OtherGround Forums OG doc. AMA on COVID-19

3/17/20 9:12 AM
10/23/05
Posts: 2942
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 

my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

3/17/20 9:15 AM
10/23/05
Posts: 2943
youarewhatiswrong - 

Doc, I regularly (sometimes multiple times a day) use a neti pot to flush out my sinuses with salt water.  It has had a very beneficial impact on my seasonal allergies, I have not had a respiratory illness (to which I have historically been prone) in a long time.  Is this advisable or contraindicated?


Neither. This has never shown to decrease your likelihood of catching the flu. It definitely helps for many other things (including allergies) and clearing your sinuses and clearing mild sinusitis, but no data on COVID. So carry on :)

3/17/20 10:41 AM
5/11/11
Posts: 2159
southcraw -
ons ear - Those of you with older and very "at risk" parents or friends, what precautions are you taking? Are you letting them go anywhere or just to certain places where they will run into very few people? My mother is 72 and has heart problems and we aren't letting her do much of anything aside from go to the local post office..grocery shopping is off limits and she's mostly fine with this

Am I going overboard with these precautions or should we take even more?wjat would those be exactly? Anyone else in the same boat?

Post office seems scetch to me.

 

manority of people lick envelopes still. It’s why my brothers courthouse job makes me nervous for him

Somone who works at a courthouse in California was  (allegedly) the first respoted case in one of their counties. I'd definitely take precautions working in any job where you are interacting with large groups. 

3/17/20 10:46 AM
1/1/01
Posts: 20299
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 

my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.

Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

3/17/20 11:16 AM
11/23/10
Posts: 92
Jump Kick -
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 

my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.

Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

The assumption is that aerosolization (excretion of infectious particles in the air) is mainly and perhaps only caused by sneezing, coughing, spitting or other abrupt airflow disturbances like tracheal suction.

There’s evidence that virus aerosol particles can linger in the air for a few hours, and they were demonstrated in air samples from Wuhan ICUs and restrooms. But no evidence that this can be caused to a significant degree by just breathing.

However, this early on, no evidence does not necessarily mean a lot. Besides, droplets can be spread on surfaces without coughing etc. from infected persons without symptoms (preliminary studies suggest asymptomatic rates of 50-60% of all cases!!) and is probably a lot more contagious, so don’t wait for coughs before taking distancing precautions.

 

3/17/20 11:29 AM
7/25/09
Posts: 1178
If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?




3/17/20 11:34 AM
1/13/10
Posts: 47377

this guy who has Coronavirus has gone viral with his experience. He’s type 1 diabetic.

3/17/20 11:40 AM
10/23/05
Posts: 2944
BigJohnSTEWD - If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?





Ideally, try to have that person alone at home.

If that's not possible, wash hands regularly, keep your distances (at least 6 feet), minimize the time being in the same room, keep that person confined to 1-2 room (and let that person to their own bathroom).

3/17/20 11:41 AM
2/4/09
Posts: 10520
Job Security -
Jump Kick -
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 

my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.

Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

The assumption is that aerosolization (excretion of infectious particles in the air) is mainly and perhaps only caused by sneezing, coughing, spitting or other abrupt airflow disturbances like tracheal suction.

There’s evidence that virus aerosol particles can linger in the air for a few hours, and they were demonstrated in air samples from Wuhan ICUs and restrooms. But no evidence that this can be caused to a significant degree by just breathing.

However, this early on, no evidence does not necessarily mean a lot. Besides, droplets can be spread on surfaces without coughing etc. from infected persons without symptoms (preliminary studies suggest asymptomatic rates of 50-60% of all cases!!) and is probably a lot more contagious, so don’t wait for coughs before taking distancing precautions.

 

I think this paper is right up your alley. Chances are you already came across this 

 

https://science.sciencemag.org/content/early/2020/03/13/science.abb3221

3/17/20 11:45 AM
2/4/07
Posts: 31546

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?

3/17/20 11:50 AM
10/23/05
Posts: 2945
Sandy Pantz - 

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?


Hydroxychloroquine should work if chloroquine does. And has a much better safety profile. It's being studied in a trial.

https://clinicaltrials.gov/ct2/show/NCT04307693

I do think this a STUPID trial. You're unlikely to die in mild COVID infections. And notice the bogus primary outcome.

3/17/20 11:59 AM
2/4/07
Posts: 31547
mataleo1 -
Sandy Pantz - 

If chloroquine ends up being an effective treatment, would hydroxychloroquine also work in theory?  Like it someone was taking hydroxychloroquine for arthritis, could they theoretically be immune from catching the disease?  Is anyone studying this angle at all?


Hydroxychloroquine should work if chloroquine does. And has a much better safety profile. It's being studied in a trial.

https://clinicaltrials.gov/ct2/show/NCT04307693

I do think this a STUPID trial. You're unlikely to die in mild COVID infections. And notice the bogus primary outcome.

Thanks!

3/17/20 11:59 AM
11/23/10
Posts: 94
BigJohnSTEWD - If someone in your household does come down with symptoms or tests positive what do you suggest to best contain that person and protect the other members of the household?




Safest option is probably isolation on a separate floor/outhouse/trailer/tent with separate bathroom/kitchen facilities from rest of household. If you don’t have vulnerable individuals in household, probably not worth it. Simpler, less strict distancing measures may be effective also (hand-hygiene, masks/PPE etc).

3/17/20 12:06 PM
1/13/10
Posts: 47378

It sucks working in health care because hospitals won’t close down. I can’t stay home and keep my baby away from day care. 
 

we’ve had a few patients test positive, I’m just concerned those nurses or doctors that were exposed to the patients could potentially spread something to their kids.

3/17/20 12:12 PM
6/30/07
Posts: 60051

Trump/Pence in tv now talking about buying a "massive" about of ventilators and about setting up "MASH"like field hospitals.

 

Saw a stat recently about best guess for the # of vents in the US at 64,000.

 

3/17/20 12:16 PM
11/17/10
Posts: 52467
mataleo1 -
In Limbo - 
NoNeed4aScreenName - 
The_Pundits_Ghost -

Just saw this online. Im guessing you would agree with this statement?

 

View this post on Instagram

I received the following text from an ER doctor in NYC this morning. It underscores how bad things might get and how important it is to isolate now, if possible. Here's the text: “Please spread the word to all of your nyc friends that this situation is sooooo bad!!!! Testing is frighteningly inadequate. While I do think our hospital system is doing the best it can and even doing in house testing now, they can still only do 180 tests/day, so we can only test people who are getting admitted to the hospital and sick healthcare workers. No one is testing sick people in the community!!! And we are seeing tons of them and turning them away. It is truly frightening. The life threatening lung issues are most common in the 2nd week of illness, so I think it’s going to get really bad in a week. My colleagues and I are all getting really scared and feel that the city is unprepared. Anyway, please don’t use my name or hospital affiliation, but I would definitely spread the word that everyone needs to be isolating themselves as much as possible. This may be obvious at this point, but I felt it my duty to warn people.”

A post shared by Tim Ferriss (@timferriss) on

Theres also some fear mongering going in the same manner as the old email forwards. 

 

SIft through the disinformation


i personally spoke with Drs. and Nurses that work in some of NYC's most well known, public hospitals

..Bellevue Hospital (the flagship hospital of NYC....LAw & Order SVU always has seens there and about Bellevue hospital) emergency room, which is normally ocnsidered crazy, is beyond crazy at this point

there are so many people, that hallways are crowded, cops are sent in for crowd control and they are supposedly starting to set up tent screening centers outside on the city block

 

NY pres and methodist hospital is experiencing a severe shortage of surgical and protective masks, gloves, swabs, goggles, etc......and are prioritizing who they hand them out to....meaning  many staff who normally wear masks and gloves, may not have them at this time

 

it is very real, and the stress and panic you hear form the nurses and doctors working within those confines is very palpable

 

 

 


Thank you for reporting this and, no, this is not exaggerated in the slightest.

gov cuomo and trump working ahnd in hand, with no bullshit politics....to have the army corps of engineers come in to renovate, expand, existing hospitals and to build some off site medical centers all throughout NYC and NY parts of NY

 

the employees have been pleading and begging for measures liek this and thankfully there is a response

3/17/20 12:51 PM
9/8/02
Posts: 24640
Someone please post:

https://youtu.be/zfjcEiW-Rzc
3/17/20 12:58 PM
2/24/11
Posts: 7204

I've just left work early, on my way to pick up my daughter because the school has informed me she is coughing a lot. 

I don’t want to give in to panic but she is under 3 and we've just had report of a newborn born eith CODVID 19. Not sure at that stage if this was in utero or a possible virus mutation which will now affect kids.

 

OP, please share your wisdom.

Edited: 3/17/20 1:01 PM
2/24/11
Posts: 7205
jcblass - Someone please post:

 

 

3/17/20 1:05 PM
10/23/05
Posts: 2946
GrindOnLine - 

I've just left work early, on my way to pick up my daughter because the school has informed me she is coughing a lot. 

I don’t want to give in to panic but she is under 3 and we've just had report of a newborn born eith CODVID 19. Not sure at that stage if this was in utero or a possible virus mutation which will now affect kids.

 

OP, please share your wisdom.


Serious complications of COVID are very unlikely in kids and deaths almost unheard of. If she has it, she'll be sick, but it very likely won't go anywhere. Thoughts are with you. Keep other members safe, you included.

3/17/20 1:05 PM
11/23/10
Posts: 95
NoNeed4aScreenName -
Job Security -
Jump Kick -
mataleo1 -
Jump Kick - 

If someone gets infected and is aware of it, when do they stop being contagious? How can they know if recovering at home? 
 

my 7 year old daughter has asthma and got pneumonia last winter, is she at any increased risk if she gets the CV19?


For most respiratory viruses, you stop being contagious when you become asymptomatic. COVID has been found up to 35 days in respiratory mucous membranes, so technically you may be contagious that long although you might no be shedding any significant amounts then. However, based on preliminary data from China on how new cases are decreasing, it seems that 14 days is a better estimate. So if you're sick, stay home 7 days after the end of your symptoms.

For your daughter, theoretically, yes. But data so far shows that kids (even those with chronic conditions) are fairly protected against severe disease.

Thanks a lot.

Is there any evidence that someone with active CV19 can transmit the virus by simply breathing near someone else? Does a cough or sneeze need to be involved? 

The assumption is that aerosolization (excretion of infectious particles in the air) is mainly and perhaps only caused by sneezing, coughing, spitting or other abrupt airflow disturbances like tracheal suction.

There’s evidence that virus aerosol particles can linger in the air for a few hours, and they were demonstrated in air samples from Wuhan ICUs and restrooms. But no evidence that this can be caused to a significant degree by just breathing.

However, this early on, no evidence does not necessarily mean a lot. Besides, droplets can be spread on surfaces without coughing etc. from infected persons without symptoms (preliminary studies suggest asymptomatic rates of 50-60% of all cases!!) and is probably a lot more contagious, so don’t wait for coughs before taking distancing precautions.

 

I think this paper is right up your alley. Chances are you already came across this 

 

https://science.sciencemag.org/content/early/2020/03/13/science.abb3221

Thanks for the link - hadn’t read that article. Chinese data are chinese-contextual of course, but that fits with the article drafts from Italy that I’ve been forwarded from my network regarding asymptomatic transmission. Just even worse. And predicts all too well the current situation... 

3/17/20 1:07 PM
3/23/12
Posts: 25163

3/17/20 1:22 PM
9/20/19
Posts: 1973
Barry_BondsMVP -

It sucks working in health care because hospitals won’t close down. I can’t stay home and keep my baby away from day care. 
 

we’ve had a few patients test positive, I’m just concerned those nurses or doctors that were exposed to the patients could potentially spread something to their kids.

Kids are safe, dude. Zero deaths 9 and under worldwide. Very low mortality 10-20. 

Edited: 3/17/20 1:30 PM
11/23/10
Posts: 96
GrindOnLine -
jcblass - Someone please post:

 

 

Uhm. I don’t agree with most of that. I wish I could though.

Most of all the comparison of deaths to Influenza, which has been in circulation/season for half a year. Covid19 has been been in circulation in Europe/USA for what? 1 month? With early data suggesting an avg. time from infection to death (if death occurs) of 4 weeks. With all pandemics/contagious diseases like this, you must expect exponential growth in infected, sick and dead. Covid19 hasn’t had time to climb up the exponential slope yet. Compare it to influenza in 6 months, and hopefully it’s overblown, but all early indicators suggest this has much deadlier properties - and hoping that it respects seasons like the flu is optimistic, and so far, not convincing.

Edit: he’s right that media-induced panic and blame is the enemy of the good here, but going about one’ s business is what Italy did for a few weeks too long.

3/17/20 1:35 PM
10/23/05
Posts: 2947
Job Security - 
GrindOnLine -
jcblass - Someone please post:

 

 

Uhm. I don’t agree with most of that. I wish I could though.

Most of all the comparison of deaths to Influenza, which has been in circulation/season for half a year. Covid19 has been been in circulation in Europe/USA for what? 1 month? With early data suggesting an avg. time from infection to death (if death occurs) of 4 weeks. With all pandemics/contagious diseases like this, you must expect exponential growth in infected, sick and dead. Covid19 hasn’t had time to climb up the exponential slope yet. Compare it to influenza in 6 months, and hopefully it’s overblown, but all early indicators suggest this has much deadlier properties - and hoping that it respects seasons like the flu is optimistic, and so far, not convincing.

Edit: he’s right that media-induced panic and blame is the enemy of the good here, but going about one’ s business is what Italy did for a few weeks too long.


AGREED Completely.

All indicators are suggesting this is something vastly different from the flu. Propagation, Virulence, Outcomes, Length of symptoms.

Talk to people from China, Italy, Spain and they'll tell why it resembles nothing like the flu. I've been practicing for a while and we deal with a flu season every year and i've never seen anything like this.