Covid-19

[Lloyd Braun]

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.

I read this interview with him as well. This is this cliffs notes version of the interview that highlights similar points. Interesting stuff indeed.

[paulxu]

Xavierhoops....on line for years....ahead of the curve!

[GIMMFD]

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.

Haha I wish I was more optimistic about medicine to be honest with you. There are a lot of terrible things going on in medicine right now, not to mention the system itself is very outdated. I could go into a rant about health care but quite frankly it wouldn't do anything, I think unfortunately until more progressive people get into positions like the NBME, as residency directors, etc. then we can change the tune of this weird cult of almost "bullying" that's going on for people. Not to mention the cuts in funding, etc. There may not be systemic changes, but I do want to my part at least to try to be a damn good doctor, and hopefully others can follow suit after that.

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.

So I'm listening to it as we speak, I do think Dr. Osterholm is very legitimate. I also read the CNN link that Lloyd Braun linked, and really I think I'm on the same page as him, however he's just a little cautious about it than I am about it. In the CNN article, he said this:

The COVID-19 virus has a case fatality rate that is somewhere between seasonal flu in a bad year, which is 0.1%, and the 1918 pandemic, which, of course, preferentially killed young adults with a case fatality rate of 2.5% to 3%

Which still falls in line with the 1-3% risk of fatality I said in the beginning.. and also

BERGEN: So, if in a regular year in the US, the case fatality rate of influenza is 0.1%, you're saying that COVID-19 will be higher?
OSTERHOLM: Twenty to 30 times higher. It could easily be that. We just don't know yet and it could go down based on what we learn.

20-30x higher than 0.1% is 2-3%.. it's still the same fatality rate. Chance due to chance alone, and he says the fatality rate increases with risk factors (ie where he talks about the elder Chinese men who are smokers). The biggest thing is how underprepared and under-equipped hospitals, etc. are to adequately control this thing, so I agree with him there too. He's basically saying this is the same as a flu outbreak, but will be worse because of inadequate resources across the country, which I whole-heartedly agree with.

I agree with the point that it's basically inevitable now, and that it's most likely going to spread, and he is correct sanitation isn't an end-all game, it definitely won't stop the spread of the virus. The analogy of blowing in the wind is actually a very good analogy, I'm not sure about the 480,000 deaths however. The thing with predicting mortality is that you've never going to be accurate because you can't correctly identify who's going to get infected. Tons of people will get this and recover from it without knowing they've had it, and tons of people will probably die from this. I think he's right in saying be weary, but my opinion is that you should assess your own risks and determine how you want to approach it. If you fall in an older age range, maybe are slightly immunocompromised, or other risk factors, you should take more precaution than say, your average run of the mill 30-40 year old. If anybody is unsure if they have any risk factors or what not and don't want to discuss it in public, feel free to PM me and I can try to help to the best of my ability of course.

I think that Dr. Osterholm is very knowledgable about it, and expressing his concerns about it, and I do believe he's right that it's inevitable, but I fall somewhere between the spectrum of it's nothing to "oh my god board off all of your windows," because in medicine nothing is 100%. Everything varies by case to case, and I think depending on who the person is, is how they kind of express their beliefs on the severity of it. I have plenty of people I know in health care that are frightened, and plenty of people that are very calm about it. My goal here is to just give accurate information to the best of my ability, and try to explain it in a way that can allow each individual to assess their own risks and make their own decisions of course.

[xavierj]

Haha I wish I was more optimistic about medicine to be honest with you. There are a lot of terrible things going on in medicine right now, not to mention the system itself is very outdated. I could go into a rant about health care but quite frankly it wouldn't do anything, I think unfortunately until more progressive people get into positions like the NBME, as residency directors, etc. then we can change the tune of this weird cult of almost "bullying" that's going on for people. Not to mention the cuts in funding, etc. There may not be systemic changes, but I do want to my part at least to try to be a damn good doctor, and hopefully others can follow suit after that.



So I'm listening to it as we speak, I do think Dr. Osterholm is very legitimate. I also read the CNN link that Lloyd Braun linked, and really I think I'm on the same page as him, however he's just a little cautious about it than I am about it. In the CNN article, he said this: Which still falls in line with the 1-3% risk of fatality I said in the beginning.. and also 20-30x higher than 0.1% is 2-3%.. it's still the same fatality rate. Chance due to chance alone, and he says the fatality rate increases with risk factors (ie where he talks about the elder Chinese men who are smokers). The biggest thing is how underprepared and under-equipped hospitals, etc. are to adequately control this thing, so I agree with him there too. He's basically saying this is the same as a flu outbreak, but will be worse because of inadequate resources across the country, which I whole-heartedly agree with.

I agree with the point that it's basically inevitable now, and that it's most likely going to spread, and he is correct sanitation isn't an end-all game, it definitely won't stop the spread of the virus. The analogy of blowing in the wind is actually a very good analogy, I'm not sure about the 480,000 deaths however. The thing with predicting mortality is that you've never going to be accurate because you can't correctly identify who's going to get infected. Tons of people will get this and recover from it without knowing they've had it, and tons of people will probably die from this. I think he's right in saying be weary, but my opinion is that you should assess your own risks and determine how you want to approach it. If you fall in an older age range, maybe are slightly immunocompromised, or other risk factors, you should take more precaution than say, your average run of the mill 30-40 year old. If anybody is unsure if they have any risk factors or what not and don't want to discuss it in public, feel free to PM me and I can try to help to the best of my ability of course.

I think that Dr. Osterholm is very knowledgable about it, and expressing his concerns about it, and I do believe he's right that it's inevitable, but I fall somewhere between the spectrum of it's nothing to "oh my god board off all of your windows," because in medicine nothing is 100%. Everything varies by case to case, and I think depending on who the person is, is how they kind of express their beliefs on the severity of it. I have plenty of people I know in health care that are frightened, and plenty of people that are very calm about it. My goal here is to just give accurate information to the best of my ability, and try to explain it in a way that can allow each individual to assess their own risks and make their own decisions of course.

This thing can kill people that are sick or have weak immune systems. Elderly people and sick people with weak immune systems die sometimes. Some of the stuff people are doing is just dumb. I will just keep living my life and not freak out.

[Muskie in dayton]

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

And here come the calls to cancel the NCAA Tournament.
https://www.usatoday.com/story/sports/college/columnist/dan-wolken/2020/03/10/coronavirus-ncaa-needs-pull-plug-risky-basketball-tournament/5016117002/

[kmcrawfo]

And here come the calls to cancel the NCAA Tournament.
https://www.usatoday.com/story/sports/college/columnist/dan-wolken/2020/03/10/coronavirus-ncaa-needs-pull-plug-risky-basketball-tournament/5016117002/

Lots of things in this thread are making this much more complicated then I think it needs to be. Bottom line is that age is the number one predictor of mortality for this virus.

AGE
DEATH RATE
confirmed cases

80+ years old
21.9%

70-79 years old
8.0%
60-69 years old
3.6%
50-59 years old
1.3%
40-49 years old
0.4%
30-39 years old
0.2%
20-29 years old
0.2%
10-19 years old
0.2%
0-9 years old
no fatalities

There's a multiplier that can be added based on comorbidities oh, but these percentages give you the bottom line.

[xubrew]

I seriously doubt they will cancel it. They may postpone it, but they won’t cancel it.

[kmcrawfo]

The reason this is important and why drastic measures for isolating cases is important is because while it does not affect the vast majority of people in our population it is extremely dangerous for the elderly to contracted. Therefore, as a society, we must do our best to prevent its spread to that segment of our population. That is why we are taking such drastic measures to prevent this from happening. Just look at what this virus did to the nursing home population in Washington State. It obliterated folks in that facility and several of them are still likely to die.

[kmcrawfo]

I can't go into too many details, but I actually have a working relationship with one of the labs that is working on a rapid PCR test for this virus. Hoping to have much more accurate and fast results available to our country soon.

[kmcrawfo]

Final note. Current mortality rates and prevalence rates are likely way off. Prevalence of this virus is likely extremely under-reported because it is virtually asymptomatic in younger segment of the population. Therefore, those segments are not likely to present to hospitals or doctors and get tested. Eventually, we will understand the mortality rates but that is not likely to be anytime soon. Bottom line, if you are old it can kill you with a much higher rate. If you are young, the virus is likely harmless, but you can spread it to the older patient population where it can be deadly.