Outside Topic Covid-19 considerations - Printable Version
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RE: Covid-19 considerations - 2006alum - 03-11-2020
(03-11-2020, 12:00 PM)cardcrimson Wrote:(03-11-2020, 11:01 AM)2006alum Wrote: Stockpile non-perishable sources of fruits and vegetables: It's one thing to have lots of cans of beans, bags of rice, and bottles of water. But that's not complete nutrition. In the event of widespread supply shortages, shelf-stable canned fruits and vegetables (or soups) and frozen fruits and vegetables can take you a long way to complete nutrition if you need to cook in for several weeks. Same with frozen meats and fruit juices.
Helpful, thanks.
Out of curiosity, what about fresh fruit and veggies? Anyone concerned that the produce section at your local Safeway could be like the meat market in Wuhan? How would one clean a carrot, not very tasty to use a Clorox wipe?
Good question. I am probably on the far end of crazy/Chicken Little, but I've been cooking all raw meats and fresh fruits and vegetables such that anything that goes in my mouth I know if virus-free. We've been replenishing the fresh stuff every few days (taking the precautions I and M T outlined above) so as to save the non-perishables for down the road, but we have been thoroughly cooking everything.
Stock + just about any vegetables makes a tasty soup or stew. Throw in cooked meat if that's your preference. Fruits are harder, so I've been going the frozen route with those, or else hard skin fruits that you peel like bananas, citrus fruits, and avocados. Berries, etc., I'm only doing frozen. Fresh salads are out - there's just no way to do it.
FWIW, I'm low risk myself but have several high-risk relatives that I can't avoid entirely for the next 2-3 months, so as much of this is for them (and the community at large) as for me. I'm also fortunate to be in the position right now that I can cancel all social plans and work entirely from home, however. I realize not everyone is so lucky.
BTW, here's a terrific deep dive into everything involving the state of the research involving the epidemiology and virology of COVID-19:
https://ourworldindata.org/coronavirus
RE: Covid-19 considerations - M T - 03-11-2020
I bemoaned not having some stats on age versus serious cases of Covid-19. So I am deriving some from table 1 of this NEJM article from China (data ended Jan 29) of 1099 patients. NOTE: I do not know how these patients were chosen. That might affect the validity of any conclusions one might draw.
Percentages are number of severe cases / total number of cases in age group
Age 0-14: 11.1% 1 of 9 cases were severe.
Age 15-49: 12% 67 of 557 cases were severe.
Age 50-64: 17.5% 51 of 292 cases were severe.
Age 65+: 28.8% 44 of 153 cases were severe.
NOTE: These numbers are minimums. More of the cases could have become severe after the data was taken.
Percentages are number of severe cases in the age group / total number of cases (ie, 163)
Age 0-14: 0.6%
Age 15-49: 41.1%
Age 50-64: 31.3%
Age 65+: 27.0%
My conclusion: Those in the 15-49 group may be at 12% risk of a serious case, but the age group's serious cases will be a major impact on the health system.
Note that ages are only given for 1011 of the patients. I do not know why 88 are not counted. (Death?)
Note that this study seemed to use patients that were caught very early.
Of the 280 or so, for which exposure was known, they were admitted 4 days after exposure.
Only 44% had a fever on admission. 68% had a cough.
To me, this means that the selection criteria was simply a positive test prior to or concurrent to first seeking medical attention.
I am neither a physician nor a statistician.
RE: Covid-19 considerations - burger - 03-11-2020
(03-11-2020, 12:54 PM)M T Wrote: I bemoaned not having some stats on age versus serious cases of Covid-19. So I am deriving some from table 1 of this NEJM article from China (data ended Jan 29) of 1099 patients. NOTE: I do not know how these patients were chosen. That might affect the validity of any conclusions one might draw.
Percentages are number of severe cases / total number of cases in age group
Age 0-14: 11.1% 1 of 9 cases were severe.
Age 15-49: 12% 67 of 557 cases were severe.
Age 50-64: 17.5% 51 of 292 cases were severe.
Age 65+: 28.8% 44 of 153 cases were severe.
NOTE: These numbers are minimums. More of the cases could have become severe after the data was taken.
Percentages are number of severe cases in the age group / total number of cases (ie, 163)
Age 0-14: 0.6%
Age 15-49: 41.1%
Age 50-64: 31.3%
Age 65+: 27.0%
My conclusion: Those in the 15-49 group may be at 12% risk of a serious case, but the age group's serious cases will be a major impact on the health system.
Note that ages are only given for 1011 of the patients. I do not know why 88 are not counted. (Death?)
Note that this study seemed to use patients that were caught very early.
Of the 280 or so, for which exposure was known, they were admitted 4 days after exposure.
Only 44% had a fever on admission. 68% had a cough.
To me, this means that the selection criteria was simply a positive test prior to or concurrent to first seeking medical attention.
I am neither a physician nor a statistician.
As with all these studies, the results are only as accurate as the testing is complete. So if they were not testing everyone or a random sample, the denominators in all of those percentages are uncertain, and so are the results. And it's not clear from the paper how they decided whom to test. The best you can say that these are the percentages of serious cases for those that were tested and positive and hospitalized. Generalizing to all CV cases is impossible.
That said, the increase with age is completely consistent with a bunch of other results.
The missing 88 people is probably just cases where the age or some other data point was not recorded. Easy to imagine that happening in a crisis.
RE: Covid-19 considerations - BostonCard - 03-11-2020
Rough guideline based on the data I’ve seen.
1/5 of diagnosed cases require hospitalization. It is higher with higher age groups, and lower in younger patients. This obviously excludes cases where testing wasn’t done, and testing is more likely in hospitalized patients.
1/4 of hospitalized patients (≈5% of diagnosed cases overall) require intensive care.
About 1/2 I’d ICU patients die. The numbers are smaller here, so there is less precision. That gives an overall mortality of about 2.5%
BC
RE: Covid-19 considerations - cardcrimson - 03-11-2020
Truly March Madness. NCAA suspends spectators from the both the men's and women's tournament.
(As i've mentioned elsewhere, let the athletes play, keep the fans away)
RE: Covid-19 considerations - Papa John - 03-11-2020
That's good news, IMO.
RE: Covid-19 considerations - Goose - 03-11-2020
(03-11-2020, 01:57 PM)Papa John Wrote: That's good news, IMO.
Me too. We don't have any great tools to halt the disease itself, so we must use what tools we have to al least slow it down.
RE: Covid-19 considerations - 76lsjumb - 03-11-2020
I'm trying to imagine the sound of one basketball bouncing in the middle of a virtually empty Mercedes-Benz Stadium [capacity 71,000]...
Weird.
RE: Covid-19 considerations - cardcrimson - 03-11-2020
(03-11-2020, 02:03 PM)76lsjumb Wrote: I'm trying to imagine the sound of one basketball bouncing in the middle of a virtually empty Mercedes-Benz Stadium [capacity 71,000]...
Weird.
The logical alternative would be to play the games in a much smaller facility. Even a high school gym would even work. . . .
RE: Covid-19 considerations - PAsportsfan - 03-11-2020
[/quote]
The logical alternative would be to play the games in a much smaller facility. Even a high school gym would even work. . . .
[/quote]
Exactly my thought too. Playing in a high school gym would be super cool.
RE: Covid-19 considerations - burger - 03-11-2020
This article (https://www.bmj.com/content/368/bmj.m810/rr-2) suggests that ACE inhibitors taken for blood pressure control may play a role in the high Covid-19 mortality for older people and people with cardiovascular disease. I've seen this speculation elsewhere, and it's interesting enough that someone needs to be looking into this.
Quote:Is a link between these observations possible? Is the expression of ACE2 receptor in the virus targeted cells increased by the use of ACE-inhibitor/angiotensin-receptor blocker and is the patient therefore more at risk for a severe course? We need rapid epidemiological and preclinical studies to clarify this relationship. If this were the case, we might be able to reduce the risk of fatal Covid-19 courses in many patients by temporarily replacing these drugs
RE: Covid-19 considerations - M T - 03-11-2020
Reword that as "asks" rather than "suggests'. "Suggests" is way too strong at this point. I do not read that LETTER (not article) as suggesting what you say.
(03-11-2020, 02:57 PM)burger Wrote: This article (https://www.bmj.com/content/368/bmj.m810/rr-2) suggests that ACE inhibitors taken for blood pressure control may play a role in the high Covid-19 mortality for older people and people with cardiovascular disease. I've seen this speculation elsewhere, and it's interesting enough that someone needs to be looking into this.
RE: Covid-19 considerations - cardcrimson - 03-11-2020
(03-11-2020, 02:57 PM)burger Wrote: This article (https://www.bmj.com/content/368/bmj.m810/rr-2) suggests that ACE inhibitors taken for blood pressure control may play a role in the high Covid-19 mortality for older people and people with cardiovascular disease. I've seen this speculation elsewhere, and it's interesting enough that someone needs to be looking into this.
Quote:Is a link between these observations possible? Is the expression of ACE2 receptor in the virus targeted cells increased by the use of ACE-inhibitor/angiotensin-receptor blocker and is the patient therefore more at risk for a severe course? We need rapid epidemiological and preclinical studies to clarify this relationship. If this were the case, we might be able to reduce the risk of fatal Covid-19 courses in many patients by temporarily replacing these drugs
Can one of the doctors out there please translate for those of us on these drugs. . . .
"On the one hand, it has been shown that the Covid-19 agent (also known as SARS-CoV-2), uses the SARS-COV receptor angiotensin converting enzyme (ACE) 2 for entry into target cells [4]. The interface between ACE2 and the viral spike protein SARS-S has been elucidated and the efficiency of ACE2 usage was found to be a key determinant of SARS-CoV transmissibility [4].
On the other hand, it could be shown in animal experiments that both the ACE-inhibitor lisinopril and the angiotensin-receptor blocker losartan can significantly increase mRNA expression of cardiac ACE2 (5-fold and 3-fold, respectively) [5]. Further, losartan also significantly increases cardiac ACE2 activity [5].
Is a link between these observations possible? Is the expression of ACE2 receptor in the virus targeted cells increased by the use of ACE-inhibitor/angiotensin-receptor blocker and is the patient therefore more at risk for a severe course? We need rapid epidemiological and preclinical studies to clarify this relationship. If this were the case, we might be able to reduce the risk of fatal Covid-19 courses in many patients by temporarily replacing these drugs."
RE: Covid-19 considerations - 82lsju - 03-11-2020
Quote:"Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances.
...
The principle they settle upon is utilitarian. “Informed by the principle of maximizing benefits for the largest number,” they suggest that “the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care.”
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/?utm_campaign=the-atlantic&utm_source=facebook&utm_term=2020-03-11T16:56:39&utm_content=edit-promo&utm_medium=social&fbclid=IwAR1ode6r5_rqLygS3A3E8xDj3wVR-XNyWTFMT4WIk-ZESG1O0nAaKuwrjwM
RE: Covid-19 considerations - burger - 03-11-2020
(03-11-2020, 03:19 PM)M T Wrote: Reword that as "asks" rather than "suggests'. "Suggests" is way too strong at this point. I do not read that LETTER (not article) as suggesting what you say.I was explicit that this is speculation. What specifically did I get wrong in my summary?
(03-11-2020, 02:57 PM)burger Wrote: This article (https://www.bmj.com/content/368/bmj.m810/rr-2) suggests that ACE inhibitors taken for blood pressure control may play a role in the high Covid-19 mortality for older people and people with cardiovascular disease. I've seen this speculation elsewhere, and it's interesting enough that someone needs to be looking into this.
RE: Covid-19 considerations - Hurlburt88 - 03-11-2020
Regarding the question about sanitizing fresh fruits & vegetables . . . we lived in china for 4 years, and when we moved there our local doctor (chinese born, american trained) told us that she always put these things in a large bowl or pot of water with just a little bleach--like a few drops. would let soak for 5-10 minutes. Someone with more science on this can comment if sounds useful or not.
RE: Covid-19 considerations - M T - 03-11-2020
I understand that you were thinking a weak form of "suggest" as in "to offer for consideration". But "suggest" is often used as a stronger form indicating the author believes something to be true, without really saying directly: "To express or say indirectly", "To make evident indirectly". Consider the common phrasing "the data suggest..."
At this point, it sounds like there is no evidence, just a hypothesis: "While the epidemiological association has not been investigated yet, several indicators underline the hypothesis of the link..."
The author is very clear that he is asking a question "The question is, does there exist a connection.."
i think clearly indicating that he is asking the question in a letter is clearer than saying "This article ... suggests". When I read your post initially, I misunderstood and expected some evidence demonstrated this link, but not strongly enough to say that the data proved the link.
That said, if I were on an ACE inhibitor, I might be asking my doctor if another drug might be substituted.
(03-11-2020, 03:31 PM)burger Wrote:(03-11-2020, 03:19 PM)M T Wrote: Reword that as "asks" rather than "suggests'. "Suggests" is way too strong at this point. I do not read that LETTER (not article) as suggesting what you say.I was explicit that this is speculation. What specifically did I get wrong in my summary?
(03-11-2020, 02:57 PM)burger Wrote: This article (https://www.bmj.com/content/368/bmj.m810/rr-2) suggests that ACE inhibitors taken for blood pressure control may play a role in the high Covid-19 mortality for older people and people with cardiovascular disease. I've seen this speculation elsewhere, and it's interesting enough that someone needs to be looking into this.
RE: Covid-19 considerations - martyup - 03-11-2020
This thread has gone viral.
RE: Covid-19 considerations - BostonCard - 03-11-2020
You can attend this seminar (virtually, of course) put on by infectious disease professors at Stanford and UCSF (warning, conflicts with MBB):
![[Image: db59410d59418c5d62287815a35c49ad.jpeg.max800.jpeg]](https://d3926qxcw0e1bh.cloudfront.net/post_photos/db/59/db59410d59418c5d62287815a35c49ad.jpeg.max800.jpeg)
BC
Also, San Mateo county health department site on COVID-19
https://www.smchealth.org/coronavirus
BC
RE: Covid-19 considerations - baymeadows3408 - 03-11-2020
I'm currently in graduate school at the University of Maine, which is in a pretty remote location (Orono, near Bangor). Today we learned that after spring break (which begins at the conclusion of classes this week), all classes will be online only for the remainder of the semester. Students who are leaving the area for spring break (whether to visit home or go on vacation) are not supposed to return. I'm in the communication disorders program, and we're in a weird limbo right now because no decision has been made about whether our speech-language clinic will remain open. It's possible that our classes will be online but we'll be expected to resume our clinical work. I'm sure this situation also making things complicated for other students in other programs who are clinicians or researchers. The athletic program has yet to announce if fans will be allowed to attend the tournament games the hockey team is hosting this weekend, but I know that other programs have already determined that they will not be admitting fans.