quarantining all the over 70 in UK, is it true? That would be a brilliant idea.

99% of the dead in Italy are > 70yo, in fact the average is 80.3, large majority with more than one preexisting condition (most common: hypertension, cardiopathies, diabetes), also most of them are in critical conditions in recovery units that are running out of space, which is the biggest problem at this time.

Plus in Italy you cant get the oldies to stay the fuck home, even in the evening you see a lot of bar full of granpas playing cards (this before the bars were closed down for the epidemic of course).

But even to this day, i see them out doing shopping in grocery stores or whatever, going out every fucking day.

 

 

 

 

 

That seems to be the plan but ‘not yet’. Not sure what they’re waiting for! Any sensible >70 should probably be staying home anyway. 

3/15/20 7:33 PM
1/7/09
Posts: 15801
Dragunov -
pidgey -
Dragunov -
mataleo1 -

I'm going to take a break from the thread for a little while. But I'll answer questions tomorrow AM.

A lot of backlash (and now backtrack) on the Herd immunity approach of the UK.

Get some rest man. I’m in the UK. Not at all happy with the approach so far. It’s almost as if we’re waiting for it to really hit the fan before putting any significant measures in place.

I heard something about quarantining all the over 70 in UK, is it true? That would be a brilliant idea.

99% of the dead in Italy are > 70yo, in fact the average is 80.3, large majority with more than one preexisting condition (most common: hypertension, cardiopathies, diabetes), also most of them are in critical conditions in recovery units that are running out of space, which is the biggest problem at this time.

Plus in Italy you cant get the oldies to stay the fuck home, even in the evening you see a lot of bar full of granpas playing cards (this before the bars were closed down for the epidemic of course).

But even to this day, i see them out doing shopping in grocery stores or whatever, going out every fucking day.

 

 

 

 

 

That seems to be the plan but ‘not yet’. Not sure what they’re waiting for! Any sensible >70 should probably be staying home anyway. 

It's not just old people, or the death rate that matters though.  Italy has 12.7% of people infected needing ICU. Of those, half are younger than 65.

3/15/20 7:36 PM
12/12/07
Posts: 13869
androb -
mataleo1 -
tbizzle - 

Why is COVID-19 more dangerous than swine flu when 60 million Americans were infected and 300,000 were hospitalized? There was no where near this amount of panic back then. 


We don't have exact data to compare and numbers might be completely off, but, based on what we have, I can break it down quickly:

Mortality: for swine flu (in the US) was about 4k/22 million and preliminary data from Italy and Spain is that it's somewhere between 2-5%

Acute Care necessity: around 0.2% for swine flue and about 10-15% for COVID-19.

Hospitalizations: about 1-2% for swine flu, about 25% for COVID

Again, the numbers might be completely different as we know more, but it seems reasonable to be prepared.

That’s from Italy. (Not sure why Italy is such a hotbed) but there are other countries reporting numbers not nearly so scary. 
 

and a previous post of yours says 90% of people showing symptoms that are tested are coming back negative 

Italy is a hot bed because they didn’t take the virus serious at all. So when the virus spread, they weren’t able to handle the amount of cases they were receiving to the point where if you were considered a high mortality chance, they’d send you home to die. 

3/15/20 7:39 PM
1/1/01
Posts: 7971


stay safe guys
3/15/20 7:47 PM
2/4/09
Posts: 10471
captainplanet -
androb -
mataleo1 -
tbizzle - 

Why is COVID-19 more dangerous than swine flu when 60 million Americans were infected and 300,000 were hospitalized? There was no where near this amount of panic back then. 


We don't have exact data to compare and numbers might be completely off, but, based on what we have, I can break it down quickly:

Mortality: for swine flu (in the US) was about 4k/22 million and preliminary data from Italy and Spain is that it's somewhere between 2-5%

Acute Care necessity: around 0.2% for swine flue and about 10-15% for COVID-19.

Hospitalizations: about 1-2% for swine flu, about 25% for COVID

Again, the numbers might be completely different as we know more, but it seems reasonable to be prepared.

That’s from Italy. (Not sure why Italy is such a hotbed) but there are other countries reporting numbers not nearly so scary. 
 

and a previous post of yours says 90% of people showing symptoms that are tested are coming back negative 

Italy is a hot bed because they didn’t take the virus serious at all. So when the virus spread, they weren’t able to handle the amount of cases they were receiving to the point where if you were considered a high mortality chance, they’d send you home to die. 

Surprised the Pope hasn't had it. 

 

Wasn't he going around shaking hands?

Edited: 3/15/20 7:52 PM
4/7/10
Posts: 9705

How worried should I be about my wife and our unborn child? My wife is 14 weeks pregnant. She is an OD and owns her practice so she comes into close contact with patients every day. 

3/15/20 8:04 PM
5/8/09
Posts: 2357
I have an appointment to be tested on Tuesday. Never had a fever, a bit of a cough but mostly shortness of breath that comes and goes. I don't know if it's anxiety but I feel like I'm going to pass out. Problem is I can't just go to the hospital. I have to call the same hotline I called to get an appointment and I was on hold for 4.5 hours before I got through.
3/15/20 8:04 PM
12/12/07
Posts: 13870
NoNeed4aScreenName -
captainplanet -
androb -
mataleo1 -
tbizzle - 

Why is COVID-19 more dangerous than swine flu when 60 million Americans were infected and 300,000 were hospitalized? There was no where near this amount of panic back then. 


We don't have exact data to compare and numbers might be completely off, but, based on what we have, I can break it down quickly:

Mortality: for swine flu (in the US) was about 4k/22 million and preliminary data from Italy and Spain is that it's somewhere between 2-5%

Acute Care necessity: around 0.2% for swine flue and about 10-15% for COVID-19.

Hospitalizations: about 1-2% for swine flu, about 25% for COVID

Again, the numbers might be completely different as we know more, but it seems reasonable to be prepared.

That’s from Italy. (Not sure why Italy is such a hotbed) but there are other countries reporting numbers not nearly so scary. 
 

and a previous post of yours says 90% of people showing symptoms that are tested are coming back negative 

Italy is a hot bed because they didn’t take the virus serious at all. So when the virus spread, they weren’t able to handle the amount of cases they were receiving to the point where if you were considered a high mortality chance, they’d send you home to die. 

Surprised the Pope hasn't had it. 

 

Wasn't he going around shaking hands?

He also has Jesus protecting him, sooo...

3/15/20 8:25 PM
1/1/01
Posts: 7972
PoopingTom - I have an appointment to be tested on Tuesday. Never had a fever, a bit of a cough but mostly shortness of breath that comes and goes. I don't know if it's anxiety but I feel like I'm going to pass out. Problem is I can't just go to the hospital. I have to call the same hotline I called to get an appointment and I was on hold for 4.5 hours before I got through.

isn't the fever a huge part of it?
maybe one of the MD's can chime in
feel better man
3/15/20 8:28 PM
5/8/09
Posts: 2358
Yeah there's usually a fever but to be tested here you have to have traveled, have a fever or cough. Anyway, probably just anxiety kicking in.
3/15/20 8:37 PM
2/4/09
Posts: 10473

Whats with worldometers info.... 

 

Suddenly the entire vatican just died. 

3/15/20 8:38 PM
2/4/09
Posts: 10474
NoNeed4aScreenName -

Whats with worldometers info.... 

 

Suddenly the entire vatican just died. 

never mind. They fixed it. It was a little unreal to show a someone the site and suddenly there was 800K deaths, almost all from the vatican

3/15/20 8:40 PM
2/4/09
Posts: 10475
The_Pundits_Ghost -
NoNeed4aScreenName -
captainplanet -
androb -
mataleo1 -
tbizzle - 

Why is COVID-19 more dangerous than swine flu when 60 million Americans were infected and 300,000 were hospitalized? There was no where near this amount of panic back then. 


We don't have exact data to compare and numbers might be completely off, but, based on what we have, I can break it down quickly:

Mortality: for swine flu (in the US) was about 4k/22 million and preliminary data from Italy and Spain is that it's somewhere between 2-5%

Acute Care necessity: around 0.2% for swine flue and about 10-15% for COVID-19.

Hospitalizations: about 1-2% for swine flu, about 25% for COVID

Again, the numbers might be completely different as we know more, but it seems reasonable to be prepared.

That’s from Italy. (Not sure why Italy is such a hotbed) but there are other countries reporting numbers not nearly so scary. 
 

and a previous post of yours says 90% of people showing symptoms that are tested are coming back negative 

Italy is a hot bed because they didn’t take the virus serious at all. So when the virus spread, they weren’t able to handle the amount of cases they were receiving to the point where if you were considered a high mortality chance, they’d send you home to die. 

Surprised the Pope hasn't had it. 

 

Wasn't he going around shaking hands?

He probably did. Wasn’t he coughing and out of sight for a while? Has he been seen recently?

Yeah the labelled the mystery illness just a cold