OtherGround Forums OG doc. AMA on COVID-19

3/14/20 2:47 PM
2/9/07
Posts: 1150

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?

3/14/20 2:48 PM
7/2/09
Posts: 6831

Doctor, thanks for posting.  Keep up the good work, keep safe, keep healthy.  God bless.

3/14/20 2:49 PM
10/23/05
Posts: 2809
The Closed Guard - 

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. 

 


I would suggest postponing any non-essential flight. Planes are the worst environment to get droplets on you.

It is very serious. I am contact with several friends in Italy and it's downright scary what is happening over there. As mentioned in other threads, there are specific reasons why Italy might have a lot more cases. Nevertheless, we need to be prepared and hope nothing bad happens over here. Hysteria never helps and is never justified. But yes the overwhelming feeling among health care professionals is that this is very serious.

3/14/20 2:52 PM
2/9/09
Posts: 10192

How realistic is the CDCs 8 week window before things are under control? 

3/14/20 2:53 PM
2/9/09
Posts: 10193

Also Thank You for doing this. Stay safe

3/14/20 2:55 PM
9/3/18
Posts: 1270

In. Thank you 

3/14/20 2:57 PM
10/23/05
Posts: 2810
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.

3/14/20 3:00 PM
10/23/05
Posts: 2811
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?


All right, this is from my wife and NOT based on solid data.

The flu rarely kills young people but it does kill pregnant women to a much higher rate (won't go into the specifics on why, but it's both because of immunosuppresion and because your body overreacts when infected). I know that this isn't the flu but if my wife was pregnant, I would tell her to stay home.

3/14/20 3:01 PM
10/23/05
Posts: 2812
The Closed Guard - 

How realistic is the CDCs 8 week window before things are under control? 


Can't comment myself, but according to my wife this is a reasonable estimate

3/14/20 3:01 PM
8/23/11
Posts: 8433
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)

3/14/20 3:04 PM
10/23/05
Posts: 2813
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!

3/14/20 3:04 PM
8/23/11
Posts: 8434
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 

3/14/20 3:04 PM
7/25/09
Posts: 1176

I have an office of 10 employee’s. Do you recommend we work remote starting ASAP? 
 

 

3/14/20 3:05 PM
11/17/10
Posts: 52406
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

3/14/20 3:06 PM
11/17/10
Posts: 52407
mataleo1 -
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.

NYCHHC system?

you dont ahve to answer obv

3/14/20 3:06 PM
8/23/11
Posts: 8435
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

 

3/14/20 3:08 PM
2/8/08
Posts: 4390
Is there any truth to people getting the virus a second time? I believe they reported this in Japan, but I cant find the source.
3/14/20 3:09 PM
11/17/10
Posts: 52408
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.

dont mind trob

his sole purpose on this forum is to thump his chest about how awesome his life is while putting others down for their jobs or calling bullshit on people with more higher paying jobs than his, insulting other people's wives and kids, his 4 touchdowns in 1 game glory days, etc.

 

not sure if he is serious or trolling, either way, that's the schtick

then when someone hits the nail on the head and calls him out on his BS, he claims he was "trolling"

3/14/20 3:10 PM
10/23/05
Posts: 2814
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 


Yes correct. And yes I know that we don't have a proper denominator.

Regardless, here are data from various countries:
https://www.worldometers.info/coronavirus/

Spain: 3.1%
US: 2.2%
Italy: 6.8%
China: 3.9%

Yes, a previous comment mentioned that 90% don't have it but these are different ratios:
Deaths/Total infected cases= Mortality
vs Infected/Total tested

3/14/20 3:11 PM
10/23/05
Posts: 2815
BigJohnSTEWD - 

I have an office of 10 employee’s. Do you recommend we work remote starting ASAP? 
 

 


If possible, yes especially if you're in a state that has many cases

3/14/20 3:12 PM
10/4/02
Posts: 5940

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

3/14/20 3:15 PM
10/23/05
Posts: 2816
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

 


Yes agreed 100%. South Korea has possibly the best data as to incidence in whole populations. Their mortality rates may be lower than others, and one possibility is because they've tested a lot and may have a lot of relatively healthy carriers.

3/14/20 3:16 PM
10/23/05
Posts: 2817
SeattlesbigDprolapsedME - Is there any truth to people getting the virus a second time? I believe they reported this in Japan, but I cant find the source.

Yes, there's been 1 case in South Korea if I remember correctly.

Also, there are patients who've it but don't develop protecting antibodies, so this seems to be a real possibility.

3/14/20 3:18 PM
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 

3/14/20 3:19 PM
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)