OtherGround Forums OG doc. AMA on COVID-19

18 days ago
6/1/16
Posts: 7121
ltlurker -

What are the risks to pregnant women and newborn child?

 

 If your wife was due to have a baby in the next two weeks what would you do?

I’m literally in this situation 

18 days ago
7/15/14
Posts: 386

Based on the information that's out there, i don't think it's necessary nor a good idea to wear a mask.  It also causes you to fidget with it, which brings your hands on your face or close to it...Peter Attia MD mentioned the same thing in one of his recent videos on the subject.  

 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

 

>>>If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.

 

>>Wear a mask if you are coughing or sneezing.

 

What to do:

 

(1.) Get a thermometer, fever is 100.4 or higher

(2.) Purchase a Pulse Oximeter to measure your oxygen levels at home.  Since COVID-19 causes a slow decrease in Oxygen levels before someone actually feels the effects, that's why you would measure your levels at home.  If you notice it go below 95% contact your doctor right away.

18 days ago
10/23/05
Posts: 2818
androushka - 

If you get hospitalized from this thing, what is the treatment? How far would just keeping the fever in check with acetaminophen at home go?

Anything in the way of health practices/diet/widly available meds known to help with immunity/virus in general?

Appreciate the info man, it is very important and helpful


Depending where you live, you might be treated with some antivirals (Remdesivir or Kaletra). Corticosteroids seems to worsen outcomes (preliminary data from China).

I'd go with NSAIDs, lots of fluids.

As improving immunity, nothing specific, but exercise, good diet, stop smoking. Won't go into curcuma and other things (that's a thread on its own)

18 days ago
2/9/09
Posts: 10194

Do you think once major countries (Italy, China) let people back out from the lockdown we will see a second phase of infection ? 

18 days ago
1/1/01
Posts: 8439
ttt
18 days ago
3/20/12
Posts: 35214

ages of your positive tests with symptoms ?

just give a range if you can't be precise

18 days ago
6/13/04
Posts: 11384
androb - 
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!

Yes. That’s why I’m asking. They are testing more people and have more data than any other country (that we can trust )

-and their numbers seem to be 98% of people with symptoms that are tested don’t have corona 

.6% mortality rate 

most dying are over 80

 


In South Korea, the majority of those who have been infected have been young.

In Italy, the majority that have been infected have been older.

Also, Italian health system became over-run, leading to not enough beds/equipment/etc for people to properly care for everyone.
Edited: 18 days ago
1/1/01
Posts: 30547

I've been sick for 5 weeks coughing, wheezing, can't wait breathe get exhausted and out of breath just walking around.

 

Been on 3 roundabout antibiotics, multiple rounds of predsidone last night round started 60 mg for 4 days before the taper, on a nebulizer, benzonatate, promethazine with codeine, breo inhaler, pro air inhaler. 

 

Dr says I don't have Coronavirus but have upper respiratory infection but it's not going away. I haven't been tested and no idea how to get tested. 

 

I'm going to die am I?

 

Edit 

I also live in the same neighborhood the first reported case in AZ was confirmed. 

18 days ago
10/23/05
Posts: 2819
acai - 

Based on the information that's out there, i don't think it's necessary nor a good idea to wear a mask.  It also causes you to fidget with it, which brings your hands on your face or close to it...Peter Attia MD mentioned the same thing in one of his recent videos on the subject.  

 

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

 

>>>If you are healthy, you only need to wear a mask if you are taking care of a person with suspected 2019-nCoV infection.

 

>>Wear a mask if you are coughing or sneezing.

 

What to do:

 

(1.) Get a thermometer, fever is 100.4 or higher

(2.) Purchase a Pulse Oximeter to measure your oxygen levels at home.  Since COVID-19 causes a slow decrease in Oxygen levels before someone actually feels the effects, that's why you would measure your levels at home.  If you notice it go below 95% contact your doctor right away.


n95 masks do reduce transmission but they have limitations (not full proof) but early data is promising in very endemic areas.

Your suggestions for diagnosis (fever and low sat) is helpful but not fullproof. Fever only has a sensitivity as marker of 80-85% meaning there are quite a few false negatives. And low sat is a bad prognostic factor but not a diagnostic one.

18 days ago
1/18/03
Posts: 3410

My mother is above 70 and has some health issues (I believe it's referred to as aut-immune diffeciencies).  On the radio today it was saying they should all self quarentine.  She now rarely leaves the house but I got her to go out to an indoor facility where at most (including us) there were less than 10 people.  Should I  stop doing that?

 

Also we are thinking of bringing my neice over while this is going on, as long as she's not showing any symptoms we should be good with that or should we avoid that?

18 days ago
1/7/09
Posts: 15770

What are your thoughts on anti-hypertensive medications such as Losartan as far as how they could influence the severity of an infection? 

 

Along the same lines, when we are told that high blood pressure is a risk factor, does that mean treated or untreated?  

 

I have seen thoughts on both sides, some suggesting that because the virus binds to ACE2 as its means of entry into the body, that drugs which increase expression of that enzyme such as Losartan would lead to worse outcomes(which seems to be supported by the stats on hypertension as a comorbidity), but there are others saying that the increase in ACE2 has actually been shown to be protective and has been shown to prevent lung damage in other instances of viral pneumonia and ARDS, with some theorizing it could even be used as a treatment for covid19.  But I'm not a doctor so I dont know what to think of it all since the info is so contradictory.

 

If your parents were on Losartan, would you have them continue taking it or try to switch to a calcium channel blocker or something else? 

18 days ago
10/23/05
Posts: 2820
The Closed Guard - 

Do you think once major countries (Italy, China) let people back out from the lockdown we will see a second phase of infection ? 


I don't know. It has a long incubation period and a long shedding period, so this may very well happen.

18 days ago
1/7/09
Posts: 15771
mataleo1 -
androushka - 

If you get hospitalized from this thing, what is the treatment? How far would just keeping the fever in check with acetaminophen at home go?

Anything in the way of health practices/diet/widly available meds known to help with immunity/virus in general?

Appreciate the info man, it is very important and helpful


Depending where you live, you might be treated with some antivirals (Remdesivir or Kaletra). Corticosteroids seems to worsen outcomes (preliminary data from China).

I'd go with NSAIDs, lots of fluids.

As improving immunity, nothing specific, but exercise, good diet, stop smoking. Won't go into curcuma and other things (that's a thread on its own)

What are your thoughts on chloroquine as a treatment?  It seems to be used often in China and South Korea

18 days ago
4/12/04
Posts: 7142

Does it seem to impact people of certain ethnicities than others? There's speculation that people of African decent don't seem to be impacted as much as Asians or Whites. Most of the cases in Africa, are cases of expat people who are White or Asian

18 days ago
10/23/05
Posts: 2821
trobinson21 - 
In Limbo -
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.

ok we get it, trob

 

youre such an alpha who just doesnt give a fuck

 

 

 

 

but yet here you are, caring about what others do and calling actual physicians bullshitters bc you want to maintain this wannabe alpha "youre all panicking and im the chill alpha spiral man" schtick

Don’t get upset, I’m just wondering why a busy doctor pulling “16 hour shifts” at his busy hospital fighting to get this thing under control has 8 straight hours to post on the OG.

7 hours ago this dude was in the Italy thread explaining how our healthcare system is just like theirs when the fact is Italian hospitals are notoriously operating at peak capacity without the coronavirus shit.

My wife is a disaster recovery RN and our neighbor is an internist and they are taking it seriously but they would never repeat “250 deaths in Italy in 24 hours” over and over and over again while mixing in disdain for governments lack of preparation. Why wasn’t this doctor begging for tests in January instead of waiting for Trump to come deliver some to his hospital?

Sorry for interrupting your doom and gloom echo chamber.


I'll bite.

I'm not pulling "shifts" but my ER colleagues (and nurses) are.
I'm on call for ICU. When you're on call for ICU, it is for a full week. I just happened to take 2.5 weeks straight.

I never said that we have the same healthcare as that of Italy. But they do have a very good and competent system.

I do my job which is on the wards treating patients. My wife who has met top government officials for weeks now has been begging for more testing kits.

18 days ago
2/9/09
Posts: 10196

Ive heard a rumor this is mutating. Any idea if thats true? Can you be infected more than once? (If yes, wouldn't your body have created antibodies already?)

18 days ago
10/23/05
Posts: 2822
Rambo John J - 

ages of your positive tests with symptoms ?

just give a range if you can't be precise


Positives come in all ages (20-85) in equal proportions, but the sicker ones were usually older than 70. We have an intubated patient now who's in his twenties. I only work with adults so don't have experience with pediatric populations.

18 days ago
2/12/14
Posts: 2080
mataleo1 -
Bukabuki - 

Oooh look. We have a death pill describing drug pushing doctor on here. The md might as well mean mcdonalds. Fuck off with your modern medical b.s..


What pill was I pushing?

There's no effective treatment as of yet. Some antivirals may work but we still don't know.

Here's an interesting read if interested:

COVID-19

 

 

Thanks for coming on. 

Question?

 

Is there any positive results from using anti-virals? 

Specifically the new medicine under trials in Wusan. the name of the drug is Remdesivar. Any word on that?

18 days ago
2/4/09
Posts: 10415
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.

25% needing hospitalization is of.... 

 

What is the current status of COVID-19 in Canada?

As of late Thursday, there are at least 179 confirmed and presumed cases of COVID-19 in Canada.

Seventy-nine of those cases are in Ontario, mainly concentrated throughout the GTA. The total includes a new case that was reported late Thursday — in Sophie Gregoire Trudeau, the prime minister's wife.

The new cases include men and woman ranging in age from their 20s to 80s. One man, in his 80s, has been hospitalized while the rest — in Toronto, York Region, Peel Region, Ottawa, Niagara, and Waterloo — are in self-isolation.

The situation is fluid and more updates from public health officials across the country are expected throughout today. 

Some of the first dedicated coronavirus screening centres were set-up at six hospitals and health centres throughout the province yesterday.

 

https://www.cbc.ca/news/canada/toronto/coronavirus-covid-19-panic-buying-stockpiling-1.5496381

 

18 days ago
10/23/05
Posts: 2823
Mutant - 

I've been sick for 5 weeks coughing, wheezing, can't wait breathe get exhausted and out of breath just walking around.

 

Been on 3 roundabout antibiotics, multiple rounds of predsidone last night round started 60 mg for 4 days before the taper, on a nebulizer, benzonatate, promethazine with codeine, breo inhaler, pro air inhaler. 

 

Dr says I don't have Coronavirus but have upper respiratory infection but it's not going away. I haven't been tested and no idea how to get tested. 

 

I'm going to die am I?

 

Edit 

I also live in the same neighborhood the first reported case in AZ was confirmed. 


Have you been tested for RSV? Influenza? Where do you live?

Corona doesn't usually last 6 weeks, I'm guessing you have something else. Eosinophillic pneumonia? Hyperreactive bronchis (like asthma)? BOOP? Sorry I can't be of much help

18 days ago
2/6/12
Posts: 7145
trobinson21 -

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

Stop being a cunt and go work on throwing spirals.

18 days ago
1/1/01
Posts: 30548
mataleo1 -
Mutant - 

I've been sick for 5 weeks coughing, wheezing, can't wait breathe get exhausted and out of breath just walking around.

 

Been on 3 roundabout antibiotics, multiple rounds of predsidone last night round started 60 mg for 4 days before the taper, on a nebulizer, benzonatate, promethazine with codeine, breo inhaler, pro air inhaler. 

 

Dr says I don't have Coronavirus but have upper respiratory infection but it's not going away. I haven't been tested and no idea how to get tested. 

 

I'm going to die am I?

 

Edit 

I also live in the same neighborhood the first reported case in AZ was confirmed. 


Have you been tested for RSV? Influenza? Where do you live?

Corona doesn't usually last 6 weeks, I'm guessing you have something else. Eosinophillic pneumonia? Hyperreactive bronchis (like asthma)? BOOP? Sorry I can't be of much help

Thanks I live in Phoenix x-rays for pneumonia negative, valley fever negative, I do have asthma but I've never had anything to like this before and last this long. 

18 days ago
10/23/05
Posts: 2824
JLK - 

My mother is above 70 and has some health issues (I believe it's referred to as aut-immune diffeciencies).  On the radio today it was saying they should all self quarentine.  She now rarely leaves the house but I got her to go out to an indoor facility where at most (including us) there were less than 10 people.  Should I  stop doing that?

 

Also we are thinking of bringing my neice over while this is going on, as long as she's not showing any symptoms we should be good with that or should we avoid that?


Lots of people are immunosuppressed. What does your mother have specifically? Some are worse than others. Humoral vs cell-mediated? As long as she's not swamped by crowds and that she washes hands (or uses hand sanitizers) her risk is for the moment minimal, unless you're in an endemic area.

Ok to bring your niece over if she's asymptomatic. Risk is never 0 but it's minimal.

18 days ago
6/13/04
Posts: 11386
Do you recommend taking fever reducing medication?

Or since a fever helps your body fight off the infection, you should let the fever do its thing ?(unless dangerously high)
18 days ago
4/12/04
Posts: 7144
Mutant -
mataleo1 -
Mutant - 

I've been sick for 5 weeks coughing, wheezing, can't wait breathe get exhausted and out of breath just walking around.

 

Been on 3 roundabout antibiotics, multiple rounds of predsidone last night round started 60 mg for 4 days before the taper, on a nebulizer, benzonatate, promethazine with codeine, breo inhaler, pro air inhaler. 

 

Dr says I don't have Coronavirus but have upper respiratory infection but it's not going away. I haven't been tested and no idea how to get tested. 

 

I'm going to die am I?

 

Edit 

I also live in the same neighborhood the first reported case in AZ was confirmed. 


Have you been tested for RSV? Influenza? Where do you live?

Corona doesn't usually last 6 weeks, I'm guessing you have something else. Eosinophillic pneumonia? Hyperreactive bronchis (like asthma)? BOOP? Sorry I can't be of much help

Thanks I live in Phoenix x-rays for pneumonia negative, valley fever negative, I do have asthma but I've never had anything to like this before and last this long. 

you probably got the bad AIDS.. sorry.