Okay, here is an AMA COVID-19 thread. I will try to answer your questions?
People are afraid, and we don’t have a lot of trust in our federal government right now. But know that state and local governments are rising to the task.
Here is information on our local health website:
https://www.coronavirus.cchealth.org/
Bottom line: Social distancing.
I will try to answer any questions you have. I do not guarantee I will have an answer.
In my case I am working daily in my ICU and have cleared my schedule and cancelled all time off for the next few weeks. Yes, we have had COVID patients, and yes, we take precautions. No health care worker has gotten sick. We are prepared.
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235 Answers
Whenever I hear doctors giving advice, the main one is “stay home”.
What is your advice for people, who simply can not afford to stay home for financial reasons, or whose employers explicitely tell them to go to work, even when sick, or face getting fired?
@ragingloli Wash your hand frequently. Don’t shake hands. Don’t touch your face. Try to stay 2 meters away from people. Keep surfaces clean.
And for the record, I can’t say home either. I have to be in contact with COVID patients. It’s my job.
Could it be that the incept date of this virus in China was much earlier than reported based on it’s curve of rise and decline?
@lucillelucillelucille Most likely, yes. But to be fair, it’s a new virus, so they didn’t know what they didn’t know.
@Caravanfan – It makes me wonder how many people had it and survived, along with how long it has been where I am at.
I have one, why did you not direct this to those of us not from the states huh?
Only kidding doc…It’s good for morale you know? ;-}
@ucme Fair enough! I haven’t been paying attention to the UK response, truth be told. We are just working on our little section of the war front.
@Caravanfan No, no, you crack on, more power to you!
As I say, only tickling your ribs.
What’s your opinion about ordering take out food delivered from restaurants? Bad idea?
(And thank you for giving us this opportunity.)
Is it airborne?
If so, for how long/how far?
Can you tell us how much of an authority you are on the subject (no criticism, just a question)?
Thanks for doing this.
@rebbel
Is it airborne? Probably yes
How far? Nobody knows—but it’s droplet spread, so stay 2 meters away from people
How long? Virus maybe lasts 72 hours on surfaces.
How much of an authority am I? I am an ICU doctor. I am not an epidemiologist nor a coronovirus researcher. My job is to take care of you once you’re super sick, in shock on a ventilator.
If we willingly expose ourselves, will we be immune from this strain? How long until we are not carriers?
And thank you for taking questions and respect for helping people.
What about my question? ^^
Is Dove bar moisturizer soap effective? Or Irish Spring?
How long should one wait if they have symptoms, before going to the Doctor/ER?
Would you recommend a PCP, or the ER?
I woke up with a cough, the last two days. But. It goes away, after a few hours.
I am concerned that if I seek testing, I put myself at risk of contracting the virus, if I don’t already have it…
I have been staying away from others, as much as possible. Just in case…
I’m also the head of security, at a few large venues. My word, carries weight. Should I be suggesting that we cancel events? I have a big event in April, and my opinion may play a role in if we should cancel. Your opinions, would be welcomed.
@Caravanfan Do most people who wind up on a respirator from COVID19 live? What are the percentages? Also, how long once put on a respirator does it take to be able to be taken off? How long is the average hospitalization?
The patients who are very sick. but not sick enough to be put on a respirator, what is the advice for them? I feel like there is very little information about that. Should they take an expectorant? Are they being prescribed prednisone? I always hate prednisone for a cough, because it lowers immunity, but sometimes I can see where it is necessary. Are they recommending hospitalization for observation for people who are very sick, but not at death’s door? Does it matter if you live alone, can the disease progress so fast you can’t call 911 for yourself?
@MrGrimm888 I think you are supposed to call first so they know to expect you. From what I read, if you aren’t an emergency, they are telling people to stay home and self quarantine. I read that the test centers are being set up around the country. @Caravanfan can correct me if I am wrong, but if he does not come back soon, it can’t hurt to call ahead to the doctor or hospital anyway. They need to separate you from other patients possibly.
@Caravanfan What general percentage of adults that get this thing end up needing medical care?
Sorry I got busy at work:
@janbb “What’s your opinion about ordering take out food delivered from restaurants? Bad idea?” Good idea
@RedDeerGuy1 Any soap and water. Sing the song “Happy Birthday” twice when you’re washing your hands
@MrGrimm888
“How long should one wait if they have symptoms, before going to the Doctor/ER?
Would you recommend a PCP, or the ER?”
Go seek medical care if you are feeling really sick. If you have mild symptoms stay home. Where you go depends on your local medical resources. That’s an impossible question to answer as every local health care system is different.
“I woke up with a cough, the last two days. But. It goes away, after a few hours.”
I will not be making any online diagnoses on this thread.
“I am concerned that if I seek testing, I put myself at risk of contracting the virus, if I don’t already have it…”
That is a valid concern.
“I have been staying away from others, as much as possible. Just in case…”
That’s exactly what you should be doing.
“I’m also the head of security, at a few large venues. My word, carries weight. Should I be suggesting that we cancel events? I have a big event in April, and my opinion may play a role in if we should cancel. Your opinions, would be welcomed.”
Our public health department has recommended cancelling any event over 100 people. Impossible to know what will happen in a month. It will either blow over or be far worse.
@KNOWITALL “If we willingly expose ourselves, will we be immune from this strain? How long until we are not carriers?
For the love of all that is holy please do not do that.
@JLeslie
“Do most people who wind up on a respirator from COVID19 live? What are the percentages?” Most will live. I do not know percentages.
“Also, how long once put on a respirator does it take to be able to be taken off?”
I don’t know.
“How long is the average hospitalization?”
I don’t know.
“The patients who are very sick. but not sick enough to be put on a respirator, what is the advice for them? ”
Stay home if you can.
“I feel like there is very little information about that. Should they take an expectorant?”
Generally those are useless
“Are they being prescribed prednisone?”
Generally not.
“Are they recommending hospitalization for observation for people who are very sick, but not at death’s door?” We recommend hospitalization if people are sick enough to be hospitalized.
“Does it matter if you live alone, can the disease progress so fast you can’t call 911 for yourself?” No, it’s like the flu. It’s not ebola.
@ARE_you_kidding_me “What general percentage of adults that get this thing end up needing medical care?” That’s the million dollar question, and not able to answer yet because there are a lot of people who have not yet gotten tested.
Apparently, as a non-infected person, wearing a mask is not needed; sick persons should (that is at least my information).
Why do so many people wear masks, and what psychological effect might that have on other non-sick people who witness that (maybe they think that half the world is sick…)?
@rebbel People should only wear a mask if they have a fever or our coughing, or better yet stay home. Wearing a mask does NOT protect you from anybody. It does protect others if you have a cough.
We are running short of masks. Do not go out and buy masks.
Thank you, @Caravanfan.
My girlfriend, although she understands your (and other’s) explanation, insists on me wearing one, in two days when I will fly.
I don’t want to be a unnecessary mask wearer, but I also want to give her one reason less to be anxious about.
Decisions, decisions :-)
@Caravanfan Have you been treating young people? How young?
I feel like this virus is similar to the aftermath of violent crime in that everyone is hoping to be excluded from the group of victims. It’s “Well, going down that street in a skirt…” vs. “Oh, but he had prior health issues…”
@rebbel For what it’s worth, I understand your girlfriend. I guess you have to fly? Coming home?
Make you own masks. Folded paper towels and staple rubber-bands for ear pieces. If you think you have it !
Or don’t go anywhere ! ! ! ! !
@rebbel You’re actually probably at higher risk if you wear it. The mask won’t prevent a viral particle from from passing through and could very likely keep it next to your skin mouth if one does pass.
@longgone I don’t treat children—just adults.
@Tropical_Willie They don’t work.
@Caravanfan Thank you again for making yourself available to us!
Okay plan “B” stay home.^^^^
@Caravanfan Maybe this is a cultural difference. Here, adults in an ICU could be anything between 18 and 110. I’m asking whether you had any young patients. Anyone under 60? Under 40?
@Caravanfan Thanks for your expertise.
If someone has a mild to moderate case, stays at home, and gets over it, is better. Can they still infect others? And how long after feeling better should someone stay at home?
@longgone I can take care of anybody over the age of 14 in my ICU. We get all kinds of different clinical issues here, and it can be any age adult. The majority of the patients I see are older patients.
If I get covid and recover, am I now immune?
I just want to thank Caravanfan for taking the time out of what is surely a busy, stressful day to try to answer questions here. I’m feeling relatively isolated just being in AK, tho’ as I noted on another thread, we have had one case confirmed, so trying to stay on top of info. Again, thank you Caravanfan.
Absolutely. You could say we are fans of @Caravanfan.
Caravanfanfans
@filmfann Probably. But it may be like the flu where you have partial immunity that wears off. Honestly, nobody is really sure at this point.
Hey, if you really want to appreciate me, listen to Caravan! I’m a fan! :-)
What do you categorize it as?
An upper respiratory thing?
@lucillelucillelucille No, it’s more serious than that. In serious cases it causes pneumonia and lower respiratory infection and adult respiratory distress syndrome.
What is the average age of the people who’ve died?
@Caravanfan -Thanks, that’s what I’ve been curious about.
Just to echo @MrGrimm888‘s excellent questions:
If you’re otherwise healthy and under 40 (hypothetical) and you think you have the virus, what would be a symptomatic trigger for you that you would encourage that person to go to an ER vs. staying home/self-quarantine? Fever above 100 for x hours/days? Severe cough? Something else?
I’m not asking for specific medical advice, but if younger patients tend to recover on their own they may be concerned about unnecessarily clogging up the healthcare system, but at the same time they don’t want to wait too long and have the problem become bigger than if they’d sought medical care earlier.
If they’re above 60, does that threshold become lower for you? and in what ways?
@Caravan Thanks. It’s pretty tough staying away from older parents. That’s the only reason I wonder about how long a carrier could be ‘dirty’.
Thanks for everything that you do. And for taking time during all of this for this W.
Q: What steps have you taken to protect your own family?
Q: How long do you think social distancing needs to be in order to be effective?
@raum
1) It’s only me and my wife. I change clothes when I come home and take a shower
2) No clue. Probably weeks.
@Caravanfan I know it’s easy to lose track of our questions so I’ll re-ask: If someone has a mild case, stays home, rides it out, and gets better, can they still infect others? How long before they could reasonably be sure they are Covid-19 free?
So. Another question. Well, two.
1. What is the treatment? I’m assuming that, at this point, just treating the symptoms.
2. I haven’t heard anyone talking about this.
Our country, has other problems. Like the opioid crisis. Or. People addicted to drugs. Several large cities, have shut down many businesses, and installed curfews. I know, from working in food and beverage, and as a LEO, restaurants and bars, are full of people who sell and/or use drugs. So. All theses closings, should slow down the supply chain of narcotics. Are the hospitals preparing for lots of people who are going through withdrawal? This could be a big issue….
I have been re-watching Breaking Bad. That’s when this occurred to me…
1) No treatment. Supportive care. There are some experimental drugs.
2) I have no comment on the opioid thing
How hard is it to be enrolled in a “compassionate use” clinical trial of Remdesivir? 1 in 100? 1 in 1,000,000?
@gorillapaws So far it’s been hard, but I’ve not had many patients yet. The one patient that we could use it for we can’t because of other medical issues. But it hasn’t ramped up yet in our hospital.
What are the chances that many of us have already had it and recovered? Virtually everyone I know, including Rick and me, came down with some nasty something that took two weeks to run its course. I woke up with a very sore throat and a mild fever two weeks ago. Rick had the same, but with a substantially higher temperature. This all happened before the panic, so we didn’t do anything in particular but try to address the symptoms. We both slept a lot.
We’re OK now but we were both pretty sick.
I’ve had about all the viruses a person can have, and I’m immune, so whatever it was had to be a new one.
@Dutchess_III The chance is low, actually unless you had direct contact with someone who came from a high risk area. You probably just had a cold.
Will covid 19 be a one time thing, or will there be a new wave of it every year from now on?
@ragingloli There will probably be a wave of it like the flu. But hopefully we will have a vaccine next year.
Are they going to develop a titer test so we can be checked for immunity? Once immune, those people can help others who are sick without much concern, and can go back to a more normal life.
I realize they aren’t sure about whether people develop immunity or for how long. But, let’s say they determine people do become immune, will they prioritize checking immunity?
@Caravanfan Is that something they will definitely develop since they are testing a vaccine? I assume they need to test immunity to know it was effective, and how effective.
@JLeslie No, not necessarily. We don’t test immunity for the flu.
@Caravanfan Can one catch multiple illnesses at the same time? Like a cold and a flu or Covid19?
Should I discontinue, eating raw bats?
I just heard from one of our PAs. She’s been on a provider message board. One of the working hypotheses is that COVID-19 is attacking the heart, causing cardiomyopathy that is leading to respiratory failure, which explains the comorbidity with heart disease. Additionally, in the young, they’re hypothesizing that COVID-19 is causing a cytokine-storm in rare instances, which is what’s killing the young. Any thoughts as to the plausibility of those hypotheses based on your knowledge/experiences thus far?
@MrGrimm888 No. Bats are good because you can pick your teeth with the bones from the wings.
@gorillapaws I saw the same thing today and had an email thread with our cardiologist about it. It’s uncommon but not unheard of for people to develop a cardiomyopathy in response to sepsis. I have not yet seen the cardiomyopathy associated with COVID-19. There are standard therapies we do for cardiomyopathy depending on the severity and we are prepared for it, but know that this complication seems to be extremely uncommon. We’re talking isolated instances and people talking about it on a Facebook group. Nothing certain yet.
I’m 48, a type 2 diabetic, and have a mild (no symptoms, no meds) form of hypertrophic cardiomyopathy. If I contracted COVID-19, should I be worried?
@cookieman I’m sorry, I should have made clear: I’m not going to answer personal medical questions on this thread. That would be irresponsible. If you are concerned call your doctor.
@Caravanfan: I’m not concerned. I have no symptoms. Am not sick at all. I was just wondering if I generally fit an “at risk” profile.
Well everybody is at risk. The people who are getting super sick are the elderly.
I have a friend who is a college professor who says this virus was caused by 5G signals in China.
On one hand, she’s brilliant. On the other, that is wacko crazy conspiracy theory shit.
How can I dispute her position?
@filmfann
Ask her to detail the exact mechanism by which a radio signal would be able to create a virus, then have her perform a peer reviewed experiment.
Also, what is she a professor of?
That’s nonsense. We all know, Obama caused the virus…
@Caravanfan Is it true that the idea that moving doctors from other specialities into ICU situations to handle an onslaught of patients isn’t very practical because most doctors don’t have the training to manage a critical patient.
By the way, we have our first official case in The Villages. Travel related.
@JLeslie No, it’s not only practical but essential. As long as they have critical care people overseeing them.
That’s good.
Two by the way. I just saw an update, two here now. I assume that means there are really 50–100 by now.
How long will this pandemic last? How long will we be asked to social distance? Or is it forever from now on?
Correct. Article actually says:
Underlying medical conditions that may increase the risk of serious Covid-19 for any age.
I asked about this above, and have some more information so I will post it here. I saw Amy Klobuchar on TV today talking about Mayo Clinic looking into an immunity test so that people could help sick people without concern for catching it again, and so they wouldn’t have to worry in general. I’m sure the medical establishment will focus more on vaccinating than testing immunity, that is what they typically do anyway, but I am glad to hear a research facility was thinking along these lines. I’d gladly pay $100 to know if I am immune since I was sick with the “flu” 6 weeks ago. If I were immune I would be happy to help people who are sick.
My sister just said that there is a suspicion that high blood pressure, even controlled, is a factor in the patients who have died from C-19. Or, maybe it’s just a commonality they noticed. A lot of patients that age have high BP though.
^^^While she happens to be correct, you really should not ask us to trust your sister. Can you, please, find reputable authorities for further claims? The other option is to refrain from passing on unsubstantiated claims/rumors.
^^She saw Fauci say it. I asked @Caravanfan a question. I’m not saying in any way shape or form that it’s a fact to rely on. It’s being investigated by health professionals.
I wrote suspicion, commonality, that people in that age group often have BP anyway. I don’t know how I can write that better that there is no concrete proof of a relationship. Stop acting like I’m trying to be a doctor, I’m not. It’s a fucking question for the OP. Just like gorillapaws asked about the heart condition. Stop being obsessed with me and your group who loves to gang up on me on medical Q’s.
You actually didn’t ask me a question. You stated an opinion stated by your sister.
The actual answer is that there is no good data to support this claim. There is a paper floating about that posits a theoretical increased risk for people on ACE inhibitors or ARBs for hypertension management.
I want to mail a package. I’m fine with asking my daughter to do it for me, but the lines in the post office can often be very long. What are the rules for post office visits?
@Caravanfan I could have worded it better. Since this is a Q of questions for you, I assumed it would be seen as a question. I wasn’t careful enough I guess. I went through years of water torture here, and so I am reactive. HJ could have just asked me for a source, although I said the source was my sister, and why anyone would think she is an authority is beyond me.
One more. A jelly has a friend whose mom is in ICU now and they are upset they don’t have the COVID-19 test results back. It’s been a long time she said, I don’t know how long is long. Does it make any difference in treatment if you know the underlying cause is COVID-19?
@JLeslie No, not really. Care is supportive anyway and the treatment is the same regardless of whether or not you have COVID-19. The only difference is the experimental drugs which may or may not be effective. Just the lack of rapid testing is a pain in the ass.
@Caravanfan I hope it will make her less anxious about not having the test back quickly if it doesn’t really make a difference. Even though it doesn’t change that it’s upsetting the test process is so inefficient. I assume the doctor taking care of the mom can reassure her friend it doesn’t make a difference, assuming the doctor has the time.
Do all doctors have access to the experimental drugs? I just read there is a Japanese flu drug showing some promise. I have no idea if the source of the information is trustworthy.
How is morale among the healthcare workers at your hospital? How long can you guys sustain the current pace before exhaustion/morale become a serious factor?
@JLeslie We have access to some of them but not all of them. But not sure if they will work.
@gorillapaws It’s the waiting that is the hardest part. The anxiety is pretty high.
What precautions should we take if ordering take-out food for pick up or to be delivered?
There’s been reports of hospitals being short on N95 masks. And articles floating around on some hospital staff in Washington making their own. Now people have been talking about sewing masks.
Is this even viable? How do you test efficacy of a homemade mask? Is there a link on how to do this? What materials would be needed? And how do hospitals trust something made by the public?
@Caravanfan I was told by the jelly that hospitals aren’t letting family visit an ICU COVID-19 patient, I don’t know if that’s nationwide, so waiting for the test means not being able to be with loved ones. If it’s negative they can go in.
I saw a former FDA higher up on TV talking about how they could put together a study to look at the efficacy of the various antivirals, but not a blind placebo test, because obviously they wouldn’t want to deny treatment, but rather testing one drug against others. Hopefully, they can do something like that soon.
@janbb I saw on TV a health official, I don’t remember his name, that said heat kills the virus. He said only order food you eat hot, when it gets to your house all the obvious that the outside of the package might have virus so think about what you touch, the package, microwave handle, etc. heat it in the food in the microwave or however you typically heat food through, and it should be ok. I guess you could use gloves when handling the package, but then you need to remember gloves are the same as hands if you touch the germs and then touch your face. Some of my friends are using gloves a lot. I’ve been mostly just washing my hands.
I also heard Facebook is putting up a hub for C-19 information. Links to WHO website, CDC, and other reputable sources to combat misinformation regarding the virus. Maybe there will be answers like handling food on there.
Just to mention it, my hospital is not allowing any visitors, no matter why the patient is in the hospital.
@chyna That actually makes more sense to me. Very sad though. Very difficult on the ICU workers seeing the patients alone I would think, but at least they don’t have to deal with extra people hanging around the area.
@JLeslie Thanks for your input but since @Caravanfan has limited time to give us, it might make sense to keep this thread for his answers. Other discussions could be on other threads. Not meaning any offense.
What are your thoughts about the Covid-19 Health Care Worker Protection Act?
Has your hospital done enough to protect health care workers? If not, does this bill cover what is needed?
There are no stupid questions, right?
I have put my clothes I wore on my travel day, in a plastic bag (complied to my girlfriend’s wish).
Will any potential virus still be on it, and be ‘alive’ (after 48 hours)?
Or can I just grab ‘m out of it and put in the laundry?
@raum I’m afraid I don’t know anything about it, but we are extremely careful to protect our health care workers.
@rebbel Nobody knows yet. There is some data to suggest that the virus will over for 72 hours on some surfaces, but it’s just laboratory data. You’re probably best just to dump them in the laundry.
What percent of the COVID-19 patients that you guys are seeing end up with a PICC line?
@gorillapaws My preference would be not to put a PICC line in these patients because they can often take an hour or more of direct patient care time with the nurse. This leads to issues of nursing allocation in a critical resource situation and also just the nurse being in extended close contact with a patient.
Normally I’m in favor of PICC lines, but in this situation I would just put in a triple lumen catheter in because I can get that done in 10 minutes if I move fast and I’m not teaching a resident.
USNS Mercy has been requested! Are you relieved?
@raum Honestly I do not know how it will impact us directly. At the moment I am working on the stuff I can control, and if help arrives, great.
^Soldier on. And remind yourself, you are part of the solution.
Think of the lives, you will change. You’re a warrior, on the front lines.
A hero…
@MrGrimm Agreed. Thank you @caravanfan. Take care of yourself.
Thank you guys. So far the wave has not hit us.
No thanks to our Idiot President.
Hoping it can soften the brunt when the wave does hit. Thank you for all that you do.
Could we run an ozone generator to kill Covid-19?
This crude paper says 0.5 ppm is the sweet spot for SARS
Source
I have a high output generator that produces 10 gram per hour. If my math is right I can get my home to 0.5 ppm in about an hour. As long as I am not home this seems like a good way to sterilize the entire house. Is this crazy?
Would this be useful in an ER?
Would you like to borrow it?
What do you think of the anti malarial drug, chloroquine phosphate being used?
Does hand sanitizer work on Covid19 or just bacteria?
@RedDeerGuy1 Hand sanitizer works. Soap and water is better.
Does hand sanitizer go bad faster once opened? I have hand sanitizer that is before the expiration date, it expires in a few months, but is a few years old. It’s a pump container, and has been open over a year. Would you trust it? I realize you are not any sort of official authority for the efficacy of the product under those conditions. I was thinking of pouring some more alcohol in it, I just don’t have any alcohol right now. I’m not going out of the house currently, so I haven’t needed to use it, but I would like to keep it in my car when I do decide again to venture out into the world.
@JLeslie I don’t think so. It’s just alcohol and aloe vera gel.
You don’t think you would trust it, or you don’t think it would go bad? I asked too many questions in my paragraph. I worried the alcohol might evaporate over time in the open container even with the pump.
@JLeslie It might. I don’t know. It’s not anything I’ve ever really thought about.
What would have happened if the Coivd19 was not resisted (social distancing, hospital care, quarantine, washing hands for 20 seconds, ect.)? Would it have killed everyone , or only some than peter out?
Have you (or anyone) been able to pull a patient back even after they went into severe respiratory failure due to the virus? Or is it a certain death sentence?
@RedDeerGuy1 I can answer that one. No, it wouldn’t kill everyone. 82% of the people who get it have mild symptoms. They wouldn’t die.
@Dutchess_III Yes, people have recovered from severe respiratory failure. I am not allowed to comment on any of my own patients.
I had read the symptoms are flu like, dry cough, fever, aches. The Miami Mayor has been reporting his symptoms and he has no fever and some congestion. He says it’s more like a cold for him. I realize some people have very mild symptoms or none, but what I don’t understand is the congestion. Is there congestion with the illness or not?
Here is one paper I found in a quick search.
Ozone disinfection of SARS Contaminated Areas
My generator has 5 times the output. If my math is correct I should be able to fill a 4000 sq ft room with 10 ft ceilings in about an hour with 2 ppm Ozone. Follow it with a 1 hour soak to give it time to disinfect and a 1 to 2 hour vent so humans can enter safely.
Rubber seals will be damaged but the virus, if it is similar to SARS, will be killed .
Thanks, but I’ve read the CDC symptoms. It doesn’t talk about congestion. I don’t want to call, because there is no need to clog up the system, people who have concerns should be able to get through. I’m not concerned about having COVID for myself or anyone I know at this time, I’m just curious.
@JLeslie That’s all the information I have at this time. I’m assuming that it can cause congestion. By the time they get to me they’re sick as shit and having a runny nose is the least of their worries.
Is there any problem if I want to bake cookies and leave some on my neighbors’ porches for them?
Is there any factual basis for the rumor that ibuprofen can have adverse affects on Covid 19 patients? Snopes says this has not been proven.
Is your ICU full? Do you think your hospital will be able to keep up with the ventilator needs of your community? Will you have to choose to let older patients to not be vented to allow younger patients to be treated? Is the US following those same rules for triaging patients as Italy regarding age?
Do you think some hospitals in the country massively hoarded protective wear? I was thinking we are just at the beginning of this, and some hospitals had to be buying up a shit ton that hospitals in great need right now can’t get what they need and are actually running out of supplies. As far as I know hospitals usually don’t run out of supplies during flu season, and I know that COVID is way more massive than flu in terms of patients at once coming into the system, especially as we move forward each day where large outbreaks are occurring, but COVID is no yet widespread (high numbers) all over the country, while during peak flu season the numbers are quite high in all states including hospitalizations. I’m just talking about the country as a whole and that resources are probably in excess in some places when other places are desperate like parts of WA, NY, and CA, etc. Possibly also private hospitals are better off than public. Will the hospital community at large cooperate with transferring or selling supplies to other hospitals if their own community currently has very few cases? I feel like the government screwed up so badly on this front everyone from Trump, the CDC, and the Surgeon General were asleep at the switch. Total incompetence.
Should I prepare a sheet with my basic medical information for the hospital doctor? My daily medication, allergies, and known conditions. It’s in my medical information in my phone, do doctors check that?
For your first paragraph, I can’t comment on any specifics on my own situation because of HIPAA concerns. Ethical considerations and rationing of care are a very real issue and multiple ethics committees are working on it. I can only hope we don’t turn into Italy.
For the hoarding protective wear—no. Hospitals are not hoarding, we are using and running out. The hospitals are working together as best we can.
For the putting together a sheet—it’s always a good idea to have that in one place. We normally do not check a phone.
@Dutchess_III It’s very confusing. That whole kerfuffle regarding ibuprofen was based upon a highly theoretical paper that didn’t have any actual studies, and a tweet by a French health official. The news feeds picked up on it and it exploded.
Bottom line, we don’t know. It might be prudent to avoid it if you have symptoms but the data is very poor.
@caravanfan Thank you for taking the time to answer our questions and your patience with us. I’m sure you are tired and worried for yourself and family. Hugs!
@chyna Yep. Terrified, actually.
@Caravanfan Can a virus self-replicate in a body that is passed on? How long can a virus or Covid19 survive in a dead host?
Should people be encouraged to creamate instead of burial?
Viruses do not self-replicate. They inject their genetic material into a host cell, and tell that cell to make more viruses.
Is there a number to multiply the reported confirmed cases by that would give a ballpark estimate of actual number of cases in that area?
@gorillapaws That’s the million dollar question and I desperately wish I had an answer to it. We are desperately behind the 8 ball on testing as there is not nearly enough testing resources available yet.
Hayward just opened up a testing facility today. Hoping to see more of the same.
If some C19 patients are presenting with anosmia, but C19 doesn’t usually present with nasal congestion, does that implicate brain or nerve damage?
@raum, no probably not, but I’m not sure I believe that anosmia thing. It’s anecdotal.
@Caravanfan If we are walking outside with a friend is a two to three foot distance between us good enough or should it be 6 feet?
@janbb Public health departments are recommending a 6 foot distance for now. This is a hand-wavy distance that someone just made up. But 6 feet is probably good enough to get you out of coughing distance
@Caravanfan I’ve seen that but just hoped there was wiggle room for outside. Guess not.
@janbb It’s just a made up number that seemed like a good idea.
Is it true that masks won’t protect you from getting the virus? They just help protect other people from you, if you’re sick, correct?
@Caravanfan: What do you say to someone who says the Covid-19 virus is not worse than the flu?
What do you say to someone who says young people who are otherwise healthy (that we know of) have absolutely nothing to worry about?
I’m not @Caravanfan, but apparently, no matter your age, if you are in that percentage group that gets it bad, it’ll be the worse couple of weeks of your life.
I have friends on FB that still are arguing that it’s no worse than flu. It’s mind boggling to me that people still actually say that, @rebbel, given all the evidence.
Are doctors advising to drink plenty of water, because that is simply good advice with fever to do your best not to become dehydrated, or is there actually something special about drinking liquids all of the time with COVID or pneumonia in general?
When we bring food into the house – either groceries or take out – is it necessary to wipe it down with disinfectant?
Hokay.
@Dutchess_lll re: masks. That is correct. It is possible that they may help a little bit, and under normal circumstances I’d say go ahead and wear one. However, hospitals are running short.
@jca2 re: worse than flu? Yes, worse than flu. Mortality rate is higher. Young people are not as affected by it, but a young person died in LA yesterday.
@JLeslie re: water. No, nothing special. Drink whatever you normally drink
@janbb re: groceries Wife asked me the same question. I have absolutely no idea.
Oh, update on me. My daughter came from LA and is back with us. Now she’s sick. She probably just has a cold, but I had to jump the line to get her urgently tested because now I am quarantined and can’t go into work until she tests negative. Fun days.
@Caravanfan My best friend does. I will pass this on to her. And – good luck to you and your daughter.. How awful! Keep us posted.
@janbb She’s fine. She worked out yesterday (stole my yoga mat and now I can’t use it). Under normal circumstances I wouldn’t have thought twice about it. It’s just that I can’t go in if the shit hits the fan. (Fortunately it has not hit the fan yet).
Re. sterilizing things before they go into the house.
I am putting groceries in my garage and bathing them in Ozone before I bring them in the house. I’m immersing them in 5–10 ppm ozone for one hour and then letting the gas dissipate.
I wish I had a way to test if the procedure actually did anything. I found some research papers indicating 2 ppm does the job but I have no way to measure the viral load before and after.
I have the equipment so I’m just doing it.
@Dutchess_III Hopefully by the end of the day. Meanwhile I’ve been on video conference calls all day.
Are things easing up at all?
Update, her test is negative
No, things haven’t eased up as the surge hasn’t started yet in the Bay Area. We are anticipating next week. We are still furiously planning.
^Great news on your daughter.
@chyna Thanks. Yeah, I was pretty sure it would be negative. She was doing fine. As I said, I was more worried about me being quarantined and not being able to work in the hospital when the shit hits the fan.
@janbb “When we bring food into the house – either groceries or take out – is it necessary to wipe it down with disinfectant?”
I’ve been encouraging my parents to do so. COVID-19 lives on surfaces for days and it’s possible during the packaging/delivery process someone could have spread COVID-19 droplets onto your packages. The downside to spending a few extra minutes wiping the items down and washing your hands is pretty minimal when compared to the potential downsides from getting sick. Why risk it?
I’m pretty much out of hand sanitizer, and hand soap…
And I haven’t been able to find any more…
Do we know if regular soap, with the recommended washing time, will be effective?
Any alternatives, for hand sanitizer?
@MrGrimm888 Hard liquor is what I heard, Everclear.
@caravanfan Right?
@MrGrimm888 “Regular” soap is the most effective cleaner; hand sanitizer in its absence.
@KNOWITALL . Everclear, might work. But, I can’t keep an open bottle in my vehicle. I guess I could put it in an empty hand sanitizer bottle, and hope for the best….
@KNOWITALL Soap and water is fine. And regular bar soap is fine.
My bad for answering a question on @Caravanfan‘s thread. I lost track of which Q it was.
@Caravanfan I have a question about the people who are dying who were put on vents. Does the vent stop getting them enough oxygen to live, and they die? Or, do they go into organ failure? Or, can family decide to take them off? How is it decided when to stop trying to save the person?
@JLeslie It’s a very complicated question with a complicated answer. But the simplest answer is that patients can develop Acute Respiratory Distress Syndrome (ARDS) where the lungs basically fill up with fluid and it becomes very difficult to oxygenate. They can also develop other organ failure such as heart failure or kidney failure. Under normal circumstances decisions about taking people off of vents are done based upon the medical condition of the patient and talking to the family.
@Caravanfan I’ve heard stories that they’re going to be sharing ventilators in NY by splitting the tube for 2 patients. Do you have any opinions on that?
@Caravanfan Have doctors been trying drugs like Levoquin or Doxycycline also? Besides the drugs currently in trial? I realize those are antibiotics, and COVID-19 is a virus, but those drugs are sometimes used for pneumonia.
I was thinking that maybe the damage to the lungs by the virus creates a breeding ground for bacteria or mycoplasmas that might have been present previously but not in numbers that would be an infection until given a breeding ground to prosper.
How does that work with ICU patients, do you throw everything but the kitchen sink at it hoping something works? I’m just talking about critically ill patients not the average person who has a fever home watching TV.
@gorillapaws We are actively talking about it. It’s only really been done once and there is no data to support it.
@JLeslie We will sometimes use bacterial antibiotics to treat a superinfection of a viral infection.
@Caravanfan Do you actually culture and test for sensitivity? Or, just use a broad spectrum drug? Can you even test if they are on a vent? It’s not like you can easily get some sort of lung sample I guess.
Yes.
It depends.
Yes.
And yes, it’s easy to get a sample.
Thanks. That makes me feel better that it’s not just guessing.
How does Covid 19 compare to SARS and MERS?
Well, hard to compare. Economically, it’s much worse. Not sure about medically—I don’t have the numbers on me now.
Does disinfecting with bleach help?
@RedDeerGuy1 9 parts water and 1 part bleach. Let it air dry ! don’t put anything on it after using the solution. Old food safety class.
@Caravanfan If a cough helps us clear our lungs, once put on a vent, how do the lungs clear?
@JLeslie That’s an good question with a complicated answer that involves an understanding of ventilator and lung mechanics that is a bit out of the scope of this discussion.
But, the tl;dr answer is the lungs can’t clear by themselves. We do the best we can using ventilator settings to keep the lungs open, and we can suction pulmonary secretions with an in-line suction.
How optimistic are you with people designing ventilators with the possibility of 3d printing and otherwise crowdsourcing the designs/production? Are they sophisticated, or are they basically machines that pump a certain volume of air/O2 mix in and out at a fixed interval?
Thanks. I“ll put it on my list of things to look at today.
@ragingloli Watching it now in the background.. It’s good, thanks.
@gorillapaws Sorry, missed it. That’s all ventilators really are—pumping air in and out. The fancy ones like I’m used to have lots of bells and whistles that allow for customization. But I can work with something less complicated. Some are sophisticated and some are not. I’ll work with anything.
@Caravanfan Can one share a ventilator or take turns with one?
It would have to be thoroughly sanitized after each person uses it.
Yes. Of course. One of them could have an illness that is not detected, or have a bacteria they don’t know about.
@Dutchess_III Would it be worth the risk? If both patients have Covid19? If the alternative is death?
I would think @Caravanfan would be the only one who might know that answer.
@Caravanfan
Would it be worth the risk to share a ventilator or take turns with one? If both patients have Covid19? If the alternative is death?
At the current time we are not planning on having two patients share one ventilator. It is theoretically possible and was done once in practice after the Las Vegas shootings, but there are multiple technical issues with it that are out of the scope of this thread and the Society of Critical Care Medicine is specifically recommending against doing it.
@Caravanfan Is your city planning on having a COVID19 hospital, and moving patients around? What do you think about that idea. It seems to be good from a contagious standpoint. I was wondering how many more ICU patients there really are compared to a bad flu season lets say. I saw an interview with a NYC ICU nurse last night who works at a COVID19 hospital and she talked about how they open a new ICU unit once one fills up to get ready for the next set of patients. It’s ongoing, with all specialties helping out under the direction of an ICU doctor. That is mind blowing to think about. But, then the majority of severe COVID19 patients are being sent to this hospital.
Each hospital has a surge plan that involves increasing capacity.
@Caravanfan are the bag valve ventilators readily available and effective?
Has this affected the sales of Corona beer? ;-p
Is fighting Covid19 with every thing we have hindering or helping against Covid20? Or other new viruses? How long till the next virus outbreak? What have we learned from the past pandemics and the current Covid19?
Is testing finally becoming available? Can they test for antibodies?
^Has there been any discussion of how the hospitals, would handle a large amount of patients, who are prisoners/currently incarcerated?
It seems like prisons/jails, would be a high risk for a large outbreak…
@MrGrimm888 I’m sure there have been, but I do not know, and it’s above my pay grade.
@Caravanfan I already semi asked this, but I have more specific questions. Would it be standard practice to culture for mycoplasmas specifically, and even bacteria that would grow on the medium used for chlamydia for patients in the ICU with respiratory failure, especially young ones?
Have you seen any information on doctors trying Levoquin or doxycycline rather than Zithromax?
@JLeslie Look some posts up; there’s been opened a new thread (a part 2).
@JLeslie We do standard bacterial cultures. We test for flu. WE don’t generally test for atypicals unless indicated. We don’t see young patients in my ICU.
No. Levoquine or doxycycline is not indicated for C19 at this time.
@Caravanfan I guess theoretically Zithromax would cover mycoplasma anyway. Are you prescribing Zithromax as a standard of medicine now for critical patients, or is that just being done in the specific trial being done?
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