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The Next Pandemic: SARS-CoV-2/COVID-19


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Just now, shoshin said:

 

Do you follow the progress in medical treatments for Covid? If you don't you can find plenty of sources. I'm not going to google a ton of articles on point for you. Pretty basic knowledge at this point that we've gotten a lot better at treating a novel disease over the 6 months we've been treating it. The early ventilator panic was based on a lack of understanding that more critical patients needed more oxygen than just plain inhalation support.

 

And ventilators have been found to do more damage than good in many cases.  There are other ways of boosting a patient's blood oxygen levels, and those have been used more often now.

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9 minutes ago, SoCal Deek said:

So isn’t this exactly why the President and his task force built so many thousands of ventilators? The point was to be able to move them where they are needed....no? 

 

There's unlikely to be any ventilator shortage anywhere. Cuomo and Trump made political decisions on what they knew at the time. Turns out we shouldn't see a ventilator shortage or put it this way, if we do, things have gotten really, really, really bad and we shouldn't be excited about scoring a political point over it.

 

The ICU bed measure is one that is more than just "a bed." It's a human measure of HCW capacity too because ICU patients need a lot of human care. 

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Just now, shoshin said:

 

There's unlikely to be any ventilator shortage anywhere. Cuomo and Trump made political decisions on what they knew at the time. Turns out we shouldn't see a ventilator shortage or put it this way, if we do, things have gotten really, really, really bad and we shouldn't be excited about scoring a political point over it. 

I’m not sure what political point you believe the President made. He was asked to use the power of the federal government to manufacture ventilators and he did. He doesn’t deploy them. He just got companies to make them. I’m really not trying to bring politics into this but your comment made me wonder. 

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13 minutes ago, shoshin said:

 

ICU covid usage went up by 130 beds in 4 days. There is a total operational capacity of 200 ICU beds free and 450 nonoperational more across the entirety of Texas. That's not panic porn: That's "pay attention to these numbers."

 

Ventilator usage is down everywhere because we are much better at treating this with other modalities. I don't see that as a limiting resource and don't really track it. 

 

And I agree about that site. I wish every state had that exact chart. 

 

 

You and I can differ on our opinions, I think it is panic porn.  This whole issue is way overblown, and it doesn't really matter anyway because there is no turning back, unless you have some paternalistic government official that indicates otherwise and even then that would be an outlier and the public wouldn't effectively comply anyway. 

 

The only reason why I'm commenting on it is because I'm a data nerd and I love following these sort of things.

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3 minutes ago, SoCal Deek said:

I’m not sure what political point you believe the President made. He was asked to use the power of the federal government to manufacture ventilators and he did. He doesn’t deploy them. He just got companies to make them. I’m really not trying to bring politics into this but your comment made me wonder. 

 

Sorry, I maybe didn't phrase it well. I think Trump and Cuomo did the right thing in the moment in pushing for more capacity as they saw exponential rises and lack of projected ventilator capacity. What I'm saying about "not scoring political points" was a doomsday scenario (that I don't think we will see) where we find our current ventilator usage maxed out. If we get to that point, it will be very bad news and I'd hope we had all hands on deck in unity, not prodding each other about politics. 

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2 minutes ago, shoshin said:

 

Sorry, I maybe didn't phrase it well. I think Trump and Cuomo did the right thing in the moment in pushing for more capacity as they saw exponential rises and lack of projected ventilator capacity. What I'm saying about "not scoring political points" was a doomsday scenario (that I don't think we will see) where we find our current ventilator usage maxed out. If we get to that point, it will be very bad news and I'd hope we had all hands on deck in unity, not prodding each other about politics. 

I don’t blame either one of them and didn’t at the time. It was panic time for sure. We may differ here, but looking back, the two infamous doctors....especially Teflon Fauchi are the ones in my opinion that set this whole thing on fire. 

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5 minutes ago, Magox said:

 

 

You and I can differ on our opinions, I think it is panic porn. 

 

Making conversation here: At what point would you think they should be worried in TX?

 

Using up 1/3 of the currently available ICU beds in the last 4 days doesn't concern you much so I'm genuinely curious. 

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21 minutes ago, shoshin said:

 

Do you follow the progress in medical treatments for Covid? If you don't you can find plenty of sources. I'm not going to google a ton of articles on point for you. Pretty basic knowledge at this point that we've gotten a lot better at treating a novel disease over the 6 months we've been treating it. The early ventilator panic was based on a lack of understanding that more critical patients needed more oxygen than just plain inhalation support.

Early ventilation has been pulled back a bit in the last few months, but when patients are in full on ARDS, ventilators are required. I don’t have the data in front of me but I would bet there’s a pretty decent correlation between mortality and ventilator requirements.

 

If you aren’t worried about ventilators, why are you worried about ICU admissions? Folks can be managed on the medical floors with HFNC. What are the indications for ICU admission?

 

 

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9 minutes ago, FireChans said:

Early ventilation has been pulled back a bit in the last few months, but when patients are in full on ARDS, ventilators are required. I don’t have the data in front of me but I would bet there’s a pretty decent correlation between mortality and ventilator requirements.

 

If you aren’t worried about ventilators, why are you worried about ICU admissions? Folks can be managed on the medical floors with HFNC. What are the indications for ICU admission?

 

 

 

I worry about HCW/other healthcare resource limitations, which are well-represented by ICU bed capacity. It's purely an economics approach to it. 

 

HFNC is just one treatment modality. I have not heard (and admittedly don't have any idea) if there's a shortage there. I doubt it because those machines are pretty simple. 

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14 minutes ago, shoshin said:

 

Making conversation here: At what point would you think they should be worried in TX?

 

Using up 1/3 of the currently available ICU beds in the last 4 days doesn't concern you much so I'm genuinely curious. 

 

No, it doesn't concern me.  When I look at the average age of the people who are being infected and that a good portion of the people who are being hospitalized are much younger than before and the fact that ventilator use is not going up.   This tells me that the average person who is being hospitalized now is a completely different and less at risk demographic than before.

 

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4 minutes ago, shoshin said:

 

I worry about HCW/other healthcare resource limitations, which are well-represented by ICU bed capacity. It's purely an economics approach to it. 

 

HFNC is just one treatment modality. I have not heard (and admittedly don't have any idea) if there's a shortage there. I doubt it because those machines are pretty simple. 

There are lots of treatment modalities for poor oxygenation. HFNC, BiPap, nonrebreather, and of course ventilation.

 

From a healthcare standpoint, if ICU patients don’t require intubation, their length of stay in the ICU is likely less than someone who does. Unless they require pressors or some other indication to remain in the ICU.

 

Basically, I would argue we may see a large fluctuation of icu numbers up and down over the next few weeks.

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12 minutes ago, FireChans said:

 

 

Basically, I would argue we may see a large fluctuation of icu numbers up and down over the next few weeks.

 

Right now at least in Texas, ICU usage is exponentially up, which is why it's worth watching. And in AZ, theirs is also continuing to rise and this is not just ICU new patients, which I agree could be OK if they are in ICU for short periods of time, but total ICU patients currently in the hospital--that's the rising statistic and it's only the covid cases that are contributing to the rise--not others. 

 

If it levels out where we are in Texas, it's manageable. AZ needs it to decline. FL is fine for now. 

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Coronavirus traces found in northern Italian wastewater collected in December 2019

A new study co-led by scientists with the Italian National Institute of Health has found that the first traces of the coronavirus emerged in wastewater in several northern Italian cities as early as December 2019.

Traces of the coronavirus were found in samples collected that month in Turin and Milan, the researchers said.

Similar projects focusing on wastewater are underway in other parts of the continent to determine when exactly the virus arrived in Europe. Cases of the then-unidentified disease were first reported in late December in the Chinese city of Wuhan.

But subsequent research found that the virus must have already been present in France in late December, according to retested samples.

The new Italian research similarly suggests that the virus was spreading in northern Italy — the country’s most affected region — earlier than previously thought. Several towns around Milan confirmed their first major clusters only in late February.

“This research may help us understand the beginning of virus circulation in Italy,” Giuseppina La Rosa, a researcher for the institute, was quoted as saying by the Reuters news agency.

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16 minutes ago, shoshin said:

 

Right now at least in Texas, ICU usage is exponentially up, which is why it's worth watching. And in AZ, theirs is also continuing to rise and this is not just ICU new patients, which I agree could be OK if they are in ICU for short periods of time, but total ICU patients currently in the hospital--that's the rising statistic and it's only the covid cases that are contributing to the rise--not others. 

 

If it levels out where we are in Texas, it's manageable. AZ needs it to decline. FL is fine for now. 

Is the increase in ICU due to covid? Just curious. 

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1 minute ago, westside2 said:

Is the increase in ICU due to covid? Just curious. 

ABSOLUTELY

 

no chance hospitals are actually using their facilities to treat non-covid patints after being forced to stop all voluntary treatment

everyone knows time should stop while we wait for the vaccine

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19 minutes ago, spartacus said:

ABSOLUTELY

 

no chance hospitals are actually using their facilities to treat non-covid patints after being forced to stop all voluntary treatment

everyone knows time should stop while we wait for the vaccine

 

You need to look at the data in the link and not stick to your preferred narrative.

 

Yes, using up 130 of the remaining 300 ICU beds available in TX in the last 4 days was all due to covid-positive patients. Some upwards change in non-Covid but that data is separately identified.

 

 

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