Covid-19

Feels deserving to have its own thread at this point...

It is officially in Ohio (3 cases announced today in Cuyahoga) and will soon be widespread everywhere. The economic impact is massive obviously. I am more concerned with the general “no big deal” approach we have seen that has slowed testing and treatments. I would expect the mortality rate to be lower in the US than China, but it is concerning that we really don’t have widespread testing available at this point.

Also not suggesting a massive panic or freak out is validated but the way this has been handled here has been a cluster f.

How do you think it SHOULD be (or have been) handled here? Promise it's not a "gotcha!" question. Just curious what you think.

Why are people stocking up on toilet paper? Does the corona virus give you the shits?

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Originally Posted by Lloyd Braun

Feels deserving to have its own thread at this point...

It is officially in Ohio (3 cases announced today in Cuyahoga) and will soon be widespread everywhere. The economic impact is massive obviously. I am more concerned with the general “no big deal” approach we have seen that has slowed testing and treatments. I would expect the mortality rate to be lower in the US than China, but it is concerning that we really don’t have widespread testing available at this point.

Also not suggesting a massive panic or freak out is validated but the way this has been handled here has been a cluster f.

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I've not yet seen the 'general no big deal' response. Everyone seems to be taking it extremely seriously.

The lack of available testing kits is the biggest F up at this point imo.

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Originally Posted by GoMuskies

How do you think it SHOULD be (or have been) handled here? Promise it's not a "gotcha!" question. Just curious what you think.

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Widespread testing should have been available weeks ago, other countries have had this in place for a long time. Experts have been declaring this was inevitable since day 1 yet the response from CDC and local health departments has been mixed. Many ER doctors and professionals have already stated they may have seen several cases that they were unable to test due to lack of direction and guidelines.

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Originally Posted by xubrew

I've not yet seen the 'general no big deal' response. Everyone seems to be taking it extremely seriously.

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Media frenzy is real but this has been a “no big deal” approach from those higher up in government and those guiding health care facilities. Now that it’s in the US and spreading rapidly there is less of that approach and more “self-quarantines.”

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Originally Posted by xubrew

I've not yet seen the 'general no big deal' response. Everyone seems to be taking it extremely seriously.

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The stock market is certainly taking it seriously! It’s affecting a lot of people in a lot of ways. My wife had to cancel a HUGE national event in NYC this week. Still has to pay for the event per the contract, but they will be allowed to reschedule. Our future daughter-in-law does group sales for a BIG hotel downtown, major events. She just had a $500k event cancel on her, affecting her comp.

Testing should be easy and available. I’m not sure how that could have been neglected.

It sounds good to say everyone should be able to get tested. Here’s the question. How quickly can you make 357 million test kits? Even if only half of the people want to be tested, that’s still almost 180 million tests. How long will it then take to process those tests?

It’s impractical to suggest that’s remotely possibly, yet I’m hearing people in the media blaming Trump for not having the tests readily available.


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Originally Posted by xu82

The stock market is certainly taking it seriously! It’s affecting a lot of people in a lot of ways. My wife had to cancel a HUGE national event in NYC this week. Still has to pay for the event per the contract, but they will be allowed to reschedule. Our future daughter-in-law does group sales for a BIG hotel downtown, major events. She just had a $500k event cancel on her, affecting her comp.

Testing should be easy and available. I’m not sure how that could have been neglected.

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I'm sorry to hear that. Trump trying to cut payroll tax is a great call. Hopefully it can help a lot of people and businesses like this.

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Originally Posted by Lloyd Braun

Widespread testing should have been available weeks ago, other countries have had this in place for a long time. Experts have been declaring this was inevitable since day 1 yet the response from CDC and local health departments has been mixed. Many ER doctors and professionals have already stated they may have seen several cases that they were unable to test due to lack of direction and guidelines.



Media frenzy is real but this has been a “no big deal” approach from those higher up in government and those guiding health care facilities. Now that it’s in the US and spreading rapidly there is less of that approach and more “self-quarantines.”

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I agree with the widespread testing, but I think the problem is more societal than anything else. Whether it's swine flu, or SARS, or MERS, or bird flu, everyone gets scared, then it goes away, and then people forget that they were even scared and when it comes to funding research to identify, study, and develop treatments for new viruses, no one cares. It isn't the first virus outbreak. It isn't the first state of emergency either. Yet, here we are again. In a month or two, or whenever this subsides, I think the vast majority of people are going to put it out of their minds like it never even happened. Again.

https://www.nbcnews.com/news/amp/ncn...gNAM8bRAhHXXb0

So, I guess doctor knowledge would come in handy, here are some actual facts about the Coronavirus and you guys can determine from there how you guys want to handle it:

- We've known about Coronavirus being a thing for a lot of years, it just happens this particular strain is a little more potent. The strain changes its genetic composition, which basically means a vaccine for the thing is pretty damn hard to generate due to phases of a clinical trial you have to go through in order to have anything approved in the first place. Coronavirus is the virus responsible for SARS (South Asian Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) that were prevalent however many years ago.

- For most people, this is NOT a deadly virus, and will produce mild flu-like symptoms. The people most at risk are the ones that are elderly and young children who have poor immune systems. Obviously anybody who is immunocompromised (ie cancer, HIV, autoimmune diseases like lupus, etc.) fall in that category as well. The fatality rate for this virus is actually around 2%, which is chance due to chance alone. The risk increases to 10% with a risk factor (ie smoking, diabetes, etc. or any of the conditions above), and 20% with two risk factors. The influenza virus that happens every winter actually has a higher case fatality rate. However, this is where the problem lies, as most people who have it, aren't debilitated by it, and go out into public and end up infecting people.

- The virus is transmitted via respiratory droplets, which means talking, coughing, etc. all those things can easily transmit the virus. The virus also isn't like other viruses where warm weather kills it off, it general does alright in warm weather. The best way to prevent transmission is to practice good hand washing skills. If you get a mask, just know that the mask doesn't really protect you, it protects other people from you more than anything. Also make sure you are wearing the mask properly if you do (or buy stock in 3M who's prices rise a lot during outbreaks, look at the pricing of 3M during the last epidemic of the Swine Flu for example). Don't touch your face, all that good stuff.

Ultimately I would say the severity should be a little above non-chalant, but now as crazy as people are making it out to be. Yes, it is associated with risks, but all viruses are associated with risks. If you fall under the categories above take special precaution, but if you're a young, healthy, human with not a lot of risk factors, even getting this virus wouldn't be that big of a deal. You should definitely avoid going into public if you are feeling sick, as the self-quarantine rules are in place to try to kill off the spread of it. Ultimately, this carries no higher risk than getting the seasonal flu, nor does it cause more deaths than getting the seasonal flu. Practice good sanitation habits, but don't be afraid to carry out your day to day activities.

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Originally Posted by bjf123

It sounds good to say everyone should be able to get tested. Here’s the question. How quickly can you make 357 million test kits? Even if only half of the people want to be tested, that’s still almost 180 million tests. How long will it then take to process those tests?

It’s impractical to suggest that’s remotely possibly, yet I’m hearing people in the media blaming Trump for not having the tests readily available.


Sent from my iPhone using Tapatalk

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You don’t need to test EVERYBODY, obviously. Just those that have been exposed and are at risk. My wife recently hired an RFP writer in Boston. She flew to Ft Myers, FL this weekend to see her dying father. When she arrived she was told they had 2 confirmed with the virus in the hospital and she couldn’t see her dad one more time. She signed off on all kinds of crazy stuff and was allowed in. NOWHERE near the infected people, but she was in a busy hospital. Now she finds she’s got it, after flying back last night.

The people in that hospital should have been tested. It was known to be there, and allowed to spread to God knows where because it was neglected.

Mortality rate is unknown currently and fluctuates wildly. Current WHO estimate is 3.4%.

The tests are easy to produce if given the appropriate funds, it’s a simple RNA PCR test similar to the flu. The problem was we were waiting until it was in the US to allocate funding. I’m not blaming Trump but at the same time when it is eradicated and he says what a great job all of his people did to prevent so many deaths (which he will inevitably take credit for) I will be happy to call BS on those saying it’s not his fault now for rapid spreading and lack of testing.

Oh, and toilet paper is nice to stock up on if you don’t leave the house... I bet there are a lot of Italians in need of a nice roll of charmin.

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Originally Posted by GIMMFD

So, I guess doctor knowledge would come in handy, here are some actual facts about the Coronavirus and you guys can determine from there how you guys want to handle it:

- We've known about Coronavirus being a thing for a lot of years, it just happens this particular strain is a little more potent. The strain changes its genetic composition, which basically means a vaccine for the thing is pretty damn hard to generate due to phases of a clinical trial you have to go through in order to have anything approved in the first place. Coronavirus is the virus responsible for SARS (South Asian Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) that were prevalent however many years ago.

- For most people, this is NOT a deadly virus, and will produce mild flu-like symptoms. The people most at risk are the ones that are elderly and young children who have poor immune systems. Obviously anybody who is immunocompromised (ie cancer, HIV, autoimmune diseases like lupus, etc.) fall in that category as well. The fatality rate for this virus is actually around 2%, which is chance due to chance alone. The risk increases to 10% with a risk factor (ie smoking, diabetes, etc. or any of the conditions above), and 20% with two risk factors. The influenza virus that happens every winter actually has a higher case fatality rate. However, this is where the problem lies, as most people who have it, aren't debilitated by it, and go out into public and end up infecting people.

- The virus is transmitted via respiratory droplets, which means talking, coughing, etc. all those things can easily transmit the virus. The virus also isn't like other viruses where warm weather kills it off, it general does alright in warm weather. The best way to prevent transmission is to practice good hand washing skills. If you get a mask, just know that the mask doesn't really protect you, it protects other people from you more than anything. Also make sure you are wearing the mask properly if you do (or buy stock in 3M who's prices rise a lot during outbreaks, look at the pricing of 3M during the last epidemic of the Swine Flu for example). Don't touch your face, all that good stuff.

Ultimately I would say the severity should be a little above non-chalant, but now as crazy as people are making it out to be. Yes, it is associated with risks, but all viruses are associated with risks. If you fall under the categories above take special precaution, but if you're a young, healthy, human with not a lot of risk factors, even getting this virus wouldn't be that big of a deal. You should definitely avoid going into public if you are feeling sick, as the self-quarantine rules are in place to try to kill off the spread of it. Ultimately, this carries no higher risk than getting the seasonal flu, nor does it cause more deaths than getting the seasonal flu. Practice good sanitation habits, but don't be afraid to carry out your day to day activities.

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Why should we believe a doctor when social media is telling us differently!!??

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Originally Posted by bjf123

It sounds good to say everyone should be able to get tested. Here’s the question. How quickly can you make 357 million test kits? Even if only half of the people want to be tested, that’s still almost 180 million tests. How long will it then take to process those tests?

It’s impractical to suggest that’s remotely possibly, yet I’m hearing people in the media blaming Trump for not having the tests readily available.


Sent from my iPhone using Tapatalk

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C'mon dont be ridiculous. They dont need 350 million tests or even close to 180 million. We have tested 2,000 people (as of a few days ago) in this country. Ohio has 400 test kits total.

https://www.vox.com/science-and-heal...-kits-covid-19

"The figures we gathered suggest that the American response to the coronavirus and the disease it causes, COVID-19, has been shockingly sluggish, especially compared with that of other developed countries. The CDC confirmed eight days ago that the virus was in community transmission in the United States—that it was infecting Americans who had neither traveled abroad nor were in contact with others who had. In South Korea, more than 66,650 people were tested within a week of its first case of community transmission, and it quickly became able to test 10,000 people a day. The United Kingdom, which has only 115 positive cases, has so far tested 18,083 people for the virus."

The testing has been a cluster. There are people who have come in close contact with people who have confirmed diagnosis who are being turned away from being tested.

https://www.sciencemag.org/news/2020...y-soon-improve

"In what is already an infamous snafu, CDC initially refused a request to test a patient in Northern California who turned out to be the first probable COVID19 case without known links to an infected person."

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Originally Posted by nuts4xu

Why are people stocking up on toilet paper? Does the corona virus give you the shits?

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That's a great question. I feel like there's something I'm missing out on.

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Originally Posted by Lloyd Braun

Mortality rate is unknown currently and fluctuates wildly. Current WHO estimate is 3.4%.

The tests are easy to produce if given the appropriate funds, it’s a simple RNA PCR test similar to the flu. The problem was we were waiting until it was in the US to allocate funding. I’m not blaming Trump but at the same time when it is eradicated and he says what a great job all of his people did to prevent so many deaths (which he will inevitably take credit for) I will be happy to call BS on those saying it’s not his fault now for rapid spreading and lack of testing.

Oh, and toilet paper is nice to stock up on if you don’t leave the house... I bet there are a lot of Italians in need of a nice roll of charmin.

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The mortality rates are unknown due to how it's being reported (aka some countries may not be honest with their numbers, etc.), but I tell you whole heartedly without any doubt in my mind, with a lot of medical jargon crap that I won't bore you guys with, that the numbers I said (1-3% in the general population, 10% with a risk factor, 20% with two risk factors) are how it plays out. The reason the mortality rate is fluctuating wildly is really because it depends who gets infected, the ones more at risk are obviously have a higher chance to die, and as it is a respiratory droplet transmission virus it's much easier to transmit. If you remember the Ebola scare a few years ago, the US only had 1 case I believe, and it was pretty well contained in Africa, that's because that virus spreads through human contact (ie bodily fluids basically), couple that with the fact that this one does decently well in warm weather, it's going to play out longer, so the mortality rates will continue to fluctuate, again depending on who gets infected.

You are very correct about the testing, and I will agree that the US government has dropped the ball on appropriately preparing for this endemic. Unfortunately because the strain is very different from past Coronaviruses we aren't exactly sure the complete characteristics on it, how long it can live on surfaces, etc. There's probably not going to be a vaccine for it made (ie in 2003 when SARS was going on, they were making a vaccine for it, but then the endemic stopped before the vaccine reached clinical trial), but it absolutely blows my mind that when it first started becoming a major thing in China why we weren't already pushing out testing for places. Though testing is going to be more available in the next coming weeks, it was a complete misstep to not prepare for it properly.

Here's what Harvard's Medical Department had to say about it, I haven't read it, but I have a feeling if you read it, it'll basically be saying the same things I have: https://www.health.harvard.edu/blog/...-2020022719004

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Originally Posted by nuts4xu

Why are people stocking up on toilet paper? Does the corona virus give you the shits?

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Lmfao well actually some percentage of people have been reporting GI symptoms with it, but in general no, I think it's just in case you run out of toilet paper and there's a shutdown like what's going on in Italy. I'm sure you could go the old European way and figure out a makeshift bidet.

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Originally Posted by D-West & PO-Z

C'mon dont be ridiculous. They dont need 350 million tests or even close to 180 million. We have tested 2,000 people (as of a few days ago) in this country. Ohio has 400 test kits total.

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I agree that it’s ridiculous, but some of the talking heads on the Left leaning media have been blaming Trump for not having tests available for everyone. Of course, he’s busy patting himself and the administration on the back. The reality is somewhere between the two.


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Originally Posted by bjf123

I agree that it’s ridiculous, but some of the talking heads on the Left leaning media have been blaming Trump for not having tests available for everyone. Of course, he’s busy patting himself and the administration on the back. The reality is somewhere between the two.


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The issue isnt that we dont have tests for everyone (anyone who says that is the issue is wrong) it is that we dont even have tests for everyone that has been confirmed to be in contact with those who have confirmed diagnosis including healthcare workers. The US was incredibly slow and bungled at the very least the test kits part.

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Originally Posted by D-West & PO-Z

The issue isnt that we dont have tests for everyone (anyone who says that is the issue is wrong) it is that we dont even have tests for everyone that has been confirmed to be in contact with those who have confirmed diagnosis including healthcare workers. The US was incredibly slow and bungled at the very least the test kits part.

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This seems undeniable.

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Originally Posted by GIMMFD

Here's what Harvard's Medical Department had to say about it, I haven't read it, but I have a feeling if you read it, it'll basically be saying the same things I have: https://www.health.harvard.edu/blog/...-2020022719004

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This link is mostly “old” data that is in all common terms. Which is fine and has value... There are some interesting tidbits coming out in the medical community regarding treatments and vaccination. The time to make a vaccine is actually only a few weeks away but the virus is supposedly mutating too rapidly for it to be effective. There is evidence of several medications being effective against this strain of coronavirus, one of which is chloroquine. This is a widely available medication in the US. Other antivirals that are likely effective may be less available. The Chinese have done a lot of research on this outbreak and for what it’s worth, have contributed a lot of data to the research community.

I do agree that mortality rates are poorly reported for many reasons. Further, there are likely hundreds (at minimum probably thousands) of undiagnosed cases that people survived. The WHO tries to factor those in but it is impossible to do so accurately. When it’s all said and done it will likely vary by country. Strangely enough Germany has a very good reported mortality rate thus far FWIW.

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Originally Posted by Lloyd Braun

Strangely enough Germany has a very good reported mortality rate thus far FWIW.

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good news for midwesterners

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Originally Posted by GIMMFD

So, I guess doctor knowledge would come in handy, here are some actual facts about the Coronavirus and you guys can determine from there how you guys want to handle it:

- We've known about Coronavirus being a thing for a lot of years, it just happens this particular strain is a little more potent. The strain changes its genetic composition, which basically means a vaccine for the thing is pretty damn hard to generate due to phases of a clinical trial you have to go through in order to have anything approved in the first place. Coronavirus is the virus responsible for SARS (South Asian Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) that were prevalent however many years ago.

- For most people, this is NOT a deadly virus, and will produce mild flu-like symptoms. The people most at risk are the ones that are elderly and young children who have poor immune systems. Obviously anybody who is immunocompromised (ie cancer, HIV, autoimmune diseases like lupus, etc.) fall in that category as well. The fatality rate for this virus is actually around 2%, which is chance due to chance alone. The risk increases to 10% with a risk factor (ie smoking, diabetes, etc. or any of the conditions above), and 20% with two risk factors. The influenza virus that happens every winter actually has a higher case fatality rate. However, this is where the problem lies, as most people who have it, aren't debilitated by it, and go out into public and end up infecting people.

- The virus is transmitted via respiratory droplets, which means talking, coughing, etc. all those things can easily transmit the virus. The virus also isn't like other viruses where warm weather kills it off, it general does alright in warm weather. The best way to prevent transmission is to practice good hand washing skills. If you get a mask, just know that the mask doesn't really protect you, it protects other people from you more than anything. Also make sure you are wearing the mask properly if you do (or buy stock in 3M who's prices rise a lot during outbreaks, look at the pricing of 3M during the last epidemic of the Swine Flu for example). Don't touch your face, all that good stuff.

Ultimately I would say the severity should be a little above non-chalant, but now as crazy as people are making it out to be. Yes, it is associated with risks, but all viruses are associated with risks. If you fall under the categories above take special precaution, but if you're a young, healthy, human with not a lot of risk factors, even getting this virus wouldn't be that big of a deal. You should definitely avoid going into public if you are feeling sick, as the self-quarantine rules are in place to try to kill off the spread of it. Ultimately, this carries no higher risk than getting the seasonal flu, nor does it cause more deaths than getting the seasonal flu. Practice good sanitation habits, but don't be afraid to carry out your day to day activities.

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Everything I've heard about the outbreak so far reports that children have been uniquely unaffected by this

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Originally Posted by Lloyd Braun

This link is mostly “old” data that is in all common terms. Which is fine and has value... There are some interesting tidbits coming out in the medical community regarding treatments and vaccination. The time to make a vaccine is actually only a few weeks away but the virus is supposedly mutating too rapidly for it to be effective. There is evidence of several medications being effective against this strain of coronavirus, one of which is chloroquine. This is a widely available medication in the US. Other antivirals that are likely effective may be less available. The Chinese have done a lot of research on this outbreak and for what it’s worth, have contributed a lot of data to the research community.

I do agree that mortality rates are poorly reported for many reasons. Further, there are likely hundreds (at minimum probably thousands) of undiagnosed cases that people survived. The WHO tries to factor those in but it is impossible to do so accurately. When it’s all said and done it will likely vary by country. Strangely enough Germany has a very good reported mortality rate thus far FWIW.

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Ah, I figured it would have some decent information, someone sent it along to me, I just hadn't had a chance to look through it. My apologies! The problem with vaccines are that, the virus does mutate very quickly, basically the virus is a single-stranded RNA, positive sense, helical capsid, and enveloped. So to break that down a little bit, basically a positive sense RNA virus is very similar to mRNA, mRNA is basically the genetic code that gets translated into proteins in you body, which proteins obviously have a vast variety of functions. Because of that it means that human hosts immediately translate this into protein. Now, the capsid is like a shell almost for the virus, and enveloped means that the capsid is coated with fats, this is also acquired by the host. This basically ends up protecting the genetic make up of the virus and allows for it to communicate with hosts. The protection is very strong, it protects it from stuff like radiation, acids, temperature, etc. Then, we gotta understand that RNA viruses mutate more than DNA viruses, and this is because RNA viruses kind of lack a "proof-reading" function that DNA viruses do. That's the whole basis of how the viruses is changing itself. The timing is sensitive, and it's the regulation more of having to do clinical trials, which is necessary to assess side effects, efficacy, etc. It's just really hard to try to streamline that process to make an effective vaccine.

I did see the reports out on Chloroquine seeming to be pretty effective. It's undergoing the clinical trial phase for Coronavirus actually. This is a basically a drug used to treat Malaria. The way it works for Coronavirus is a little bit different than what it does for Malaria. It basically goes into one type of your cells, makes that environment more basic, and then interferes with another process that allows for the virus to get into your cells. Chloroquine is actually a pretty relatively safe drug, so I could see that becoming one of treatments moving forward. The other drug they researched that seemed to be effective was the anti-viral Remdesivir, which was seen as promising for SARS/MERS, and is clinical development for treatment of Ebola. I have think that one may be a little tougher to get in the United States, so this is true. I still do think that these treatments will be held off unless it's for severe cases, with the typical treatment being still the quarantine and letting your immune system fight off against it however. Sorry for all the medical jargon, hopefully I simplified it well enough to be followed, because I do think us as the medical community are very bad at communicating in ways that people can understand, and that can lead to fears.

Yup, that's the thing, it's incredible difficult to try to follow up with recovery cases, not to mention the amount of people who might have had it, mistaken it for the common flu, and never went to go get it checked out. It's definitely something I think people should be weary about, but I definitely think a lot of the fear is from not exactly knowing what's going on about the virus, and what it's characteristics and stuff are. Ultimately, we don't know everything about this virus, but we do know the general characteristics of Coronavirus to be able to help communicate and hopefully negate some of the worries. Obviously if there's any questions by anybody here, I'm more than happy to try to simplify it a bit more and make some analogies that will make sense! I also want to express I'm in no way trying to be combative or anything, in case any of this comes off as arrogant or what not. Just enjoy a good discussion about medicine from time to time!

I suspect that the actual number of infected is 100-1000x larger than the number being reported.

https://twitter.com/normmacdonald/st...37479674281984

the current media-centric debate of whether or not it's appropriate to label the virus with its country of origin made me think of this norm tweet

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Originally Posted by GIMMFD

Ah, I figured it would have some decent information, someone sent it along to me, I just hadn't had a chance to look through it. My apologies! The problem with vaccines are that, the virus does mutate very quickly, basically the virus is a single-stranded RNA, positive sense, helical capsid, and enveloped. So to break that down a little bit, basically a positive sense RNA virus is very similar to mRNA, mRNA is basically the genetic code that gets translated into proteins in you body, which proteins obviously have a vast variety of functions. Because of that it means that human hosts immediately translate this into protein. Now, the capsid is like a shell almost for the virus, and enveloped means that the capsid is coated with fats, this is also acquired by the host. This basically ends up protecting the genetic make up of the virus and allows for it to communicate with hosts. The protection is very strong, it protects it from stuff like radiation, acids, temperature, etc. Then, we gotta understand that RNA viruses mutate more than DNA viruses, and this is because RNA viruses kind of lack a "proof-reading" function that DNA viruses do. That's the whole basis of how the viruses is changing itself. The timing is sensitive, and it's the regulation more of having to do clinical trials, which is necessary to assess side effects, efficacy, etc. It's just really hard to try to streamline that process to make an effective vaccine.

I did see the reports out on Chloroquine seeming to be pretty effective. It's undergoing the clinical trial phase for Coronavirus actually. This is a basically a drug used to treat Malaria. The way it works for Coronavirus is a little bit different than what it does for Malaria. It basically goes into one type of your cells, makes that environment more basic, and then interferes with another process that allows for the virus to get into your cells. Chloroquine is actually a pretty relatively safe drug, so I could see that becoming one of treatments moving forward. The other drug they researched that seemed to be effective was the anti-viral Remdesivir, which was seen as promising for SARS/MERS, and is clinical development for treatment of Ebola. I have think that one may be a little tougher to get in the United States, so this is true. I still do think that these treatments will be held off unless it's for severe cases, with the typical treatment being still the quarantine and letting your immune system fight off against it however. Sorry for all the medical jargon, hopefully I simplified it well enough to be followed, because I do think us as the medical community are very bad at communicating in ways that people can understand, and that can lead to fears.

Yup, that's the thing, it's incredible difficult to try to follow up with recovery cases, not to mention the amount of people who might have had it, mistaken it for the common flu, and never went to go get it checked out. It's definitely something I think people should be weary about, but I definitely think a lot of the fear is from not exactly knowing what's going on about the virus, and what it's characteristics and stuff are. Ultimately, we don't know everything about this virus, but we do know the general characteristics of Coronavirus to be able to help communicate and hopefully negate some of the worries. Obviously if there's any questions by anybody here, I'm more than happy to try to simplify it a bit more and make some analogies that will make sense! I also want to express I'm in no way trying to be combative or anything, in case any of this comes off as arrogant or what not. Just enjoy a good discussion about medicine from time to time!

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Really appreciate your insight and all this information.

I know these are loaded questions, but do you feel there are things that aren’t being done that should be done? And do you feel that there is anything being done that really doesn’t matter or help?

Are we better prepared now than we were for the swine flu/H1N1 outbreak ten years ago that I think ended up killing over 12,000 Americans?

My opinion: we are not better prepared for this because we do not have adequate testing in the community. Every state has testing but it is a complicated process to have an individual tested. I believe there are only 75 or so labs currently able to test. Symptoms are fairly mild for most people, so they will not likely go to the ER for this, they will end up at their doctors office or urgent care/minute clinic. This will lead to more rapid transmission in the community. The screening questions for identifying someone at risk (recent travel or contact with someone who traveled) are essentially out of date everyday as more communities have diagnosed illness. If you have any question on whether we are prepared or not, call your local doctor’s office and ask if they can test for it. The answer is likely no, which is frankly unacceptable at this point.

Serious question - is anyone actually concerned about the status of the NCAAT ?

I have gone back and forth some days thinking this will get uncontrollably bad, some days thinking this is the twitter / freakout generation.

I will humbly say , I don't know what is going to happen in the next 1-2 months, which I think for a lot of people adds to the panic.

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Originally Posted by SemajParlor

Serious question - is anyone actually concerned about the status of the NCAAT ?

I have gone back and forth some days thinking this will get uncontrollably bad, some days thinking this is the twitter / freakout generation.

I will humbly say , I don't know what is going to happen in the next 1-2 months, which I think for a lot of people adds to the panic.

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Yes, I'm concerned about the status of the NCAAT. I don't think it will be cancelled. I do think that it may be altered.

They have a "task force," or whatever they're calling it. It consists almost exclusively of health care professionals, and they meet twice a day. After every meeting so far, they say that their plan is to proceed as scheduled. But, that could change.

But, if they need to postpone it because actual healthcare professionals recommend it and it isn't just some knee jerk reaction, the it's probably the right call if that's what they decide to do.

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Originally Posted by xubrew

Really appreciate your insight and all this information.

I know these are loaded questions, but do you feel there are things that aren’t being done that should be done? And do you feel that there is anything being done that really doesn’t matter or help?

Are we better prepared now than we were for the swine flu/H1N1 outbreak ten years ago that I think ended up killing over 12,000 Americans?

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I think the first thing I'd tackle is about the H1N1 outbreak. So the swine flu outbreak was actually an Influenza virus, which is the same as seasonal flu, the letters of H and N stand for hemagglutinin and neuraminidase, these are basically found on the surface of the virus, hemagglutinin binds the virus to the host cell (so for humans, think cells in your airways) to allow for it to get inside the cell, and then neuraminidase think of like scissors that cuts the virus up to allow for it to be replicated. The numbers stand for the particular strain, and those vary, which is why there's no flu vaccine. A company was working on a universal flu vaccine that covered a whole lot of the strains, but only had it at 7 shots (and who wants to get 7 injections in a sitting, nobody,) but I never followed up with that to see where they are with it. There was an interesting documentary on Netflix called "Pandemic" that I heard talks about this company and the people on the forefront trying to prevent another pandemic, but quite frankly we've basically reached one already. I'm in my 20s, so for the H1N1 problem 11 years ago, I'll be 100% honest and say that I did not care about what the government was doing or what not during it, because I didn't find that it was relevant to my day to day life (as a typical teenager would) lol. So I think it'd be a little unfair to compare the level of preparation, but for what it's worth everyone I've talked to in health care say that we were definitely more prepared in 2009.

Now, I don't want to get too political or anything, but the government really dropped the ball on this one. China bought us a month to prepare for this, knowing it was a respiratory transmitted illness. I think some countries did really well with this, South Korea had a significant outbreak, and they did very well by testing over 140,000 people for it and relatively containing it. I think they have a pretty low mortality rate reported as well. We knew for a month. The CDC didn't have enough testing kits, the government refused WHO testing kits, and then basically told places "don't go using up all of the kits since it's so limited." The State Department, over objections from the CDC, allowed 14 people infected to fly on a plane full of people who underwent quarantine and were deemed as "safe" (https://www.washingtonpost.com/healt...74f_story.html) Not to mention they also want to cut funding to the CDC. The decisions being made make no sense to me currently.

It's slightly strange that we're not having experts in Public Health and outbreaks really leading the response to this, my biggest issue about it is the fact that we knew for a month and STILL didn't properly have things in place. I'm not sure why the government isn't listening to the advice of the CDC and other things. We could be and should be doing better and containing this thing, however I'm afraid that it's basically too late at this point. The outbreak is going to continue to grow over the next few weeks, and unfortunately health care workers aren't fully prepared for that. I think my underlying point is that I don't think we should have panic attacks about Coronavirus because it is relatively mild, and as such don't let your daily activities be effected if you practice good sanitation and don't have risk factors, however the fact that this thing was not properly prepared for was an astronomical fuck up, and probably could have saved numerous lives for the people who are at risk.

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Originally Posted by Lloyd Braun

My opinion: we are not better prepared for this because we do not have adequate testing in the community. Every state has testing but it is a complicated process to have an individual tested. I believe there are only 75 or so labs currently able to test. Symptoms are fairly mild for most people, so they will not likely go to the ER for this, they will end up at their doctors office or urgent care/minute clinic. This will lead to more rapid transmission in the community. The screening questions for identifying someone at risk (recent travel or contact with someone who traveled) are essentially out of date everyday as more communities have diagnosed illness. If you have any question on whether we are prepared or not, call your local doctor’s office and ask if they can test for it. The answer is likely no, which is frankly unacceptable at this point.

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Yup, honestly 100% agree with this. I would also add that cost concerns probably factor in as well to the people that are mildly sick, let's face it, insurance and hospital costs are expensive. People do their best to avoid ambulance rides even, if they feel relatively okay with a mild infection, they're definitely not going to want to pay a crap ton for Coronavirus testing, etc.

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Originally Posted by scoscox

Everything I've heard about the outbreak so far reports that children have been uniquely unaffected by this

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I would say this is the case with children for the most part. Unlike the swine and this year’s flu (140 kids have died this year), the Coronavirus does not seem to be virulent to kids. However, haven’t seen any data on how a kid with asthma or certain autoimmune diseases would respond.

If X was playing in Dayton I was going to go but I have decided as someone who is immune-deficient I can't do that. I work in healthcare too with geriatric population so I have made some adjustments to that that I have been lucky enough to be able to make. I am going to try and limit my exposure to big crowds but at the same time I can't not leave my house and wouldnt do that. I am a relatively healthy immune-deficient person luckily, there are people who have what I have who have a lot of other things too and comorbidities etc. I do not have those.

The hardest thing for me is not to touch my face, I am so bad at that!

Hey GIMMFD,

Thank you for the information - I've found it actually very helpful. Speaking for myself, I think the panic a lot of people are facing (living in NYC) would be helpful if we had real doctors and politicians telling us real facts. Not getting political in this thread, but certain leaders calling it the flu doesn't seem to instill much confidence that this country has this under control.

I'm someone whos in their 30s and and relatively healthy. As much as I'd love to cheer X on, in your opinion would you not recommend going to MSG tomorrow and (hopefully) throughout the weekend? I would 1000% go if the risks of catching the flu were the same (abiding best sanitary practices, etc).

Lastly, does taking any sort of Zinc, Vitamin C doses, one a day vitamins etc have potential to do anything at all to boost your immune system, other than normal health benefits? Obviously this is not going to prevent anything, but in terms of anything in the meantime for an edge at a quicker recovery? (living in NYC sort of anticipating things getting crazy here in short time).

This may seem like panic / overreaction questions but it's tough to decipher between real information and what's being spread. Appreciate your time!

UC, Miami and Ohio State are moving to online classes for the next 30 days. Dean's are making the call to continue the labs, music, etc or close them. This is what I'm hearing and do not wish to be spreading rumors. Please let me know if this is incorrect.

No problem answering questions, because quite frankly we as healthcare professionals are TERRIBLE at communicating. I agree that doctors/scientists/etc. in the know about this would help erase a lot of fears, but I also think a lot of us get too impatient. Or we use medical jargon that someone doesn't understand, and it gets a bit frightening, and a lot of people don't ask questions, or get put down by it. I think that's where a lot it plays out, is that there's a problem in healthcare about communicating, listening, and being empathetic. A lot of physicians just get immediately flustered and frustrated, and find it beneath them to explain things, it's quite silly in my opinion.

I also get the feeling of it definitely not seeming like a typical "flu," especially when we're saying we have it under control when I would say it's not "under-control." A little preparation would have went a long way, honestly with all of the "vaccines cause autism," and "these crystals will heal your cancer," crowd gaining traction, would have been nice for health care to get a win, but that's a separate topic lol.

I'll address the Zinc, Vitamin C, One A Day question first. So the main anti-oxidant in your GI tract (mouth --> esophagus --> stomach --> intestines --> anus) is Vitamin C, and the main one in your blood stream is Vitamin E. So basically what happens is when you have something like a virus, bacteria, radiation etc. is that it produces "reactive oxygen species," right, this is basically a super-charged oxygen molecule, that causes a break in your DNA strand. Think of it like a highway, and one lane getting closed off, things don't run smoothly, there's a traffic congestion, and it becomes a nightmare. For the human body, the cell when this happens, has two choices: A. Die, or B. Mutate. Reactive oxygen species are kind of like a pin-ball, they go through and just slam into a bunch of things to cause these DNA breaks. So anti-oxidants go through your body and bind up these reactive oxygen species to stop them from acting on various cells through your body. This helps you by preventing cells from dying or mutating. These mutations and deaths are very normal and occur regularily every day, such as your skin being dry and shedding, etc., so think of it as a small scale thing, nothing large enough to cause cancer, but anti-oxidants do help boost your immune system by preventing some levels of damage. Zinc is important for structure of collagen, aka keeping your hair healthy, skin not wrinkly, etc. The one a day, I could get into, but you'd end up having to read more of an essay than I'm already typing throughout this thread, so I'll spare you haha. You got to be careful though, because Vitamin A, D, E, K are fat soluble vitamins, which mean they hang out in your fats, muscles, etc. and an excess can lead to toxicities (you'd have to be ingesting a ridiculous amount, but still mentioning it just in case). I would say the packets of Emergen-C or even the anti-oxidant waters that they sell would be beneficial to giving a little boost to your immune system, but nothing that'd be insanely beneficial. Basically, viruses do cause reactive oxygen species to form, but it also causes all kinds of other problems too, anti-oxidants would probably help in you not feeling as terrible, but you're probably going to still feel terrible lol.

As for going to MSG, this here has a chart of the average age of the patients who have died: https://www.kxan.com/news/coronaviru...hs-in-the-u-s/, as you can see it's more so the older population. For someone in their 30s that's pretty healthy, I'd say the risk is exactly the same as catching the common winter flu. The reason I say that is the common winter flu and coronavirus are both transmitted through respiratory droplets, and both have relatively similar presentation. Influenza is also an RNA virus just like coronavirus, differs slightly, but ultimately relatively the same. At the end of the day, there will be a lot of people at MSG, and you could very well catch coronavirus from someone who doesn't know they have it, etc. but from my opinion if you were going to go to MSG with the same risk of catching the normal winter Influenza, then I would definitely go. Sanitation is your best bet of course, wash your hands with soap and water, at least for 20 seconds, try not to touch your face, etc.

https://m.youtube.com/watch?v=E3URhJx0NSw

I haven't listened to all of this podcast, but the first 15 minutes were pretty startling, if this guy is correct. GIFFMD, do you know if this guy is legit? He says washing and santitizing your hands is always a good idea, but it won't stop the spread of the virus because it's respiratory. He also said trying to stop the spread of a respiratory virus is like trying to stop the wind. Predicts 480,000 deaths in the US.

X is going to online until after Easter....


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First and foremost, we should take any virus seriously. However, it is truly amazing how much the media can still drive a narrative. Hats off! Obviously this is antidotal, but to see how the reactions of democratic leaning vs republican leaning individuals on this message board has been impressive.

Not to put anyone into a box, the Democrats are changing their daily lifestyles (not a bad thing) while having major concerns and Republicans are not...interesting. With any disease, precautions should always be considered, but don’t overreact.

Being in the medical profession over 20 years , I too thought medical stuff would transcend politics, but I’ve since been corrected. Man I wish I could rewind the clock and bring back the optimism in medicine GIMMFD has...

Sorry this post has been political, but thread already is. On a positive, this will have a positive effect on the flu season and reduce the mortality rates.