Coronavirus Outbreak...

[NorrinRadd]

Article in Lancet Medical Journal has theorized that those on certain Blood pressure medications (and also diabetics) may be at higher risk of contracting the virus:

The Lancet Respiratory Medicine,

High blood pressure and diabetes medication taken by 13 million Americans could raise the risk of serious coronavirus symptoms, scientists say
ACE inhibitors and angiotensin receptor blockers are medications take by at least 13 million Americans who have high blood pressure or diabetes
Coronavirus binds to cells by attaching to ACE2 receptors, which are found on the surface of upper respiratory cells
Scientists say these drugs increase amount of ACE2 they have on their cells, which could cause more copies of the virus to 'hijack' cells
However, patients should not stop taking their medications unless their doctor says so...

I'm nearing 60 y.o. and I'm on a ACE inhibitor blood pressure med...

Ditto. I'm also on two *other* BP meds.

Considering the fact that the *reason* for those meds was that my BP was 230/130, and even with them it remains in the 145/95 range, I doubt I'll be going off any of them.

This article says the danger has not been demonstrated in humans, and in fact some theorize ACE-inhibitors could actually be beneficial.

[NorrinRadd]

I'm over 60 and on Lisinopril. Considering my blood pressure when I wasn't on it I might get to decide between coronavirus and a stroke.

I'd kinda be ok with a stroke, as long as it was instantly fatal.

[NorrinRadd]

Piffle. I went to my pharmacy a few weeks ago, and the nice lady who waited on me was a hacking, gurgling, dribbling, spraying, bipedal petri dish. She belonged on South Park.

[NorrinRadd]

I have a few questions, and I'm not sure how to go about finding answers:

1) I know people who have suggestive symptoms -- respiratory + fever. They have not been tested, and don't plan to be tested, because they don't have insurance. Is there a way to get tested gatis? I don't know if that would make a difference to them, but it would remove one excuse.

2) For people who had wicked respiratory afflictions several weeks ago and presumed it was flu -- is there a way to get tested "retroactively" (and at little or no cost)?

3) Can one be tested for Kung Flu antibodies? If so, how would one go about donating them? (Plasma / antibodies from recovered patients has been shown to be a useful therapy.)

[lilpixieofterror]

And how would you describe discussing with you?

[lilpixieofterror]

Why would trump want to call it an emergency?

Yes, even the Spanish flu came and went. But before it went away, it left a trail of millions dead. So it leaves my question on if life is really precious.

The Spanish Flu likely would have been less deadly today.

[lilpixieofterror]

Piffle. I went to my pharmacy a few weeks ago, and the nice lady who waited on me was a hacking, gurgling, dribbling, spraying, bipedal petri dish. She belonged on South Park.

I would have tried to go somewhere else.

[simplicio]

The Spanish Flu likely would have been less deadly today.

What have health professionals written on it? Outside of some vaccine, it would likely not be, outside of improvements in acute care such as a hospital setting, and the improvements like antibiotics to deal with the secondary problems. It is a classic candidate for bioweapon, social distance (which used to be called isolation, last century) is the most effective response.

Problem is the lag time between when a novel virus pops up and gain in information, the ability to test, and the development of vaccines targeting the virus. In many respects, we are seeing a new Spanish flu. South Korea and Singapore have shown technical competence. The US has not.

[oxmixmudd]

Seriously!

You are behind in toeing the party-line line. Trump has reversed himself - surprise, surprise. "On Monday, Trump acknowledged that the situation is "bad," that the virus is not under control, that the country might well be heading into a recession, and that American life would not get back to normal for months".

https://edition.cnn.com/2020/03/17/p...rus/index.html

Current stats:

We have crossed 200,000 cases world wide.

Unfortunately, the overall mortality rates are climbing - I assume due to the fact that in some countries the Medical systems are overrun and now some people are having to be left to die.

naive: (#deaths/#cases) 4.04%
worst case: (#deaths/#recovered+#deaths): 9.04%

This with increased testing. It is not good.

(excepting Italy which reports later in the day) Spain, Germany, and Iran are now taking the lead on new cases and new deaths. Spain is out of control with almost 2000 new cases and 65 new deaths, Iran added 'only' 1100 or so, but more than doubled Spain on the death count at 147.

If anyone is still thinking these State Governor directed shutdown actions are 'over-reacting', consider:

The US is still looking at perfect exponential growth in #new cases. That is, a flat line of constant slope on a logarithmic scale:

US_logscale_corona_0318.PNG

This is EXACTLY what Italy looked like just TWO weeks ago in terms of #of cases and more importantly - just THREE weeks ago in term of # of deaths.

The slopes of the curves on the logarithmic scale are nearly identical. So we have 2 to 3 weeks before our numbers look like Italy's. The difference being we are a larger country so the cases and deaths potentially are more spread out. But not so New York.

[NorrinRadd]

I would have tried to go somewhere else.

I was so stunned, I just walked away in shock.

I've heard from a friend -- a pharmacist herself -- who had the same experience and the same reaction there.

If I see anything like that again, I'm going to contact the pharmacist and tell him he needs to run a much tighter ship.

[lilpixieofterror]

What have health professionals written on it? Outside of some vaccine, it would likely not be, outside of improvements in acute care such as a hospital setting, and the improvements like antibiotics to deal with the secondary problems. It is a classic candidate for bioweapon, social distance (which used to be called isolation, last century) is the most effective response.

Problem is the lag time between when a novel virus pops up and gain in information, the ability to test, and the development of vaccines targeting the virus. In many respects, we are seeing a new Spanish flu. South Korea and Singapore have shown technical competence. The US has not.

[oxmixmudd]

I have a few questions, and I'm not sure how to go about finding answers:

1) I know people who have suggestive symptoms -- respiratory + fever. They have not been tested, and don't plan to be tested, because they don't have insurance. Is there a way to get tested gatis? I don't know if that would make a difference to them, but it would remove one excuse.

2) For people who had wicked respiratory afflictions several weeks ago and presumed it was flu -- is there a way to get tested "retroactively" (and at little or no cost)?

3) Can one be tested for Kung Flu antibodies? If so, how would one go about donating them? (Plasma / antibodies from recovered patients has been shown to be a useful therapy.)

Yeah - I'd like to know answers to those as well. I know in my state, MD, they are converting the vehicle inspection stations into drive through testing areas. Not sure how long it will take to bring that 'online' as it were. I thought the idea behind the original covid-19 bill was to make testing available free.

The anti-bodies question is real. I wish I knew. There is so much talk about 'maybe you have it/had it w/o knowing it. It would be nice to be able to find out. And nice to be able to help someone that is reacting in a very dangerous way to it.

[carpedm9587]

We learned that these viruses come and go. We are reminded to wash our hands and to avoid touching our faces. We should remember not to overreact and shutdown the economy for a virus that might be a little worse than the flu.

We are starting to learn that there is a the trend to shun those people who are trying to bring sanity back into America.

Another way to look at the Wuhan virus is that it is a media driven epidemic. Once the media goes away, the virus will virtually disappear.

I couldn't disagree more. The media is doing what the media should be doing: reporting on what is happening. Are they spinning the story to get eyeballs? Of course. That's the kind of news we all consume so we are getting what "we the people" want. Meanwhile, the medical experts are very clear about this, and the consequences of a "it will just go away" attitude have enormous historical precedence. Look at the history of the 1918 Spanish Flu pandemic and what has already happened in Italy, Iran, and Spain.

Germany is interesting to me. Whatever they are doing, it has some strong positive elements. They are fifth in total number of cases (over 10,000) but have only 27 who have died from the disease so far. Why is their mortality rate so much lower than other countries? Just dividing total deaths by total reported cases (and I know that is a simplistic way of determining mortality rate that excludes a lot of nuance):

• China: 3,241 deaths out of 81,102 reported cases = 4.00% mortality
• Italy: 2,503 out of 31,506 reported cases = 7.94% mortality
• Iran: 1,135 of 17361 cases = 6.54% mortality
• Spain: 602 of 13784 = 4.37%
• Germany: 26 of 10,069 = 0.26%
• S. Korea: 84/8,413 = 1.00%
• France: 148/7696 = 1.92%
• U.S.: 114/6,496 = 1.75%
• Switzerland: 27/2700 = 1.00%

Germany is clearly out of the norm. Why? Something they are doing right? Lack of reporting/testing?

Curious...

[carpedm9587]

I have a few questions, and I'm not sure how to go about finding answers:

1) I know people who have suggestive symptoms -- respiratory + fever. They have not been tested, and don't plan to be tested, because they don't have insurance. Is there a way to get tested gatis? I don't know if that would make a difference to them, but it would remove one excuse.

The bill currently working through congress would make all COVID-19 testing free. For now, unfortunately, it isn't and the situation you describe is fairly common. There are several in my community in the same situation, and I have heard the same thing from numerous friends around the country. It is part of the ongoing testing mess in the U.S. There is no easy solution for the poor right now.

ETA: I just got word that a local charity we started in our town, called Neighbor Helping Neighbor, is making its resources available to help pay for testing. If you have that kind of charitable organization in your community, it's an option.

2) For people who had wicked respiratory afflictions several weeks ago and presumed it was flu -- is there a way to get tested "retroactively" (and at little or no cost)?

In the U.S., not that I know of. I am in that situation myself. I had a very bad cold in late January and the cough STILL hasn't let go completely. Still, I am self-isolating and I am reasonably sure it was NOT Covid-19.

3) Can one be tested for Kung Flu antibodies? If so, how would one go about donating them? (Plasma / antibodies from recovered patients has been shown to be a useful therapy.)

I have to admit that this one threw me a bit. The only reference to Kung Flu I can find is an article from the Harbin Clinic, but the term is only a marketing term for being proactive about protecting from the flu. Do you have any references about these antibodies? I'd love to read them.

[simplicio]

I disagree and here’s why:

1. The Spanish Flu mainly killed those previously young, previously healthy adults between around 20-40 while this new one mainly kills older adults. There’s far more younger people than older, so that right there is one reason I don’t think it will be as deadly.
2. Our hygiene practices are better today.
3. Hospitals do not use the open bays, common in the 1910’s.
4. We can isolate and study the disease where nobody could do that in the 1910’s (virology started in 1892, it was less than 30 years old in 1918 and we still lacked the ability to see them).

One quirk of the 1918 epidemic was the extremely old adults probably had some immunity, leading some to surmise that there was a related virus which swept the nation in the 1830s. The Spanish flu moved fast when it did infect. The mortality rates were highest in the war torn areas of Belgium and France. And some have suggested that the young might have been affected by a greater virus load, greater exposure (older people are more likely to be cautious).

I do wonder if we are really 'cleaner' today, cleanliness was probably the single practiced emphasized in nursing (back then nurses were little more than maidservants, the profession has changed). Though outside of hospitals things are cleaner today.

Have you seen the comparison of Philadelphia and St Louis? St Louis establish a partial lockdown, limiting public events, while Philly did nothing, and paid the price in lives.We are relying on the same practices of a century ago. Much of our hard info comes from epidemiological studies from Singapore and South Korea, who were able to effectively record and track cases, a point brought up by Gov Cuomo and Gov. "Snake" Inslee of Washington.