OtherGround Forums OG doc. AMA on COVID-19

Trying to be useful in this time of crisis and uncertainty.

MD here working in both the US and Canada. Have seen and treated a few cases so far. My wife is an epidemiologist and ID doc working for the IDSA and CDC so she's right in the middle of this.

I'll answer any mindful and respectful question unless I'm busy on call.

For the record, I thought that Trump behaved irresponsibly when this came out and we are now lagging behind. However, I entirely support his decision to close the borders from Europe and I think he's behaved like a responsible leader these last 2 weeks.

Ask away

Let's keep this civil.

Edited: A big shout out to fellow MDs RahjaiMD, sage77, NoNeed4aScreenName for their input!

Been hearing kids under 9 aren't getting it, is that true?

What SHOULD we be doing other than avoiding people? 

Thanks for your answers in the other thread. Appreciate it!

Also, are there tests in the US or not? Can you clear that up at all? I know they fucked the first kit up, but is there something better?

How close to a vaccine? 

Thank you!

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?

Believe in the Power of One - 

Been hearing kids under 9 aren't getting it, is that true?

What SHOULD we be doing other than avoiding people? 

Bear in mind this is based on incomplete data.

There are many cases of infants and children having it, but no lethalities so far.

What to do:
-Avoid crowds
-Avoid unnecessary travel
-If you're sick, stay home, many toll free numbers out there to help you figure out if you have symptoms.
-If you're very sick, go to the ER, try protecting your mouth on your way there (or wear a mask if you have one)

What do you consider a safe distance to keep from others? I've seen 1 meter and 2 meters. How far can COVID-19 travel from a sneeze or a cough?

Have any of your co workers gotten the virus?

Believe in the Power of One - 

Also, are there tests in the US or not? Can you clear that up at all? I know they fucked the first kit up, but is there something better?

How close to a vaccine? 

Thank you!

I'm in NYC and we do have access to tests for patients considered at risk and those with typical symptoms.

Some teams already claim they have a vaccine but it still takes testing (pharmacokinetics, safety, immunogenic responses, etc...). I'd say we're about 6 months away to having vaccines available to large populations.

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.

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.

Tim Duncan - 

Have any of your co workers gotten the virus?

Several have been quarantined, 2 have tested positive (1 in Montreal, 1 in NYC)

What’s your opinion on the British approach here, trying to let healthy folks get infected sooner so that herd immunity then kicks in to protect the vulnerable? It seems to me the question is what fraction of healthy, young people need hospitalization. If it’s small enough so as to not overwhelm the system, this might be a good plan. 

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

How many bullshitters are you getting who just have just want attention? I'm guessing all this hoopla is gonna bring out the looneys.

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..

And this is a perfect example of why informed professionals (or professional fighters) are often driven away from the forum.

Real MD vs OG MDs, here we go! Your expertise is appreciated btw

CDC says 8 weeks before they think its under control. Thoughts on that number? 

Piyo - 

What’s your opinion on the British approach here, trying to let healthy folks get infected sooner so that herd immunity then kicks in to protect the vulnerable? It seems to me the question is what fraction of healthy, young people need hospitalization. If it’s small enough so as to not overwhelm the system, this might be a good plan. 

VERY CONTROVERSIAL.

Epidemiologists are battling this one out.

You may have heard about "flattening the curve" but this doesn't tell the whole story. It's more about "reducing the area under the curve" which better reflects mortality and morbidity.

The problem with the UK approach is that it might induce greater mortality and morbidity. It seems like about 5-10% of people with the infection requires acute care (not necessarily critical care)

But it certainly is a cost-reducing approach. Other countries (including the US) has not taken up the approach.

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?

1. Would you suggest avoiding airplanes? Even shorter 2 hour flights? 
 

2. How serious do you think this is? People blowing it out of proportion? Or is there a reason for the hysteria. 

 

NiteProwleR - 

How many bullshitters are you getting who just have just want attention? I'm guessing all this hoopla is gonna bring out the looneys.

Several, including those having a runny nose. People are scared, I get it but if you're not coughing, don't have shortness of breath or no fever, you don't have COVID-19.

The Closed Guard - 

CDC thinks 8 weeks before they think its under control. Thoughts on that number? 

Nope, but my wife is (ID and microbiologist). Internist, intensivist, nephrologist and toxicologist.

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. 

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)