Here is a fourth COVID-19 AMA thread?

One of the things that people use to argue against going for testing, at least in my country, is that you would get the virus by going into hospitals, even when you are perfectly healthy. The argument is that you could be misdiagnosed for Covid, while you just have a cold for example, and when you go to the hospital you would get the virus that is already floating around there, so that would be a double whammy. Is there any proof that disprove that claim?

I’ve heard two different things on this: can you get the virus from surfaces or not?

@Mimishu1995 The tests are extremely sensitive and specific.
@chyna Probably

Why are you only high risk if you have 15 consecutive mins of contact with a positive person without a mask (and you don’t have a mask either?) I know someone who had a lot of contact with a positive person, both without masks. They were told that according to the health department they are not high risk because it wasn’t 15 consecutive mins. (But it was over 30 mins total, less than 6 feet, just not always face to face)

If this is something you get either from droplets or it being airborne, why does it matter how much time? Shouldn’t any length of time with a positive person put you at high risk with no masks? I don’t get it.

@SergeantQueen They had to pick an arbitrary number. But I agree with you here.

So they picked a random number, but people are taking that to mean that any contact at less than 15 mins is not putting them at risk. I think that’s going to cause a lot more problems than they think if it hasn’t already. It would have been better to just classify all contact as a risk.

Thank you for answering

Is it possible to have COVID while coughing up mucus? Or is it strictly dry (unproductive) cough?

(1) What’s wrong with reusing a “disposable” mask? If it’s mainly for the protection of others, won’t the one you wore yesterday work just as well today? It seems like some mask is better than no mask.

Thank you.

(2) My son went to an urgent care clinic two days ago with an ongoing and worsening GI problem. (This is what his oncologist told him to do in a phone call.) Lately he’s been running a temperature with it too. When he finally went to the clinic and answered “yes” to temperature, they shunted him to a covid test section even though he has no other virus symptoms. Instead of waiting among the potential covid patients, he just left.

Three years ago, as a cancer patient, he contracted severe sepsis from a badly placed chemo port and spent 3 days in the ICU, coming home with a rigid every-8-hours treatment routine of powerful antibiotics through the same port. We’re on alert for similar signs.

Q: What should he say to get past the covid-19 watchdogs and be seen by someone who can address the symptoms he does have?

Thank you.

Clarifying (1): I should have said “the one I wore yesterday.” I’m referring to the type of disposable mask I can buy in a box of 25 at CVS and not a specialized mask that medical professionals wear.

@Jeruba If it were me, I would reach back out to your oncologist’s office, explain what happened and have them reach out directly to the urgent care facility on your behalf. They may be able to establish a safe way to be seen.

@gorillapaws, thanks, I tried to persuade him to do that. I said, go through the oncologist and get her to clear the way for you. He said, she’ll just tell me to go through the PCP.

This is the county healthcare system, which takes some effort to navigate even when there isn’t a global health crisis (plus the opioid crisis, homelessness crisis, job loss-insurance loss crisis, and fire-and-smoke-effects crisis, all affecting the burden on county providers). I can do only so much for a grown young man; he does not want me to go into mama-bear mode and fight through the brambles for him.

@SergeantQueen There may be epidemiological data behind the recommendation. I do not know what it is.

@Mr_Saturn512 If you have COVID you are infectious regardless of the type of cough

@Jeruba question #1 (mask) Because the masks get saturated. I throw out my disposable masks too, and I wash my cloth masks. Question #2, he should get a COVID test, and they are following the correct protocol. If he gets more sick he should go to an ER.

How are you interpreting this story about a man in Hong Kong becoming the first documented case of being infected with COVID twice 142 days later?

Is this possible that it could be one of those weird outliers that sometimes happens in nature? or is this fairly indicative that any immunity from being infected is short-lived?

@Caravanfan To piggy back on @gorillapaws latest question, I would think scientists are testing immunity in people who have been positive ongoing. To get a gauge on how long immunity lasts. Isn’t that the case? I would be sure they are doing it with the vaccinated subjects.

I recently saw a scientist saying that the media had been incorrectly interpreting the information on immunity that was put out a couple of months ago. He said the media has been saying the immunity might only be 3 months, when in fact the reports the media outlets were referencing were saying the immunity has shown to still be intact at the 3 month mark. Meaning, immunity could be go on and be 3 years or 30 years. Simply, covid had not been around long enough at the time of that one report to know.

I have my doubts about this Hong Kong case, but I am very interested to knowing what you think about it.

Yeah, it’s kind of terrifying, but it’s also noteworthy that it’s making the news. That means that it’s rare. Not sure what else to think about it. We just need to wait and see.

@Caravanfan Is there any work being done to see if prior coronavirus infection, NOT covid 19, is giving people immunity or much milder cases? Or. looking for genetic markers that people with no symptoms share in common? Some way to take an educated guess who might have low risk and who has high risk.

@JLeslie No idea, sorry.

How uncomfortable is the nasal swab Covid test? I’m having eye surgery in a few weeks and I’m very anxious about the swab test.

@janbb Depends on which they’re doing. The nasopharyngeal test can be uncomfortable. The anterior nasal swab is nor more uncomfortable than picking your nose.

But don’t worry about it. They’re fine.

What are your thoughts about the statement from WH about Trump’s timeline and treatment?

@Caravanfan They did the anterior nasal swab and it was a piece of cake metaphorically speaking. It was a rapid response test – are they always done that way?

@raum I didn’t watch it. Just saw the twitter blowback. IN terms of the treatment it’s hard to say as they’re obfuscating. I haven’t heard of that monoclonal antibody before yesterday. No idea of the data on it.

@janbb Yes, most tests are anterior nasal now.

Is Trump a good candidate for the experimental bleach injection therapy that he invented?

^^^^ YES!!!

Is having asthma a valid reason not to wear a mask in public?

@brian1946 No.

@Caravanfan I keep seeing on MSNBC doctors saying Trump must have received the steroids because he was very sick, and now I just heard that he is probably one of the only people to receive Remdisivir and antibodies and steroids all at once. Does that really sound that odd to you? Do you think it is more likely he does not have severe symptoms?

I know your patients are ICU level, so that’s different than Trump’s situation, but I remember you said that many drugs are tried hoping something will work.

A friend of mine with covid was on steroids for her breathing and I don’t know if she was given anything else. She never was hospitalized. She has a history of asthma and she struggled with covid.

Doctors give prednisone at the drop of a hat in my experience for cough from flu and other viruses. I know this steroid being given for covid is not prednisone, I don’t remember the name.

Giving Remdesivir, steroids and plasma is extremely common, and steroids are given out like candy, pretty much to everybody now. We don’t have access to the monoclonal antibody yet, which is fine with me as it’s not been shown to do squat yet. The steroid is dexamathasone, but any steroid would probably do.

I’m guessing that Trump is probably fine and had a mild case. Nevertheless he is still a fucking asshole for going back to the White House, refusing to wear a mask and potentially infecting people around him.

@Caravanfan I agree with the asshole part, I just am tired of MSNBC and CNN sounding like left wing propaganda idiots. I want them to be better than that (which I think they were years ago). They can just stick to the legitimate fucking asshole part and it would be better in my opinion. I don’t understand why they are hell bent on making Trump’s case into it must have been severe. It seems obvious to me it wasn’t, unless he suddenly takes a downward turn.

I don’t watch any TV news. So I can’t comment on what they are reporting.

Smart @Caravanfan Trump is acting like an ass, in public without a mask after discharge.

@Tropical_Willie, not even really a discharge, more like a transfer from one medical facility to another.

True @canidmajor and still contagious with no mask.

@Tropical_Willie I encourage all to listen to this Dan Carlin Common Sense episode. This is why I do not watch the TV news.

TV news isn’t interested in giving you the news. They are interested in keeping you watching so they can increase advertising revenue. So they artificially make everything a crisis or “breaking news”.

The Weather Channel is the same way during a big storm. Don’t watch that either.

I miss the Weather Channel. Sniff.

I got my flu shot. Would getting a pneumonia vaccine be helpful as well in terms of the Coronavirus?

NPR confirms that a man who previously had C19 was reinfected. This confuses me. Until NPR came out with that I thought it was, like @Caravanfan said, news gone wild. Saying anything to keep the virus at the forefront.

@Dutchess_III The latest I heard was that 15 people in the world have gotten it twice so far.

NPR says 2.

@Dutchess_III I thought I’d read 15 but looking it up I see a few sources that say 5:

https://www.aljazeera.com/news/2020/10/13/covid-19-again-reinfection-cases-raise-concerns-over-immunity

@janbb No, they are unrelated, however getting pneumococcus is bad so get your vaccine.

@Dutchess_III There have been reported cases of reinfection, but it’s rare

Have there been other instances of reinfection with other types of viruses?

The news I read was was that the second infection of COVID-19 is a different strain !

Well, that would make more sense.

Genetic sequencing of the virus showed he was infected twice by different strains of Sars-CoV-2, according to researchers.

Thanks @Tropical_Willie.

Is it helpful to wash your gloves with sanitizer or soap while wearing them?

@RedDeerGuy1 Yes, but best to just change them.

What are your thoughts on the phase 3 Pfizer vaccine situation? On a scale of 1–10, how optimistic are you with this news?

@gorillapaws 10. It could be a gamechanger.

@Caravanfan I know you wouldn’t bullshit us, so that’s so incredible to hear! Thanks so much for your honest analysis during this nightmare. These threads have really been invaluable to me (and I hope the others too), and I am deeply grateful for you taking the time to share your knowledge and experience with us.

@gorillapaws @Caravanfan I second that emotion!

@gorillapaws No problem. Now, the vaccine is still in early trials, but reports are putting it at 90% effective. That’s way better than the flu vaccine. If everybody gets vaccinated, and you wipe out 90% of future infections, then it will burn itself out.

But it will only work if everybody buys into it. My hesitation is that the Facebook-fueled conspiracy theories will keep enough people unvaccinated to make the vaccine useless. That’s why I’m totally fine with the Trumpists claiming credit for this vaccine. If it gets them vaccinated when that comes about and if they want to give Trump the credit, fine whatever.

Ultimately I’m a really lazy person. I would just as soon have a super quiet ICU where I can waste time on Fluther rather than struggling with ventilated Covid patients I am having difficult oxygenating.

I heard a rumor that the virus can remain airborne, all by itself for days! I don’t think that’s correct. Is it?

One thing I don’t understand is about vaccination. If only 50% of the population buy into getting it, wouldn’t that still reduce the number of people getting sick? And couldn’t those people resume all normal activities? I know you haven’t achieved herd immunity levels but wouldn’t that still be a big win?

@janbb As I understand it it’s all about getting the Effective reproduction number (R t) below 1. If that happens then the virus will burn itself out over time. That’s called heard immunity. I can only imagine that 50% immunity (from vaccinations) would go a long ways towards getting R t to be less than 1. I’m sure there are actual models by real epidemiologists that have a pretty-good idea of what those numbers would need to be before we can go back to life as normal. Please apply the appropriate level of skepticism to the opinions of someone with no medical degree to what I have said.

^^ Thanks. I understand most of that. (But it’s “herd” immunity not “heard”.)

@janbb Haha. I’m an idiot. Thanks for catching my error.

^^ At least you didn’t put “heard mentality”!

@janbb: The article I read today on Reuters said that they are not sure if the vaccine also makes you less contagious.

@Caravanfan Would you say a lot of people died who might not have, because they were intubated too soon in the early days of the pandemic? From what I understand doctors wait longer now.

@JLeslie No. A lot of people died because this disease sucks.

I don’t question that the disease sucks.

@JLeslie The way your question is stated, you seem to be blaming the doctors for Covid-19 deaths. I don’t think that’s your intention is it?

@chyna I don’t blame doctors. They did the best they could, and did what was the recommended care at the time. That is why we have standard of practice laws, because medical science does not always have all of the answers.

From what I understand doctors are now waiting longer to put some patients on ventilators. It wouldn’t be shocking that we can possibly treat patients better over time. Doctors are using steroids more now maybe also. Watching for clotting, maybe giving medication prophylactically to those at high risk for clotting? I also heard doctors say they know better now what settings work best on the ventilators.

I was just asking our resident doctor what his experience was and what he has heard. I wasn’t trying to blame anyone. If it is the case that we are better at treating it now there would be no shame in that. I keep telling the no-maskers that preventing the spread matters, because getting sick in a year might be more easily treated than today. Just like when people want to live long enough for a cure for their cancer, and just like getting HIV today is much different than catching it in1985.

If they find a magic medication tomorrow that was a 30 year old drug, but no one had thought of it until now, no one would be to blame.

@chyna I wasn’t feeling blamed. I was just answering the question. Early intubation does not lead to increased deaths. COVID leads to increased deaths.

It is true that many of us are trying to stave off intubation if only because these people end up being intubated forever. But if we need to do it we need to do it.

@JLeslie As I said, I didn’t think you were.

@chyna I didn’t mind you asking.

I heard a rumor that the virus can remain airborne, all by itself, for days. I don’t think that’s true, is it?

Are you planning on trying to get vaccinated under the Emergency Use Authorization in December? or are you going to wait for full FDA approval? also if you have the option of which vaccine to take, do you have a preference? first available?

@gorillapaws I’m going to get it when my hospital offers it to the staff, whenever that is.