Coronavirus Discussion Thread

SandpitMedic

Crowd pleaser
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absurd rantings cut for brevity
Truly an example of "it takes all kinds."

It's like trying to have a conversation with a turkey sandwich except I can stomach a turkey sandwich. I have had more insightful conversations with manic, intoxicated, hallucinating psych patients.
 

Bullets

Forum Knucklehead
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Spoke to one of my former coworkers in central NJ last week... she said they were getting slammed, and FEMA had sent them additional ambulances to cover the rising call volume.

around here, the ERs are mostly empty. EMS call volumes are down. People are working from working remotely and staying home. I don't think its a dud, but it has highlighted how underfunded EMS and public health is for a pandemic. And how if you watch the mainstream media, you will think the sky is falling, because they are fearmongering many of their ignorant viewers.
Highly regional even within Central Jersey. Outside the northeast corner, it has been pretty slow. We never hit capacity. A main academic center had 30 ventilators sitting in a room unused. FEMA trucks were used in the central but that was more to alleviate the longer turn around times due to deconing. Plenty of hospitals south of the Raritan that are empty
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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Please do cite examples of this. I'd actually like to read the literature on this and learn if TB treatment has been actually changed by co-infection by SARS-CoV2.
Nobody is in the offices right now for me to get my hands on the studies. There is one quite well translated from Thai I will try to get so I ask you to settle for anecdotal purely from observations for the moment. TB is extremely prevalent in most of the third world relative to quality and availability of health care. That is one paper I'll try to get my hands on.
Back in the early 2000s during a serious AIDS epidemic TB was becoming active on a serious scale. A hospital in Mae Rim had over 90% TB opportunity infection rate. HIV-AIDS patients went straight to the respiratory wards.
I believe in 2006 there were several extensive studies done which all appear to be down in Kuala Lumpur at this time at the tropical disease center where they were correlating the opportunity infector incidents with the local epidemics most notably AIDS, Dengue, Hepatitis - all forms, encephalitis, and I forget which others. Cholera and Leptospirosis were also included due to their prevalence in outlying areas where all villages had free ranging chickens and raised hogs.
Again, I'm going by first hand experiences here. There was a white paper which I'm trying to get my hands on that correlated weakened immune system from the common epidemic infections with TB becoming active. (Everyone tests positive for TB presence throughout S.E. Asia).
There are a LOT of studies done on this.
Anyway, obviously any new virus that targets the lungs and or has a significant effect on the immune system is a concern that active TB is almost a given. This paper gives a good general scope of the problem:

Esp.
"Despite encouraging progress, the burden of tuberculosis (TB) remains enormous with about one third of the World population latently infected with the etiologic agent Mycobacterium tuberculosis,1 8.7 million new cases of active disease and 1.4 million people died in 2011.2 Some authors state that 95% of all cases and 98% of deaths due to TB, occurs in tropical countries.3 "

Additionally, something I never followed up on. When my sister-in-law contracted dengue, she was moved to a different hospital where they had full respiratory support capabilities and were undertaking an extensive study in the apparently unrelated symptoms of dengue were triggering active TB episodes. She had developed pneumonia around the end of the first week of the dengue developing and was placed in a ward with several other dengue patients. The language barrier coupled with physicians (who spoke English) being present for less than an hour per day made it next to impossible for me to get additional information. A very common problem on getting the low down on anything here.

In reciprocal, if you have any info, links, I''d very much appreciate you posting them.


And something worth bearing in mind here. I'm flying blind nearly all of the time. Operating on ancient paramed skills from the 80's and 90's. Almost no medical professional I meet speaks English, nurses and technicians operate rote by written instructions and them thinking on their feet is most often sternly forbidden. The average pay of a physician is $7 per patient for an initial office visit and nearly all physicians make most of their money as 'used car dealers'. Selling diagnostics in hospitals and getting kickbacks.
This is not the first world cutting edge medical wise. If I want any serious low down on medical issues the most available info is in hospitals down in Bangkok 500 miles away and anything epidemilogical is mostly down in Malaysia.
 
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RedBlanketRunner

Opheophagus Hannah Cuddler
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@Akulahawk Off on an odd tangent. I recently read about a strange corollary that is presently being explored. The incidence rate of TB in migrants to the European countries and the Covid-19 incidence rate is approximately the same. Italy, Spain, France, Germany and the UK the major infection centers of both, but the diseases and their spread are apparently unrelated. Or are they?
The paper I read was focused mainly on globalization and the 'our back yards are now becoming everyone's back yards' concept and that the entire world wide medical community is going to be forced to rethink itself and the standards of practice. All community communicable diseases may/will eventually become endemic in every country on the planet. We can't simply go into lockdown every time an epidemic flares up. I'm trying to find out if that paper is publicly released and will link if possible.
 
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DrParasite

The fire extinguisher is not just for show
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OK, I might not be as smart or educated as some of the others, but I am having trouble understanding how any of the above two posts are related to Covid-19 at all (especially the first one). It looks like a lot of irrelevant information that doesn't answer the question @Akulahawk asked. Can someone help me out?

Other than how we can't lock down society every time an epidemic flares up. Which is odd, because that is what the conservatives in the US have been saying, while the liberals have been saying the opposite.
 

SandpitMedic

Crowd pleaser
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Other than how we can't lock down society every time an epidemic flares up. Which is odd, because that is what the conservatives in the US have been saying, while the liberals have been saying the opposite.
Actually a lot of us here have been saying that as well. And RumRunner has been arguing that lockdown was necessary to avoid the apocalypse, yet now he seems to have slipped a little crow eating into large irrelevant rants instead of just acknowledging he may have missed the mark.
 

FiremanMike

EMS Coordinator
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Since his KSA’s are 30 years old...
No formal education IIRC, 10 hour first aid class, all street learned..

Or something.

Cric'd a dude in the middle of the woods in rural Cali though, then hopped on "the bird" to help the crew fly.. or something.
 

ffemt8978

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That's enough. Get back on topic without getting personal.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
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@Akulahawk Not the papers I referred to but some backgrounder info

I'll keep looking.
 
OP
Akulahawk

Akulahawk

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@Akulahawk Not the papers I referred to but some backgrounder info

I'll keep looking.
I don't put much stock in WHO's abilities these days, considering they basically parroted the info that China wanted them to. However, the info in the Thailand Medical News does sound interesting and I await peer review and publication of their findings. I'm not saying, and haven't said, that SARS-CoV2 doesn't preclude co-infection or reactivation of an existing infection, just that I want to see the studies that will help the rest of us quantify the risks.

Please keep looking.
 

SandpitMedic

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So are we going to take bets on the 2nd spike? I’m saying around July 14th.
 

Peak

ED/Prehospital Registered Nurse
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Considering that we currently have no adult ICU patients with active COVID infections and that we have never filled to ICU capacity (or even came close), I don’t think that there’s any guarantee that we will see another spike, let alone one that overwhelms the system.
 

DesertMedic66

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One of the areas near me is just starting to get slammed with COVID patients. Several hospitals in Mexico have closed down causing all the American citizens who were there to cross the border and seek medical attention at the 2 hospitals in that area. The hospitals have declared an emergency since the 15th and have been flying out around 15 patients per day, the majority of them are critical COVID patients.

All ambulance traffic with patients who have any COVID signs or symptoms are being diverted to hospitals that are 2 hours away if their patients are stable. It has made for a lot of sleepless nights and staging at locations closer to the hospitals.
 

RedBlanketRunner

Opheophagus Hannah Cuddler
201
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I don't put much stock in WHO's abilities these days, considering they basically parroted the info that China wanted them to. However, the info in the Thailand Medical News does sound interesting and I await peer review and publication of their findings. I'm not saying, and haven't said, that SARS-CoV2 doesn't preclude co-infection or reactivation of an existing infection, just that I want to see the studies that will help the rest of us quantify the risks.
Re WHO. Numerous people have been voicing gripes about WHO. Mixed signals. Single source info. Their aggregates still seem to be trustworthy. What is of greater concern is the possibility of politics entering into the works. I was closely monitoring China and WHO response, appreciated the announcement China was giving WHO free run of the place, then WHO started sounding like a sycophant. WTF??

Not sure what is going on down in Kuala Lumpur. Tropical Disease center seems to be in limbo. Numerous experts aren't answering emails. I'll keep trying. Really want to get my hands on those white papers. I might try an end run, maybe MSF, but they are a huge pain to get any info out of. Everything in French and Nes Pas Diffuser on every page.
 
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SandpitMedic

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I don’t know about the timing of a spike, but I’m guessing the timing of the next wave of new fear mongering and shutdowns and political uproar will be closer to Election Day than that.
You might be on to something there.
 

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