Okay, here is a second AMA COVID-19 thread?

Thank you, @Caravanfan. Many thanks for the other thread and this one and for taking the time to share your expertise.

We have oxygen equipment in the house because my husband is a COPD patient on continuous O2. Would any of his gear be useful to anyone else in the household if they come down with CV-19? (I don’t mean physically sharing it with him, of course.)

O2 tanks
O2 concentrators, floor model and portable
nebulizers & fluid
(& plenty of cannulas & tubing)

He went online to buy a new nebulizer because the old one was acting flaky and found that his preferred model was sold out, so apparently some people think so.

Does the contagion stay put at contact points on surfaces, or does it migrate on its own?

By the time I clean that spot I touched on the counter, has it already spread from there by itself?

We’re told, “Don’t touch your face.” What if I touch my foot, or the back of my neck, or my hair? Does it amount to the same thing?

How are Covid19 precautions helping prevent other infectious diseases from being caught from humans? Do you have the perecent reductions?

@Jeruba
re: Oxygen. I wouldn’t share the oxygen.
re: contact points: The current thinking is that it can migrate through droplets.
re: counter: It probably doesn’t jump from the counter to the air
re: face: It’s your face that matters. Your eyes, nose, mouth are entry points.

@RedDeerGuy1 I don’t know statistics.
https://www.youtube.com/watch?v=YUakLzaboMo

@Caravanfan Ok I will make it one of my questions.

@Caravanfan Is it ok to wash ones hands with different blends of hand sanitizers or disinfection on surfaces? I know that one can make mustard gas when mixing bleach and comet. What is the exact blend to avoid?

@RedDeerGuy1 Just use soap and water. Don’t mix bleach and comet.

@Caravanfan Ok. Thanks.

If someone is staying home, not going out, and nothing (and no one) is coming in, does all that extra hand-washing really do anything? If everybody in the house is sick, or if no one is, what does it accomplish?

I don’t mean to be argumentative. I just want to get the picture, as much as I can.

In my case, also, I was treated for a skin condition more than a year ago, and the doctor said, “And don’t wash your hands too often.” I’m trying to maintain a reasonable balance while also taking all necessary precautions.

As long as you don’t go shopping or get the mail, or eat anything that comes from outside the house.

Let’s say someone had it and recovered, no more coughing and sneezing, how could they still pass the virus on?

Thank you @Caravanfan. I didn’t know it was going on until now.

So is it true that your breathing would be permanently damaged if you get the virus? This has been a rumor spreading around my place lately and I want to verify it.

@dutchess. Viral shedding is estimated at about 25 days. Maybe more

@mismishu it’s a silly rumor. The virus has only been around for 4 months so no way to tell if damage is permanent or not.

Thank you @Caravanfan. I’ll come back if I have more question. Right now just want to say thank you for spreading awareness because there are just so many myths about the virus right now.

What is viral shedding? From whence does it shed and how long does it shed?

Oh. Stuff you already had in the house—cans and packages you brought in a week ago, maybe. I didn’t think of that. Thanks.

Sneaky business, isn’t it?

I do bring in the mail (and the newspaper!), park it and let it cool for a while, and immediately wash my hands.

On my run just now I passed a field full of cows, they were packed close together & were openly mocking me…you could tell, trust me!
Do you reckon they’d achieved herd immunity & were gloating?

Should asymptomatic people wear protective masks, when they’re out in public?

Think about it, @Brian1946, it’s springtime here in the northern hemisphere. Asymptomatic people may have allergies and be coughing or sneezing because of that. If they’re not wearing a mask, maybe the rest of us should be, because we just don’t know who is an asymptomatic carrier…with allergies.

@Brian1946 Unclear at this point. It can’t hurt. The CDC is going that way.

I got a blood test today. They gave me a facemask. Do I toss it or can it be cleaned or re-used? I drooled all over it.

I’m hearing that COVID-19 spreads via aerosols now and not just droplets. Is that the method of transmission your hospital is protecting healthcare workers against now?

How the hell is it possible for something that fundamental to not be figured out earlier? Surely they must have special lab facilities at the CDC and in other countries where they figure out the specific characteristics of the disease (such as its lifecycle, methods of transmission, duration of time on various surfaces where it’s still transmissible, etc.).

@Caravanfan Do you think COVID19 hospital workers would utilize a hotel provided to them so they don’t have to feel concerned about bringing the infection home to their families? An option for them, not mandatory, near their hospital?

Something like a Residence Inn with a kitchen and laundry.

@Caravanfan

What’s the feasibility of getting a non-contact, handheld, cutaneous, infra-red thermometer?

What aerosols are you talking about GorillaP?

@Dutchess_lll Here is an article in Nature that discusses it.

@gorillapaws Unclear. It’s thought to be droplet but we treat it like airborne
@Brian1946 No idea what the feasability is. We got a few and my hospital director was going around pointing it at people and checking their temperature.
@JLeslie Yes
@RedDeerGuy1 toss it

@Caravanfan I posted the idea on facebook and it seems it is being done in some cities. Some are using college dorms, some are using hotels.

What percent of people put on ventilators finally recover?

(I have heard a depressingly small number but I cannot verify whether it is true.)

@JLeslie Not sure what my hospital is going to us but I am assured there are accommodations. Worse comes to worse I can afford a hotel room.

@LuckyGuy there are a couple of issues here. First is that this is not a fast disease. For a cold or even flu you can be better in a week. Also, there appear to be three phenotypes of hospitalized patients from moderately bad, to severely bad. (The milds stay home). So the people who get intubated are the worst of the worst. Additionally, they stay sick and intubated for 3 weeks or more, with all the inherent complications that that comes with. Usually when we intubate someone with, say, a flu, we can get them extubated within a few days. Not COVID. So yes, the percentage of people who don’t survive on a ventilator are high; I’m seeing high numbers myself.

Am I just imagining things, or is it possible that my husband and I, both high-risk, have had a mild version of this thing for 4 or 5 weeks without getting any better or worse—and without high temperatures or respiratory trouble?

When cold or flulike symptoms come on, they usually develop and then recede. They don’t just hang on at a mild level for weeks on end, while I feel what I just call “offish.” (And when my husband gets them, he’s probably on the way to urgent care or the ER. But this time—no.)

Not asking you to diagnose me—just asking if this is one possible manifestation of the virus, even in my risk category.

@Caravanfan The number I’ve heard is about 20% leave the ventilator successfully recover. Is that a realistic estimate?

FYI, Many years ago, I had the “pleasure” of being on a ventilator. It was one of the most frightening experiences in my life. I recall falling asleep between breaths and the ventilator waking me up each time. 20 hours of torture. As I began to regain my wits and strength I tried to fight the ventilator by trying to exhale when it was forcing me to inhale, and biting the hose to stop the flow. which was impossible because the tube was too strong.
Apparently I was not the first ventilator patient to try this. It was also a sign that I was recovering and almost ready to be taken off.

I have a question but I’m going to hold off until he gets around to @Jeruba and @LuckyGuy. We’re swamping him, dudes!

@Jeruba Yes, there are mild manifestations of the virus
https://www.coronavirus.cchealth.org/if-you-are-sick

@LuckyGuy Probably closer to 50% maybe higher.

Now, this “shedding” business is nagging at me. I am trying to figure out exactly what that means. I know how a snake sheds his skin, and how a dog sheds his fur, but how do humans shed a virus? I looked it up. After it’s done doing it’s damage it bursts through the cell wall (I never liked that cell anyway!) and goes “intracellular,” I think is the term they used. But from there does it make it’s way to our lungs, or something, so we breath out viruses as we walk along?

Thanks, @Caravanfan. I’ve read about mild cases. I didn’t think people like us, over 65, with pulmonary weakness and other conditions (e.g., DM, high BP), could get a mild case. I thought we’d be out the door horizontally in no time. Hence the Q.

@Dutchess_III You cough it and viral particles spew out.

@Caravanfan I saw today that there is now a website for doctors to report findings from treatments they’ve tried. It was called oracle. Real time information, and they will be compiling the data. You can sign up to report on your work covid19@oracle.com I’m not sure if doctors can sign up just to read the information from others?

Also, from what I’ve read just talking can throw droplets a couple of feet. We see it when we talk during cold weather the vapor that is our breath. My guess is that choir that met a couple of weeks ago for practice had so many cases because singing has even more velocity behind the droplets, but less than a cough or sneeze. In fact I remember even Burx or Fauci mentioning just talking and breathing early on when they said why we need to distance, but maybe it was a different doctor I saw on TV. I think a big reason some people didn’t take distancing seriously was because maybe they felt health and weren’t coughing and sneezing.

Thank you.

@JLeslie Not sure what happened with the choir but my guess is that they didn’t keep 6 feet apart, and they touched surfaces and touched their face.

@Caravanfan That too. My guess is singing throws the droplets farther than talking, but not as far as sneezing. A matter of the force of the air coming from the lungs.

I can’t remember if it was Fauci, Burx, or some other health expert I saw talk about it very early on, but I found this article from March 16 quoting an ID doctor.

“Experts believe the virus is mainly spread through droplets that come out of your mouth and nose. When an infected person speaks or exhales or coughs or sneezes, the droplets travel about 3 to 6 feet (1 to 2 meters) before gravity pulls them to the ground.”

“Here’s the source”: https://abcnews.go.com/Health/wireStory/social-distancing-works-means-69629911?fbclid=IwAR3Vg-HRpEDDptf3OBjBKRx5eWuzdi4VVg644Dpb24n1iTKTtmr62VQEotE

I don’t want to sidetrack your thread, but I have people all over where I live standing too close, and I think they don’t have to worry if they feel well, because they don’t feel they will sneeze or cough, but it is dangerous to be close period. I just felt it was important to state here. I’ll leave it at that. People can do further research if they want.

Sorry, but I’m still not clear: can even old, sick, health-compromised people have mild cases and come through them basically unscathed? Has that happened?

@Jeruba I don’t want to speak for @Caravanfan, but this might help answer your question. There was an outbreak in a nursing home rehab center in my city. They tested everyone and here was the breakdown: 92 residents positive, 53 are asymptomatic, 39 have symptoms between mild and severe. In addition there were 16 deaths and 35 negative test results. Based on that, I would say that it seems possible to come out unscathed, but I certainly don’t love the odds. I am neither an MD nor a statistician so take my opinion with the appropriate degree of skepticism.

What are your thoughts on DIY masks vs DIY face shields?

I’ve read that face shields are considered adjunctive PPE. But I think some are using them as a stand-alone measure.

Can I interrupt this thread to wish @Caravanfan a very happy birthday?

And thank you so much for your patience with all our questions!

Happy Birthday @Caravanfan!

@Caravanfan Are doctors trying steroids or other immunosuppressives? I read that it is a cytokine storm, or maybe not always technically a storm, but an overproduction causing the dire symptoms in some people. That made sense to me, between the high fever and inflammation in the lungs. Like an allergic reaction, because it’s so unknown to the body I guess. Although, quelling immune response seems scary too. Maybe a targeted drug that is out there for autoimmune problems.

Happy Birthday!

@Jeruba Yes, older people can have mild illness
@gorillapaws is correct
@raum They’re fine. They protect others from you
@janbb Thanks
@Mimishu1995 Thanks!
@JLeslie No, and thanks.

Happy birthday @Caravanfan!

@raum Thanks!

What about the cows?
They were at it again today, still haven’t mooooooved!

Happy birthday!

Feliz cumpleaños, osoraro!

Does it matter if the masks are cloth or paper? I’m thinking of ordering some from Amazon…but I just hate the idea of just throwing them away. Cloth masks I could wash.

@Dutchess_III and @Brian1946 Thanks!
@Dutchess_III I don’t know. Cloth masks are better than nothing.

@gorillapaws, are you familiar with that facility? The story you linked is of interest, but it doesn’t say anything about the residents’ age or relative health status. They could be young and otherwise healthy people recovering from injuries, right?

Anyway, thanks for the link.

@Jeruba I know there is a retirement home of the same name. I’m under the impression that this facility is their rehab satelite (for when residents need rehab). I’m not 100% certain they don’t also have younger people as well, but I do think it’s a much older demographic.

Cases seem to be increasing linearly instead of exponentially at this time (at least from the data I’m seeing). Is that your experience? If the curve is beginning to flatten will you guys in your area be able to manage? Or will it be supply < demand insanity either way at this point? In other words does it seem to you like we could be averting a worse case scenario?

So far our hospital has been unusually quiet. Other hospitals around us have a bunch of COVID patients, but we are still waiting for the other shoe to drop. Hopefully it never will.

I haven’t kept up on the statistics of cases or hospitalizations. There is just so much information out there that I am just staying in my lane at this point. Anything ICU-related I’m all over. The epidemiological stuff not so much.

That’s some good news…for now. Thanks.

@Caravanfan Does the information I have seen floating around about how the virus replacing red blood cells have any validity? It was addressing why putting someone on a ventilator might not be working, or part of the problem anyway. Here is one article, but I have seen a few, some of the others were more techincal. https://www.thailandmedical.news/news/must-read-research-reveals-that-covid-19-attacks-hemoglobin-in-red-blood-cells,-rendering-it-incapable-of-transporting-oxygen--current-medical-protoco

A quote from the article “The research discovered that some of these proteins are to hijack the red blood cells and remove the Iron ions from the heme groups (HBB) and replace themselves with it. This makes the hemoglobin unable to transport oxygen.”

Is there a way to overcome that if it is correct. Would people who are low in iron (that’s me typically) be at a disadvantage?

No, no validity whatsoever.

This link is from Forbes.

An excerpt from it “For reasons that are not fully understood, patients that have recovered from a viral infection have cells that can continue to produce viral RNA without actually making infectious virus particles. That means it is not only possible but common to detect viral RNA without there being any infectious virus present.” Does that explain the rumor going around that some people who have recovered appear to be testing positive again?

@Caravanfan I assume that the use of Zithromax showing supposed improvement in COVID19 patients likely has to do with some sort of bacterial infection, or at least presence of a bacteria that is causing problems that researchers may not understand. I know I asked you if you or other doctors are doing cultures for atypicals, but I don’t remember if I asked if doctors around the world have tried other antibiotics like Rocephin in combination with Zithromax or levoquin. Or, even Unasyn with doxycycline to try to bang out a very broad array of bacterium.

Dutch: Nobody knows

JLeslie: There is no good clinical evidence to show that any drug works yet, let alone azithromycin.

@JLeslie ”Or, even Unasyn with doxycycline to try to bang out a very broad array of bacterium.”
It’s not a bacteria. It’s a virus. Antibiotics, like azithromycin, are useless against it.

Actually, Dutch, azithromycin can exhibit some antiviral tendencies, which is why it’s being talked about. However, there is no good data with coronavirus.

@Dutchess_III I know that. That doesn’t change that there could be bacteria laying around in some people making things worse, or a secondary infection. People get flu and then secondary to that a bacterial infection. It isn’t unheard of. It also is not unheard of for the medical establishment to believe some bacterias are normal flora, and then later find out they are pathogenic, or especially in some people cause symptoms while not in others. Possibly, the virus causes a weakened immune system, or provides an environment, and people who have these bacterias in smaller numbers always laying around suddenly have them growing into infections. Anything is possible right now. The only way to know is to study it. If doctors and researchers are not trying to even culture these things, or try them even without culture, we won’t know. I’m not saying throw any old medicine at it, I am talking about medicines that are currently used for pneumonia. Zithromax has been tried, and we still don’t know if it is helping for sure or not.

Believe me, I have suffered with infections for YEARS, and it took until a doctor tried the right combination of antibiotics for me to get better. Most doctors said I did not have an infection. Some believed I definitely did have an infection, but the antibiotics did nothing. I have some bacterias present that only test positive when taken by a very specific lab, and it does not grow when sent to a typical commercial lab. Probably, a lot of people walk around with those bacterias and have no symptoms, like how some people have the ulcer bacteria and have no symptoms and some get bad ulcers.

I have been through a ton regarding bacterial infection, and in no way am I saying I am some sort of expert, but I do believe they are missed constantly and misdiagnosed. It very well might be bacteria has nothing to do with COVID severe illness, but I am curious about it.

It does appear that even people with mild COVID19 illness have injury (although might be temporary) to the lungs, and likely that is all about the virus and not a bacteria, but again, I am just curious about it, since it is not far fetched that a bacteria can come into play with pneumonia that originated with a virus.

Plus, maybe there is a mechanism we just don’t understand. Minocycline and Doxicycline have been used in some rheumatic conditions with mixed results, and the theory is they decrease inflammation, but I prefer to believe it is killing an unknown infection. It’s just my hypothesis, it could be wrong of course.

Thanks @Caravanfan. I didn’t know that.

I don’t think doctors will prescribe random antibiotics “just in case,” @JLeslie. That would be irresponsible.

@Dutchess_III Of course they will if it is an educated guess. People are dying. Then the doctors share their results positive or negative, and if the results were good, and more doctors try it, and they have good results too, eventually it can become a standard of care, even if it was never formally tested, but of course scientific testing would be best. Off label use for drugs happens all the time. I am not talking about random antibiotics.

Has COVID-19 taken the form of YARNLADY’s avatar, and infected the profiles of other jellies?! ;-0

My doctor told me when doctors prescribe Zithromax (otherwise known as the Z pack), it helps with Covid patients or any patients who have pneumonia (fluid in the lungs), since there’s no cure for Covid (as everyone is aware) but it’s treated symptomatically.

Here’s some very encouraging news from Israel: https://www.pluristem.com/wp-content/uploads/2020/04/PSTI-PR-Follow-up-on-Covid-19-treatments-FINAL-FOR-RELEASE.pdf

”the preliminary data demonstrated 100% survival rate as of today.”

@snowberry Seven patients.

Yep!

Generally I ignore press releases as sources of medical information.

7 patients isn’t exactly a huge study. Those seven would have probably lived anyway. It DOES have a 97 to 98% survival rate.

dutch, It’s not a study. It’s a tiny nonrandomized non placebo controlled industry sponsored report of a few cases. It’s garbage and entirely useless for my point of view.

^^^ Yeah. That’s what I meant to say!

Ok, you don’t have to think it’s encouraging if you don’t want to. Some people are truly glass half full types, which is sad, IMO.

They’ve just started, and for those 7, it truly is a miracle, because they were in bad shape.

It was basically an ad, not an actual study.

@snowberry No need to get hurt. I didn’t say it wasn’t encouraging. I said it was an industry funded press release, not a study, and completely useless from my point of view.

@Dutchess_III It is not a 97–98% survival rate for patients in respiratory failure on ventilators, unless you look only at a very young sample of people. The 7 were in grave condition, not part of the greater population of COVID19 sufferers. I agree with you and @Caravanfan that this is just 7 people and basically just a press release, although hopefully they have discovered some magic, but just letting you know the death rate for those put on ventilators is quite high. I have heard 25–50%, I don’t know where the numbers are now that we have many more cases.

It’s a 97% survival rate for the entire population of the world at large. Of 100% of people who get it, 97% will recover just fine. Do you understand @JLeslie?

@Dutchess_III I don’t want a big argument with you. That document posted by snowberry was about 7 ICU patients. You were saying they probably would have recovered anyway, but statistically that is very unlikely, unless they were young patients. You don’t understand. I don’t want to go back and forth on the thread about it, so I will let that topic lie after this.

Thanks @JLeslie

This is why they put it out as a press release and not as a study in a peer reviewed medical journal.

And I will just add that I see this behavior by drug companies ALL the time, which is why I am supremely skeptical. The Pharma company will put out a press release regarding their Miracle Drug and their stock price jumps. It’s typical corporate behavior.

@Caravanfan Are there any statistics on how Covid is affecting the homeless population? We have a large homeless population in my area, yet I haven’t heard if they are getting sick.

chyna, I am not an epidemiologist. But the homeless are getting sick.
https://www.latimes.com/california/story/2020-04-10/70-test-positive-for-coronavirus-at-san-francisco-homeless-shelter

@Caravanfan I’m in agreement with 7 people in a “study” is not worthy of being called a study, and I am very wary of all the MONEY to be made, and I could go on about that. Your link didn’t work for me by the way, but I don’t need to see it, I’m skeptical of anything like that too, that’s why I asked you about the iron, and even regarding the malaria drug and Zithromax I have my skepticism, because I still worry about MONEY and good ol’ boy network (believe me it exists even in the FDA) influencing things.

What are the statistics now for patients on ventilators from C19. Is the survival rate better than 50%?

JLeslie. It depends on the institution. Survival rate is probably around 50%. I have only had one patient on a ventilator so far and he survived, so I’m still at 100%.

@Caravanfan That’s great! I’m so glad you and the patient had a good outcome.

@Caravanfan Is the 2 meter or 6 feet social distancing longer for tall people? I am 198cm or 6’5. Should I stand furter back when in a line up?

It’s for horizontal distances, not vertical distances @RedDeerGuy1.

@Dutchess_lll I am not convinced. Like a cannon ball the higher the trojection as well as the angel the further the distance traveled.

How long is the delay from being tested to hearing result in your hospital lately? Are you able to test whoever you think needs one? or are there still restrictions on who gets tests?

@gorillapaws We have access to two tests. For more severe cases we can get a same day result through the public health department, but there are only a limited amount (I don’t know the numbers). For others who are relatively healthy, the tests are sent to a private lab and the test results takes about 3 days to come back (although it might be better now—that’s not where I work)

@reddeerguy…just don’t spew a cough or a sneeze outward, without blocking it, and you should be OK. Or people around you should be OK.

Okay, closing this puppy down and moving to a third thread.
https://www.fluther.com/220470/here-is-a-third-covid-19-ama-thread-see-details/