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TMW
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[*] posted on 3-10-2020 at 03:23 PM
Coronavirus


Marc Serota (one of our former allergy fellows at Childrens Mercy) posted this on facebook. I think it is the clearest statement regarding Coronavirus I have seen per one of our Current Asthma/allergy Doctors:

From an MD immunologist:

1. Coronaviruses are a family of viruses. "coronavirus" is not unique to this particular strain. Everyone reading this has likely had another different coronavirus infection. This particular strain has been named COVID-19.

2. Every upper respiratory virus has the potential to be lethal. Patients unfortunately die from many upper respiratory viral infections every year - most prominently the influenza virus. 30,000 people died from the influenza virus in 2019. The media didn't report each one. They have reported all 11 coronavirus deaths. Not telling us about the people lost but rather keeping a death "toll".

Let me repeat that:
-Coronavirus: 11 deaths (US in 2020), 3300 deaths (China in 2020).
-Influenza: 30,000 deaths (US in 2019).

*Influenza pandemic of 1918: 675,000! (US), 20-50 MILLION!! (worldwide) <---These people I think would have been in favor of receiving their annual flu vaccine.

This is not meant to minimize any of these deaths but rather to give context and put some facts to the hysteria.

3. If you're healthy, there is no need to walk around wearing a mask. In addition to looking silly and most of the time wearing/taking them off wrong - which would actually make you more prone to acquiring an infection, they don't prevent you from getting sick. If you're actually sick stay away from people and then, sure, wear a mask so you aren't spreading respiratory droplets every time you cough/sneeze. In medicine we don't wear the masks you're buying and we wear other protective equipment - not just a silly looking mask you found on Amazon. When you see doctor's walking around the world wearing a mask then you should too. Until then, stop.

4. The symptoms are that of the flu. As doctors we don't test or know about most people with mild or moderate flu symptoms. That means most people will probably get it and just think they had the flu. That means you're only going to hear about the cases that get serious - not all the minor ones which will be the vast majority of cases.

5. When it is said that people who are older or have other medical conditions are most likely to die - that is equally true for EVERY upper respiratory virus. There is nothing unique about that to this particular virus. It does mean that the only cases we tend to know about are the severe ones. Once a case is severe it then makes sense to test the patient to find out what virus in particular they have. That means you can easily overestimate how severe or lethal the virus is because the only cases you end up knowing about are the serious ones.

In summary 30,000 people died from the flu last year. Another 30,000 died in car accidents.

I remember: H1N1 (2009), MERS (2012), Ebola (2014), Coronavirus (2020).

Take it from me: The poor resident who stood at the door of the ER to triage people in 2009's swine flu (H1N1) hysteria. The over reaction is exponentially worse than the actual problem and in 2020 the over reactions I'm seeing are remarkable. In cold and flu season you'll probably get sick once or twice for about a week each. You might even get this particular coronavirus and most of you won't even know it. I've seen people raiding supermarkets, major meetings and sporting events getting cancelled and fear/racism towards Asian people. These reactions are totally unnecessary and panic based. Just do what you've always done during cold/flu season. Stay away from other people when you're sick, wash your hands and keep them away from your face, and only go to the ER if you feel your symptoms are more severe than a bad cold/flu (shortness of breath, high fever, etc.). And also realize you can't live on earth and not get viral illnesses from time to time. It's a part of nature.

Please don't ask for antibiotics (those treat bacteria - not viruses). Thats like asking for a fire extinguisher when you're drowning. It can be a life saving device - but the wrong one for the problem at hand. Some doctor's don't want to fight about it when patients insist on antibiotics so they just prescribe them - but it doesn't mean its actually helping you and in some cases they can be harmful (resistance, infections, allergic reactions just to name a few). If you're one who asks for antibiotics every time you're sick, again, take it from me: ask for a flu shot each year and a doctor's note to stay home from work when you're sick instead. You will be much better off.

The government is very proud that testing will be available to every American. Remember, we don't test for any respiratory virus other than the influenza virus routinely. The reason is thats the only virus that has a treatment (pill) you can take to shorten the duration of severity of the illness. I suspect if we start testing everyone with cold symptoms for coronavirus we're going to find lots of it. It's not going to change the recommendations to stay home and rest. And its not going to predict the small percentage of people who may develop more severe symptoms. Essentially whether someone has coronavirus 19 or some other cold/flu virus isn't going to matter to your doctor. What it will do is slam urgent cares, ER's and hospitals with every patient who has a cold so they can be tested. It is much more sensible to reserve testing for patients requiring hospitalization or more advanced treatments. Even that wouldn't change their management but would be more to confirm the diagnosis and to not waste time looking for other causes of the patients symptoms.

In conclusion, yes there is a novel virus that our immune systems haven't seen yet so to get immune to it you will have to get infected - at least until a vaccine is developed to bypass the getting sick part and just jumping straight to immune. Most people's immune systems will do that effectively and be fine. A small percentage of unfortunate patients (primarily elderly, immune compromised etc.) will not be able to do that effectively and will need more advanced care. This is true of the cold/flu viruses we deal with every year. Follow normal cold/flu precautions and seek medical care if you feel your symptoms are severe. No need to get hysterical.

These outbreaks can be instructive for overall knowledge of public health. In particular showing your immune system the uniform of a potential invader (virus) so that if it ever sees a soldier wearing that uniform it will immediately attack and neutralize it without you ever getting sick. That is a wonderful thing and probably the single biggest achievement in medicine throughout human history. That is what vaccines are. The benefit to risk ratio of them are off the charts in favor of vaccines. If viruses like coronavirus scare you, then stay up to date on your vaccines and your immune system will be running the latest software.

If you still think you should be scared consider this: Doctors, nurses and other healthcare staff are going to hospitals every day. Crowded buildings with tons of sick people. They aren't walking around the halls of the hospitals wearing masks and they haven't stopped going to work. And they are all rolling their eyes at everyone else right now.

Marc Serota, MD
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BobbyC
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[*] posted on 3-10-2020 at 04:34 PM


The only problem with this attempt to make us feel like it's really not that big of a deal is that there are relatively very few test kits available meaning that not only do we not yet know the true scope of how many are affected right now, we really don't know how many of those who have died in recent weeks were really due to the coronavirus, and not just an "ordinary" flu bug.

When we have wide availability and access to test kits we'll be able to say for sure how big of a problem this really is. Until then we just don't know for sure. I wish this administration was investing their time and efforts spent on this media campaign to convince us nothing is happening on getting a mass distribution of test kits.

Like the old saying, "ignorance is bliss".

Makes me wonder if maybe they really don't want to know?

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[*] posted on 3-10-2020 at 04:46 PM


Thanks TMW.... good words in the face of our usual crazed media.

This morning the CDC sent out a bulletin recommending that everyone over age 60 should stay home.... Brilliant!!! Who hires these people?

Just came home from Costco... No bottled water (we have a very functional well and never use the stuff) No toilet paper..... limited canned goods, lots of empty shelves. No wonder Costco stock was up seven bucks today.

Guess I will ask the neighbors if anyone has a bomb shelter left over from the 50's where we can hunker down, eat spam and MREs and wait this out.

Oh, and yes, I did see Chuck Schumer on t.v. and he said it is all Trump's fault... might have known.
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[*] posted on 3-10-2020 at 04:46 PM


Quote: Originally posted by BobbyC  


When we have wide availability and access to test kits we'll be able to say for sure how big of a problem this really is. Until then we just don't know for sure. I wish this administration was investing their time and efforts spent on this media campaign to convince us nothing is happening on getting a mass distribution of test kits.





There were no stockpiles for a test on a totally new virus.
They (commercial labs) are kicking out test kits as fast as they can.
The admin just gave a lengthy new conference on commercial labs kicking out test kits by the millions within a few days.
It's a lot more complicated than just shrink wrapping a ball of gauze and a vacutainer and shipping them out helter skelter.


You don't need a test if you don't' have symptoms.
And if you do have symptoms...you will need a doctor to green light a test for you.

What would you have done if you had been in charge of providing for tests and manufacturing them?
Would you have provided a better way or a more timely way?


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[*] posted on 3-10-2020 at 05:35 PM


I appreciate the information, but I'm a bit concerned over a couple of things he writes - or does not address.
1. current flu deaths in USA - for the 2019-2020 season (not over yet, but it's about 8500 or so according to CDC. last year was much worse, they missed on the vaccine formulation guess.

I'm also concerned because I see no mention of infection rates, and exponential growth. It is the exponential growth that is worrying, if it continues, deaths will jump up precipitously. here is a really good brief video explaining exponential growth, applys current numbers, and demonstrates the issues with exponential growth, as well as how to determine when the growth is slowing down or leveling out (as in china, korea, znd Japan right now - the rest of the world is still in exponential growrth , includingf the USA
https://www.youtube.com/watch?v=Kas0tIxDvrg

also - I have seen one set of data from Washington state that the death rate among the elderly was approaching 15%, that's a huge number particularly when you consider the death rate from flu among typically less than 1%.

epidemiologists want to know 2 things -
1. the death rate - how many infected die
2. how easily is it spread

we are still trying to determine those numbers for this virus
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[*] posted on 3-10-2020 at 05:44 PM


Quote: Originally posted by DaliDali  
Quote: Originally posted by BobbyC  


When we have wide availability and access to test kits we'll be able to say for sure how big of a problem this really is. Until then we just don't know for sure. I wish this administration was investing their time and efforts spent on this media campaign to convince us nothing is happening on getting a mass distribution of test kits.





There were no stockpiles for a test on a totally new virus.
They (commercial labs) are kicking out test kits as fast as they can.
The admin just gave a lengthy new conference on commercial labs kicking out test kits by the millions within a few days.
It's a lot more complicated than just shrink wrapping a ball of gauze and a vacutainer and shipping them out helter skelter.


You don't need a test if you don't' have symptoms.
And if you do have symptoms...you will need a doctor to green light a test for you.

What would you have done if you had been in charge of providing for tests and manufacturing them?
Would you have provided a better way or a more timely way?



actually tests were available in large quantities from Germany, the US chose to develop their own - delaying the testing.

and one thing you said - you seem to miss the significance of.

yes, in most cases, particularly the young, symptoms are mild , and some are even asymptomatic. Turns out - those cases can still be shedding virus - meaning they are infective. so people running around feeling fine can and will spread the virus, thats a huge issue! thats how you start to get pandemic numbers.

That's why we are seeing school closures, because they will function as incubators and giant vector dispersal mechanisms as their local area start to see community transmission
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[*] posted on 3-10-2020 at 09:35 PM


I feel completely reassured now that I have learned that covid-19 is nothing to be concerned about.
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[*] posted on 3-10-2020 at 10:23 PM


Quote: Originally posted by DaliDali  


There were no stockpiles for a test on a totally new virus.
They (commercial labs) are kicking out test kits as fast as they can.
The admin just gave a lengthy new conference on commercial labs kicking out test kits by the millions within a few days.
It's a lot more complicated than just shrink wrapping a ball of gauze and a vacutainer and shipping them out helter skelter.


You don't need a test if you don't' have symptoms.
And if you do have symptoms...you will need a doctor to green light a test for you.

What would you have done if you had been in charge of providing for tests and manufacturing them?
Would you have provided a better way or a more timely way?



https://www.google.com/amp/s/www.nytimes.com/2020/03/10/us/c...
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[*] posted on 3-11-2020 at 05:15 AM


Quote: Originally posted by BobbyC  
The only problem with this attempt to make us feel like it's really not that big of a deal is that there are relatively very few test kits available meaning that not only do we not yet know the true scope of how many are affected right now, we really don't know how many of those who have died in recent weeks were really due to the coronavirus, and not just an "ordinary" flu bug.

When we have wide availability and access to test kits we'll be able to say for sure how big of a problem this really is. Until then we just don't know for sure. I wish this administration was investing their time and efforts spent on this media campaign to convince us nothing is happening on getting a mass distribution of test kits.

Like the old saying, "ignorance is bliss".

Makes me wonder if maybe they really don't want to know?



Your premise that it will help to know how many people actually have/had the virus would give us a better idea of the 'real' size of the problem is based on your fear and perception that it is a problem at all.

What probably would happen is that the percentage of undesirable results from the infection would drop as we find out most who have the virus do not suffer the most extreme consequence.

It is more likely to be the same as the flu statistics where the number who suffer the most falls in percentage to the totality of the infection...when it reaches into the millions of infected we will become just as numb to the total deaths as we are right now to the flu infections.
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[*] posted on 3-11-2020 at 09:05 AM


This situation seems to have politicians making medical decisions.
Hmmmmm.....hasn't the current pos administration demonstrated its ideology re: health care by cutting funding generally?

Denial works as a temporary management strategy.....:light:





Don't believe everything you think....
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[*] posted on 3-11-2020 at 09:30 AM


Quote: Originally posted by motoged  
This situation seems to have politicians making medical decisions.
Hmmmmm.....hasn't the current pos administration demonstrated its ideology re: health care by cutting funding generally?

Denial works as a temporary management strategy.....:light:



Bingo....spot-on.
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[*] posted on 3-11-2020 at 09:43 AM


I don't trust anything coming out of the White House. But the World Health Organization just declared COVID 19 a pandemic.

https://tinyurl.com/tpcszex




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[*] posted on 3-11-2020 at 09:54 AM


TERRIFYING SCI-FI MOVIE PLOT
A deadly virus sweeps the globe, but the only information citizens receive from vital scientists and doctors must be cleared thru a religious-fanatic that believes smoking doesn't cause cancer, dinosaurs never existed and plagues are sent by god.
:rolleyes:





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[*] posted on 3-11-2020 at 10:21 AM


Are testing kits even relevant since there is no vaccine or treatment?
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[*] posted on 3-11-2020 at 10:36 AM


Quote: Originally posted by ehall  
Are testing kits even relevant since there is no vaccine or treatment?


That would probably be the position of the administration but of course that's absurd. If we cannot identify the depth and reach of this virus, containing it once a vaccine is created would be exponentially more difficult without having that much needed data.

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[*] posted on 3-11-2020 at 10:51 AM


I have no idea how Corona will turn out for us - it does not look good though. Life as we knew it, may have just ended. Feel free to believe whatever you want - but see this paper first:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

corona Italy.jpg - 82kB




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[*] posted on 3-11-2020 at 11:19 AM
"Knowledge is power"


Yes- we need testing, especially for people in frequent/high volume contact with the public.

Otherwise, consider what has already happened with 3 TSA employees in SFO: they tested positive for COVID. Before that diagnosis, they were in contact with people travelling all over the world, potentially spreading COVID via additional flights.

So: yes, get tested.
Knowledge is power.

In general: If you are positive for COVID, but are not in the "high risk" category (underlying medical conditions, poor health, age 60+), and/or have mild symptoms: STAY HOME, rest, recuperate, stay away from others.

If conditions worsen: seek medical assistance

Closer to home: I just explained to my college students that we are in the process of transitioning all our classes to online delivery by end of March.

Other colleges and universities are doing the same.

Some of us might be able to work from home, or take (hopefully paid) medical leave.

For those without these options... this will be a wake-up call re:the status of our current healthcare system in the US, and the impacts of not having paid sick days for many workers.

Quote: Originally posted by ehall  
Are testing kits even relevant since there is no vaccine or treatment?




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[*] posted on 3-11-2020 at 12:47 PM


Quote: Originally posted by TMW  


Let me repeat that:
-Coronavirus: 11 deaths (US in 2020), 3300 deaths (China in 2020).
-Influenza: 30,000 deaths (US in 2019).

...

This is not meant to minimize any of these deaths but rather to give context and put some facts to the hysteria.


Sorry, but comparing total deaths today right now from COVID-19 vs. annual flu deaths is such a dumb argument.

Gonna take 3-7 months for this thing to play out.
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[*] posted on 3-11-2020 at 12:51 PM


Quote: Originally posted by 4x4abc  
I have no idea how Corona will turn out for us - it does not look good though. Life as we knew it, may have just ended. Feel free to believe whatever you want - but see this paper first:
https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...



A lot of hypothetical data but pretty shocking even if it's half right.

Harald, what are you seeing in La Paz in the way of community concern? I see little to none here in SF and Mexicali.




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[*] posted on 3-11-2020 at 03:25 PM


New Mexico just declared its first three cases of the virus; one in Albuquerque and two about an hour south of there. The Governor just ordered a State of Emergency and is taking pro-active measures about large gatherings, etc. Some can actually fart and chew gum at the same time.

Will be interesting to see if Spanky Bonespurs tonight declares a National State of Emergency, like when he did for those nasty ''bad hombres'' Messicans coming up from the south.... or if he'll blame the media for the stock market crash and Obama for the virus.

The WalllyWorld in my little town of 6,000 was SOLD OUT of TP and paper towels today; the panic-pandemic has already started. Some illnesses spread faster than the flu.




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