COVID-19 presenting with diarrhea, loss of appetite have a higher risk of death


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Diarrhoea and loss of appetite could be early signs of coronavirus as scientists find almost half of patients experience one or more digestive symptoms

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  • Study of 204 Wuhan residents reveals 48.5 per cent had digestive symptoms

  • Most also had the normal respiratory issues but seven people did not

  • Those with digestive symptoms are less likely to be successfully treated and discharged compared to those with just respiratory symptoms

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The study, conducted by Chinese researchers, has been scrutinised by other academics and published this week in the American Journal of Gastroenterology.

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Researchers studied 107 men and 94 women with an average age of 55 that had all tested positive for COVID-19 between January 18 and February 28.

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Ninety-nine had digestive symptoms and 92 of these also suffered with respiratory problems as a result of the infection.

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The researchers add: ‘Among the 105 patients without digestive symptoms, 85 presented only with respiratory symptoms, and 20 neither had respiratory nor digestive symptoms as their chief complain.’

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The study also found the digestive issues worsened as the severity of the disease increased.

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Patients without digestive symptoms in this study were more likely to be cured and discharged than patients with digestive symptoms, the scientists say.

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Around a third (34.3 per cent) of patients that did experience digestive problems were discharged by March 5, when the study stopped collecting data.

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This figure for successful treatment rises to 60 per cent for people who did not experience digestive symptoms.

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The researchers write in their research: ‘We found that digestive symptoms are a common presenting complaint in patients with COVID-19.

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‘Compared to patients without digestive symptoms, those presenting with digestive symptoms have a longer time from onset to admission and a worse prognosis.

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Dr Brennan Spiegel, Professor of Medicine and Public Health at UCLA and co-editor of the journal the study was published in, said in a statement accompanying the release of the research: ‘In this study, COVID-19 patients with digestive symptoms have a worse clinical outcome and higher risk of [death] compared to those without digestive symptoms, emphasising the importance of including symptoms like diarrhoea to suspect COVID-19 early in the disease course before respiratory symptoms develop.’

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WHY DOES CORONAVIRUS CAUSE DIGESTIVE SYMPTOMS?

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Chinese researchers believe COVID-19 appears to cause digestive symptoms because SARS-CoV-2 is similar to SARS-CoV and can invade the human body by binding to the human angiotensin converting enzyme 2 (ACE-2) receptor.

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This can cause liver tissue injury by making too many liver cells, called hepatocytes, derived from ells in the bile duct.

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Secondly, SARS-CoV-2 indirectly or directly damages the digestive system through an inflammatory response.

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The chain reaction may injure the digestive system.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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Symptoms in Kids of Novel Coronavirus, COVID-19


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New paper released early due to importance.

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Coronavirus looks different in kids than in adults.

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A study released this week in the journal Pediatrics provides the clearest confirmation yet that coronavirus infections are, in fact, generally less severe in kids, with more than 90 percent of 2,143 children in the study in China having mild to moderate disease or even being asymptomatic.

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But it contains worrisome information about one subset — infants — and suggests that children may be a critical factor in the disease’s rapid spread.

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Pediatrics associate editors Andrea Cruz and Steve Zeichner, both physicians, say the study suggests “children may play a major role in community-based viral transmission.”

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The data suggests children may have more symptoms that make them contagious, like a runny nose, and that they may have more gastrointestinal symptoms, which raises concerns about the virus being in the feces for several weeks after infection.

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Adam Ratner, a doctor in pediatric infectious diseases at NYU Langone Health, said the clear takeaway from the study is that the novel coronavirus “is still something that has the ability to cause severe disease across the age spectrum.”

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Study: Coronavirus is not sparing children — and they may play a ‘major role’ in its spread..A new study shows coronavirus infections are less severe in kids, but they may spread it more readily than adults...The first thing to know is that children are getting infected across all age groups and genders. Among the patients studied, half were from Hubei Province, the epicenter of the outbreak, while the others were from bordering areas. They ranged in age from newborns to 18 with the median age being 7 years.
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So what does coronavirus look like in children?

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According to the analysis by Shanghai Children’s Medical Center researchers Yuanyuan Dong, Xi Mo and co-authors, mild cases (52 percent) were marked by the typical symptoms of a cold — fever, fatigue, cough, sore throat, runny nose and sneezing. Some patients had no fever and only digestive symptoms such as nausea, vomiting, abdominal pain and diarrhea.

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Those with moderate infection (39 percent) had pneumonia with frequent fever and cough, mostly dry cough, followed by a wetter cough. Some had wheezing but no obvious shortness of breath.
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Severe cases were rare (5 percent) as were those who required critical care (0.4 percent.) The severe cases began with early respiratory symptoms which were sometimes accompanied by gastrointestinal issues. Around one week the children have more difficulty breathing. Those cases sometimes quickly progressed to critical illness with acute respiratory distress or failure which in turn sometimes led to other organ dysfunction — heart failure or kidney injury.
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One boy, a 14-year-old, died on Feb. 7. No further details on the patient were revealed in the study.
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Of special interest to pediatricians is a group of seven infants (11 percent of the total number of infants in the study), and two children in the age 1 to 5 range (15 percent), who progressed to critical condition. The study suggests, the authors wrote, that “young children, particularly infants, were vulnerable.”.

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The luckiest group — 4 percent — did not have any symptoms at all even as nasal or throat swabs showed they were positive for coronavirus infection…..................

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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California: Coronavirus testing cost zero if insured, employee & employer benefits


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 Only leaves tens of millions uninsured. Does nothing about cost for medical care or home health care after testing positive..

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Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing

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Today, under the direction of Governor Gavin Newsom, the Department of Managed Health Care directed all commercial and Medi-Cal health plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the COVID-19 in theAll Plan Letter (PDF). This includes waiving cost-sharing for emergency room, urgent care or provider office visits when the purpose of the visit is to be screened and tested for COVID-19. The need for COVID-19 testing is based on medical necessity, a clinical determination made on a case by case basis by medical professionals.

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“Californians shouldn’t have to fear a big medical bill just because they took a test for COVID-19,” said Governor Newsom. “This action means that Californians who fit the testing requirements can receive the test at no cost. We’re all in this together, and I’m grateful to those health providers who have already stepped up and heeded our call.”

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“This action will ensure that Californians who need a test will receive one at no cost,” said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency. “This doesn’t mean every Californians should be seeking a test. If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care.”

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Today the California Department of Insurance issued similar direction providing cost free medically necessary testing for an additional 2 million Californians. Combined these announcements ensure that 24 million more Californians are eligible to receive testing, should their health care provider deem it medically necessary.Insurance Bulletin COVID-19 Screening and Testing (PDF).

 

The Department of Managed Health Care also directed health plans to increase capacity to screen and treat COVID-19 as needed to minimize further transmission by encouraging health plans to expand telehealth services and to take steps to ensure patients receive medically necessary medication if there is a shortage of a particular drug.

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These orders from the Department of Managed Health Care and the Department of Insurance do not apply to individuals in self-insured health coverage products.

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Support Now Available for Employers and Workers Impacted by COVID-19

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Also today, the California Employee Development Department announced support services to individuals affected by COVID-19 in California. For faster and more convenient access to those services, the use of online options is encouraged.

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Individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) canfile a Disability Insurance (DI) claim.

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Disability Insurance provides short-term benefit payments to eligible workers who have full or partial loss of wages due to a non-work-related illness, injury, or pregnancy. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 – $1,300 a week.

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Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) canfile a Paid Family Leave (PFL) claim.

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Paid Family Leave provides up to six weeks of benefit payments to eligible workers who have a full or partial loss of wages because they need time off work to care for a seriously ill family member or to bond with a new child. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 – $1,300 a week.

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Employers experiencing a slowdown in their businesses or services as a result of the Coronavirus impact on the economy may apply for the UI Work Sharing Program. This program allows employers to seek an alternative to layoffs – retaining their trained employees by reducing their hours and wages that can be partially offset with UI benefits. Workers of employers who are approved to participate in the Work Sharing Program receive the percentage of their weekly Unemployment Insurance benefit amount based on the percentage of hours and wages reduced, not to exceed 60 percent.

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Visit the Work Sharing Program to learn more about its benefits for employers and employees, and how to apply.

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Governor Proclaimed State of Emergency

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Governor Gavin Newsom yesterday declared a State of Emergency to make additional resources available, formalize emergency actions already underway across multiple state agencies and departments, and help the state prepare for broader spread of COVID-19. The proclamation comes as the number of positive California cases rises and following one official COVID-19 death.

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The emergency proclamation includes provisions that protect consumers against price gouging, allow for health care workers to come from out of state to assist at health care facilities, and give health care facilities the flexibility to plan and adapt to accommodate incoming patients.

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View a copy of the emergency proclamation (PDF).

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COVID-19 in California by the Numbers (as of 10 a.m. Pacific Time):

60– Positive cases

1 – Death

24 – Cases of positive tests related to federal repatriation flights

36 – Cases not related to repatriation flights

  • 18 – Travel-related

  • 10 – Person to person

  • 4 – Community transmission

  • 4 – Currently under investigation

9,400+ – number of people self-monitoring who returned to the U.S. through SFO or LAX

49 – Number of local health jurisdictions involved in self-monitoring

15 – Labs with test kits

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How Can People Protect Themselves:

Every person has a role to play. So much of protecting yourself and your family comes down to common sense:

  • Washing hands with soap and water.

  • Avoiding touching eyes, nose or mouth with unwashed hands.

  • Avoiding close contact with people who are sick.

  • Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.

  • Following guidance from public health officials.

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What to Do if You Think You’re Sick:

  • Call ahead: If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care so that appropriate precautions can be taken.

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California’s Response to COVID-19:

We have been actively and extensively planning with our local public health and health care delivery systems. Here are some of the things we are already doing:

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  • As in any public health event, the California Department of Public Health’s Medical and Health Coordination Center has been activated and is coordinating public health response efforts across the state.

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  • California continues to prepare and respond in coordination with federal and local partners, hospitals and physicians.

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  • California activated the State Operations Center to coordinate response efforts across the state.

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  • Governor Gavin Newsom requested the Legislature make up to $20 million available for state government to respond to the spread of COVID-19.

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  • California made available some of its emergency planning reserves of 21 million N95 filtering facepiece masks for use in certain health care settings to ease shortages of personal protective equipment.

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  • The Public Health Department is providing information, guidance documents, and technical support to local health departments, health care facilities, providers, schools, universities, colleges, and childcare facilities across California.

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  • It is coordinating with federal authorities and local health departments that have implemented screening, monitoring and, in some cases quarantine of returning travelers.

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  • In coordination with the CDC, state and local health departments, we are actively responding to cases of COVID-19.

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  • The Public Health Department is supporting hospitals and local public health laboratories in the collection of specimens and testing for COVID-19.

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  • The California Department of Public Health’s state laboratory in Richmond and 14 other public health department laboratories now have tests for the virus that causes COVID-19.

 

 

 

 

 

 

 

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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How long does COVID-19 last? Resource Centers on Coronavirus


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Lancet offers free public access on coronavirus. The Lancet resource center on coronavirus is here

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There is also The comprehensive Ars Technica guide to the coronavirus 

 

How long does COVID-19 last?

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“On average, it takes five to six days from the day you are infected with SARS-CoV-2 until you develop symptoms of COVID-19. This pre-symptomatic period—also known as “incubation”—can range from one to 14 days.”

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“From there, those with mild disease tend to recover in about two weeks, while those with more severe cases can take three to six weeks to recover, according to WHO Director-General Dr. Tedros Adhanom Ghebreyesus, who goes by Dr. Tedros.”

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From Wuhan, they followed CT of lungs. Two weeks after recovery patient discharged negative, if CT lesions appear to get worse, pneumonia symptoms recur. It’s not over til it’s over. 

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I do not have the reference and cannot verify the source. I have read that recurrence two weeks later is the overactive immune system creating a cytokine storm with excessive mucous secretions that create mucous bolts. Bolts plug airways and kill. One hospital had 50% reduction in deaths from aggressive suction of mucous.

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Dont forget to isolate and quarantine yourself even if mild. It’s wildly contagious.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Coronavirus “is like the angel of death for older individuals,” do not downplay or minimize


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Jerusalem Post, March 8, 2020:

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….Pence’s speech is a departure from the guidelines the CDC posted to their website on Friday, which told older adults and those with serious medical conditions such as a heart, lung or kidney disease – rather than just the elderly with a serious health condition – to “stay home as much as possible” and “take actions to reduce your risk of exposure.”

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Last week, Dr. Peter Hotez, dean of tropical medicine at Baylor College of Medicine, warned lawmakers not to downplay or minimize how severe the coronavirus risk is for vulnerable Americans. Speaking at a congressional hearing, Hotez explained that the coronavirus “is like the angel of death for older individuals,” AP reported.

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According to Vanderblit University infectious diseases expert Dr. William Schaffner, “The clear message to people who fit into those categories is:

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‘You ought to become a semi-hermit. You’ve got to really get serious in your personal life about social distancing, and in particular avoiding crowds of any kind….’”  

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The material on this site is

for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Italy’s Healthcare System on Brink of Collapse – Coronavirus


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Italian doctor begs not to underestimate coronavirus threat

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An Italian doctor said: ‘Our hospitals are on their knees: Italian doctor’s dire warning over coronavirus has driven his country’s healthcare system to brink of collapse – and warned colleagues in other nations not to underestimate the threat.

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China does not charge for healthcare needed for coronavirus.

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Om Tat Sat Om

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The material on this site is

for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please ignore the ads below. They are not from me….

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Coronavirus Tsunami Unlike Anything Before – fibrosis of lungs, death by sputum bolts


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First, see the PDF at bottom from Lancet: Mitigating effects of home confinement on children during the coronavirus outbreak.

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Then will see a summary of the Lancet report of how doctors treat the sickest coronavirus patients. So many die.

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It is now surely one of the most-read medical reports among caregivers in intensive care units around the world who are bracing for the novel coronavirus.

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Next, quoting Cuomo today, “I’m not urging calm. I’m urging reality.”

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An Italian doctor said: ‘Our hospitals are on their knees’: Italian doctor’s dire warning over coronavirus has driven his country’s healthcare system to brink of collapse.

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I truly fear for the safety of all when I hear people are already bored, fatalistic, saying “Well, it’s everywhere. There’s nothing I can do.” They don’t have a clue: A tsunami is coming and we are not the slightest prepared. No equipment. No masks. No gowns. No beds. Not the basics! No test kits for another two weeks…..maybe. There are things you must do to protect others. Don’t say, “It doesn’t matter, we will all get it.” Here is what’s coming.

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“more than 100 out of 120 people admitted with the virus also developed pneumonia.”

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We know from early stage COVID-19 autopsies published February 29, 2020, the two prominent lethal features are

  • severe fibrosis of distal lungs  – oxygen does nothing at scar tissue

  • sputum bolts that kill due to cytokine storm, an over-responsive immune system that kills with a surge of inflammatory cytokines that produce copious sputum.

  • “The influence of COVID-19 on the human body is like a combination of SARS and AIDS as it damages both the lungs and immune systems,”

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“…most important thing now is to take measures at an early stage of the disease to protect patients’ lungs from irreversible fibrosis,” Peng noted.”

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This Lancet article may wake you up if not too bored. It’s scares me like nothing I could imagine.

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From Lancet, February 24, 2020

Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study

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A summary, below, from The Washington Post, March 7, 2020, of a portion of the Lancet article, above:    .

How Doctors Treat the Sickest Coronavirus Patients

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It is now surely one of the most-read medical reports among caregivers in intensive care units around the world who are bracing for the novel coronavirus. The paper, published in the British medical journal the Lancet last month by a team of doctors working at the center of the outbreak, is the first study to characterize the clinical course, treatment and mortality of a group of critically ill patients infected by the new SARS-CoV-2 virus.

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The report is highly valuable, say clinicians in the United States and Europe, because it details the course of the disease in critically ill patients — that small but worrisome subset who end up in ICUs. The 52 patients were treated at the Jinyintan Hospital in Wuhan, China, during the first month of the epidemic, from the end of December through January.
The authors tracked the constellation of life-threatening symptoms, what drugs patients were given to try to combat the infection’s assault on the lungs, how supplemental oxygen was administered, and the outcomes — whether patients survived or died in the ICU.

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The grim conclusion: For patients infected with the novel coronavirus who became critically ill with pneumonia and entered their ICU, the doctors recorded “high” numbers of fatalities. Of the 52 people included in the sample, 32 died in the 28-day span of the study, revealing a death rate of 61 percent. Most died within seven days of being admitted to the ICU.
For comparison, mortality rates generally ranging between 30 and 40 percent are observed for patients who are sickened by ordinary seasonal flu and are fighting pneumonia and acute respiratory distress syndrome in ICUs.


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Specialists outside of China applaud the treatment given by the Chinese doctors to their patients in the study, saying that similar levels of care would be found in American and European critical care units.


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Like the doctors in China before them, health-care workers in South Korea and Italy are seeing their ICUs filling with critically sick patients. In Lodi, in northern Italy, one infectious-disease doctor told The Washington Post that coronavirus had hit “like a tsunami” at his hospital, where more than 100 out of 120 people admitted with the virus also developed pneumonia.

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Breathtaking. I am absolutely kicked in the gut sickened by what I know will be unfolding here. It is unlike anything we have seen before. As a physician, I cannot imagine how it is possible we will be even half prepared but even then, no respirators, not enough of a tsunami of respiratory therapists to handle the lungs that get blasts of sputum bolts and kill.

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We don’t have nowhere near enough critical care beds.

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We simply do not have the barest of necessities, already not enough masks and respirators, not to mention the flimsy gowns I’ve seen Health workers in Kirland Washington are wearing. I’ve not seen a single American Health worker wearing anything like the fully enclosed space suits even street workers wear in Wuhan.

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My mind is stunned reading what it was like there, what will get here soon, just like that and we will see what is unlike anything we have ever seen before in medicine; it is a tsunami and deadly serious.

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We’ve had 6 wasted weeks watching it come and did nothing. Test kits cannot be promised in two weeks, said Dr. Anthony Fauci on March 6. Contradicting the expert, trump on the same day said we had test kits now, but on Thursday March 5, Pence had already said we did not. 

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Just published is why seniors are more likely to die. Because they lost ability to turn off immune system when full blast no longer needed.

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Children can test positive to coronavirus but may have few to no symptoms.

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Lancet offers free public access on coronavirus. The Lancet resource center on coronavirus is here

Such as

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(Chinese translation | 附中文翻译, PDF)...

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China does not charge for healthcare due to coronavirus.

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Om Tat Sat Om

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The material on this site is

for informational purposes only.

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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

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Please ignore the ads below. They are not from me….

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The advertising below is not mine. In exchange, this blog is less expensive.

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No Respirator Masks, No Respirators, Healthcare Workers Not Protected


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National Shortage of Everything Needed to protect

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Healthcare Workers

 

A massive kick in the gut REALITY

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We will have to accept a deadly crisis as stark dead cold reality in vast numbers with things we’ve never imagined could happen here. Don’t be getting bored or lulled to sleep now by the quiet that comes before the tsunami.

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“As coronavirus cases in Washington state mounted and the country’s first death was announced Saturday, health authorities scrambled to get more specialized masks for front-line clinicians who need to protect themselves from the highly contagious disease.

Washington state authorities sent an urgent request for 233,000 respirators and 200,000 surgical masks to be released from the federal government’s Strategic National Stockpile. The stockpile is a repository of drugs and supplies for deployment in major public health emergencies, such as an infectious disease outbreak.

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Within 24 hours, Washington state’s liaison to the federal government, Casey Katims, was told his state would get assistance. But it would be less than half the amount they requested — 93,600 N95 respirators and 100,200 surgical masks..Washington’s experience highlights one of the country’s biggest gaps in preparedness for battling the respiratory virus that causes the disease known as covid-19. The United States has about 1 percent of the 3.5 billion respirators that experts estimate the health-care system needs a year to fight a severe influenza pandemic. That translates to 12 million N95 respirators and 30 million surgical masks, Health and Human Services Secretary Alex Azar has said. An additional 5 million N95 respirators may be expired, he has said.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

The advertising below is not mine.

In exchange, this blog is less expensive............

Coronavirus symptoms by order of frequency


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Comments following a Washington Post article on why the US Health System is not ready.

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The writer references the NYT – I do not have the NYT link:

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“We caught up with Donald G. McNeil Jr., our infectious-diseases reporter, to ask him what it’s actually like to contract the coronavirus, based on what we’ve learned so far from China, which has the vast majority of cases. What does this illness look like? I’ve heard some people compare it to the flu. No, it’s different from flu. It’s a lung disease, not a stuffy nose disease. Ninety 90 percent of people get a fever, 80 percent get a dry cough, and then it drops down to 30 percent get shortness of breath and malaise — you know, being tired. A runny nose shows up in only 4 percent, and that may be people who also happen to have acold or flu, too. What are we learning about asymptomatic cases? The good news is that a large study from China suggests that less than 1 percent of cases are asymptomatic. Almost all people get sick.”

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OK, back to @Flowman here:  I was appalled to see WAPO post an article yesterday that stated a common COVID-19 symptom was a runny nose.  Read the NYT quote above regarding COVID-19 symptoms again:  

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90% Fever
80% Dry Cough
30% Shortness of Breath / Malaise (fatigue/tiredness)
4% Runny Nose – but suspected of being due to concomitant cold or flu

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And for the record, I am a retired Epidemiologist.

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Reiterating what he said: “Almost all people get sick.”

The coronavirus is different from the Trumpvirus.

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We need leadership grounded in science. And we need it now. Those are not the only symptoms but they give some perspective. They are symptoms of lower respiratory disease, i.e. lung predominantly.

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Some have severe intense muscle pain, sweating, chills, some even have diarrhea and of course chest pain with shortness of breath means you should rule out a heart attack. Damage to lungs can be intense and certainly strain the heart.

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The material on this site is for informational purposes only.

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It is not legal for me to provide medical advice without an examination..

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

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Please ignore the ads below. They are not from me..

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The advertising below is not mine.

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Hand Washing the Proper Way


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According to the World Health Organization, properly washing your hands means washing as long as it takes to sing “Happy Birthday” twice — 20 seconds or so.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Policies unintended consequences. Ethical distribution of limited resources.


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Concluding paragraphs from The Washington Post, March 2, 2020:

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The coronavirus could hit the U.S. harder than other wealthy countries

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Our inequities create unique vulnerabilities —

as does our current political climate

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…To reduce exposure, people with the virus must come forward. They must also identify their contacts. Fear that this may result in deportation or harm for loved ones may make this essential step impossible for many. As we learned during the Ebola and Zika responses in New York City, without the active engagement of immigrant communities that have the closest ties to the countries with the highest burden, prevention efforts could falter.

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We don’t mean for this analysis and its grim outlook for what lies ahead to create additional fear or panic in the United States. Indeed, there is much to be reassured by: For many young, healthy Americans, as well as children, the risk of serious illness and death is low, and health departments across the country are accurately assessing risk and implementing prevention measures.

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.Yet at the national level, we need an intentional, human-rights-based response that pays attention to health equity. This will require honest conversations about the potential human rights challenges posed by quarantine and other measures as well as more discussions about the ethical distribution of limited resources. It may also require some self-reflection on how policies can have unintended consequences for public safety and public health.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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CDC blasted for removing public data on tests for coronavirus


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Lawmaker blasts CDC for removing public data on number of Americans tested for virus

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The Centers for Disease Control and Prevention has abruptly stopped disclosing the number of Americans tested for the novel coronavirus, a move one lawmaker has called “unacceptable.”

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In recent days, the agency has posted statistics to its website detailing the impact of the virus as it spread across the United States. Figures include a breakdown of confirmed and presumed patients and the total number of deaths, cases and tests administered.

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But as Rep. Mark Pocan (D-Wis.) noted Monday, one of those numbers suddenly vanished from the site.

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“Americans are dying,” Pocan wrote in a letter to CDC director Robert R. Redfield. “We deserve to know how many people have been tested.”.His letter cited comments made Sunday by Scott Gottlieb, the former commissioner of the Food and Drug Administration, who said there could be “hundreds or low thousands” of coronavirus cases in the U.S.

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Given this possibility, Pocan said, “knowing that CDC testing is keeping pace with the likely number of cases is imperative to maintaining public trust.”

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Coronavirus: Expect people you know to die. Take it seriously. Stay calm


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“Coronavirus: an email to my family”

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by an infectious disease epidemiologist.

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“I wrote this originally to share with my family.”

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…”I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC.”

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Who should you listen to?

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The CDC and your state health department are your best place for information about COVID-19. (Listen to them before you listen to me.) Be cautious about other sources of information – many of them will not be reliable or accurate.

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How bad is this going to be?

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It’s possible that COVID-19 will be similar to a bad flu year but there are a number of indications that it will be very much like the 1918 Flu Pandemic. To put that in perspective, the 1918 flu did not end civilization as we know it but it was the second-deadliest event of the last 200 years. Expect people you know to die.

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However, there is one critical difference between COVID-19 and the 1918 flu – the 1918 flu virus hit children and young adults particularly hard. COVID-19 seems to be most severe in older adults. Children and young adults generally have mild infections. We are grateful for this.

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What can we expect?

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This is not the zombie apocalypse. Core infrastructure (e.g., power, water, supermarkets, internet, government, etc.) will continue to work, perhaps with some minor disruptions. 

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There will be significant economic disruption: a global recession is very possible and there will probably be significant shortages of some products. The healthcare system will be hit the hardest. The number of people who are likely to get sick is higher than our healthcare systems can probably handle.  

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Daily life will be impacted in important ways. Travel is likely to be limited and public gatherings will probably be canceled. Schools will probably be closed. Expect health departments to start issuing these orders in the near future, especially on the West Coast.

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The acute pandemic will probably last at least for several months and quite possibly for a year or two.

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What can we do?

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We can’t keep COVID-19 from being a global pandemic but the more we can do to slow the spread of the disease, the less severe the impact will be. With that in mind, here are the things you can do:

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Stay calm but take it seriously. This will likely be bad but it’s not the apocalypse.

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Stay home if you’re sick or someone in your house is sick. 

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Leave medical supplies for healthcare workers. You shouldn’t be stockpiling masks or other medical supplies. They are needed in hospitals to keep our healthcare workers healthy.

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Wash your hands. Get in the habit of frequently washing your hands thoroughly and covering your cough.

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Minimize your exposure. Now that we’re starting to see community transmission in the U.S., it’s probably time to start cutting back on your exposure to other people. Depending on your circumstances, consider:

  • Canceling non-essential travel

  • Avoiding large-scale gatherings

  • Working from home if possible

  • Minimizing direct contact with others including hand shakes and hugs

  • Reducing your trips out of the house. If possible, shop for two weeks of groceries at once or consider having your groceries delivered. Stay home and cook instead of going to a restaurant.
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Remember, keep calm and prepare. This is likely to be bad but if we respond calmly and thoughtfully we can handle it.

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Others have added: no more fist bumps or hand shakes. Elbow bumps or, as they are doing in China, toe bumps.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Coronavirus Test Kits Alarming Impurities, Contaminated


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From AXIOS

Test Kits May Have Been Contaminated

 March 1, 2020

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Behind the scenes: The FDA official who visited the Atlanta lab, Timothy Stenzel, is the director of the Office of In Vitro Diagnostics and Radiological Health.

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  • About a week ago, when the Secretary of Health and Human Services Alex Azar was under extreme pressure over the delays in getting coronavirus testing kits to market, Stenzel traveled to Atlanta to help troubleshoot whatever technical problems might have been occurring with the tests.

  • Stenzel was alarmed by the procedures he witnessed in the Atlanta laboratory and raised concerns with multiple CDC officials, per a source familiar with the situation in Atlanta.

  • Stenzel is a highly-regarded scientist and diagnostics expert. He was on the ground in Atlanta to deal with technical issues and happened to stumble upon the inappropriate procedures and possible contaminants. He is not a laboratory inspector and thus was not charged with producing an inspection report on the lab conditions.

  • But he raised the concerns and they have been taken seriously and risen to the highest levels of the U.S. government.

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On Thursday afternoon, the concerns about the Atlanta laboratory were raised in a conference call that included senior government officials from multiple agencies including the Department of Health and Human Services, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.

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  • The call’s purpose was to figure out ways to mass produce the testing kits and get them to market quickly.

  • The Trump administration says it’s now figured out how to get over those hurdles. An HHS spokesperson promised that by the end of this week, “we will have the capacity to test up to 75,000 individuals” for the coronavirus

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What’s next: The FDA’s manufacturing concerns — which include the possible contamination of testing kits — have also resulted in the Trump administration ordering an independent investigation of the CDC’s Atlanta laboratory, according to senior officials.
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  • “HHS has launched an investigation and is assembling a team of non-CDC scientists to better understand the nature and source of the manufacturing defect in the first batch of COVID-19 test kits that were distributed to state health departments and others,” said an HHS spokesperson.

  • “HHS/CDC have been transparent with the American people regarding the issue with the manufacturing of the diagnostic and will be transparent with the findings of this investigation.” (But the administration was not transparent about the senior FDA official’s concerns about the conditions and procedures in the Atlanta laboratory.)

  • A senior administration official added that the government also moved the manufacturing of the coronavirus tests out of the Atlanta laboratory of CDC.

  • The official said that the CDC engaged with a third party contractor on Feb. 20 to help manufacture the testing kits. The official added that the FDA regulator, Stenzel, visited the Atlanta laboratory on Feb. 22.

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Between the lines: Until Thursday, the CDC’s guidance was to only test Americans for the coronavirus if they’d recently traveled to China — or had close contact with someone known to have the virus — and were symptomatic.

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  • Under this policy, the CDC initially refused to test a California patient who didn’t fit this criteria but had the coronavirus, although the CDC disputes that it denied doctors’ testing request.

  • As of Friday, South Korea had tested 65,000 people for the coronavirus; the U.S. had tested only 459, per Science Magazine. China can reportedly conduct up to 1.6 million tests a week.

  • Although the World Health Organization has sent testing kits to 57 other countries, the U.S. decided to make its own.

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There have also been problems with the tests themselves. On Feb. 12, the FDA announced that health labs across the country were having problems validating the CDC’s diagnostic test, Science reports in an in-depth account of what went wrong with the tests.

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The FDA announced yesterday that public health labs can create their own diagnostic test. Scott Becker, the CEO of the Association of Public Health Laboratories, told Science that he expects that public health labs will be able to do 10,000 tests a day by the end of the week.

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A WHO expert explains how China did it. “It’s all about speed.”
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Wash your damn hands.

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“You’re probably doing it wrong.”
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“Wash instead of sanitizing whenever possible” – good idea to review this page:
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“As for hand sanitizer, Larson says it’s important to know that sanitizers are only active as long as they’re on your hands. So even if it makes your hands feel annoyingly wet, keep the sanitizer on for at least 10 seconds.”

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The good news is dear leader is telling his people there is no problem in his crowds. All others remember keep at least 6 feet distance from others, probably more. Ain’t gonna happen at the grocer but give it time.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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U.S. badly bungled coronavirus testing


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Quoting March 1, 2020, from Science:

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As of Friday, South Korea had tested 65,000 people for the coronavirus; the U.S. had tested only 459, per Science Magazine. China can reportedly conduct up to 1.6 million tests a week. Although the World Health Organization has sent testing kits to 57 other countries, the U.S. decided to make its own.

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.There have also been problems with the tests themselves. On Feb. 12, the FDA announced that health labs across the country were having problems validating the CDC’s diagnostic test, Science reports in an in-depth account of what went wrong with the tests.

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The FDA announced yesterday that public health labs can create their own diagnostic test. Scott Becker, the CEO of the Association of Public Health Laboratories, told Science that he expects that public health labs will be able to do 10,000 tests a day by the end of the week.

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From Common Dreams, February 27, 2020:

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“Mike Pence literally does not believe in science,” tweeted Ocasio-Cortez, a New York Democrat. “It is utterly irresponsible to put him in charge of U.S. coronavirus response as the world sits on the cusp of a pandemic. This decision could cost people their lives. Pence’s past decisions already have.”

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Ocasio-Cortez pointed to Pence’s tenure as Indiana governor, where he she said his “science denial contributed to one of the worst HIV outbreaks in Indiana’s history.”

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“He is not a medical doctor. He is not a health expert,” Ocasio-Cortez wrote. “He is not qualified nor positioned in any way to protect our public health.”

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Gregg Gonsalves—a Yale epidemiologist who co-authored a 2018 paper connecting Pence’s policy decisions as governor to the 2014 HIV outbreak in Scott County, Indiana—denounced the president’s decision to allow Pence to coordinate the administration’s coronavirus response.

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“Over 200 people were infected with HIV in an outbreak, met with ignorance, bumbling, incompetence, and ideological intransigence. Two hundred needlessly infected, now on medication for life at great costs to themselves and the state,” Gonsalves tweeted Thursday morning. “Now Donald Trump has put Mike Pence in charge of coronavirus.”

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“It’s like putting an arsonist in charge of the fire department, a bank robber in charge of the U.S. Mint,” Gonsalves added. “Donald Trump made the choice of putting someone absolutely not up to the task to this crucial position. It endangers us all. This isn’t a Republican or Democratic issue—we have the potential for coronavirus outbreak in the U.S. and we needed to rise above the partisan fray.”

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Do you don’t want people to avoid tests or treatment because of a $3,000 medical bill?


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Coronavirus shows the importance of Bernie Sanders & Medicare for All.

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In a pandemic, you don’t want people avoiding getting tested or treated because they can’t afford a $3,000 medical bill. A lot of working families cannot afford that.

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We’re only as safe as the least insured person among us. Everyone has to be covered.

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One American man who flew back from Wuhan with his small daughter was hospitalized at Rady Children’s Hospital in San Diego for several days until the daughter tested negative for coronavirus. After living in Wuhan for 15 years, he did not have American insurance.

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Our CDC had no test kits available so it took many days for results to be flown to CDC and returned. England has now tested 10,000 people on national health insurance. We have tested 420 but many people were untested as kits were not available and they are in our communities spreading the highly contagious virus.

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What is the cost of high-level bio-containment units that function like ICU’s? My guess is that 6 days would easily be $60,000 if not far more.

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This poor man.

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One business man in Florida paid $3500 for a test to prove he was well after flying back from China so he did not have to quarantine for two weeks. His insurance refused to pay. Will yours pay for testing of your family?

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.ed 

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Coronavirus COVID-19 My Plan


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COVID-19   MY PLAN – NOT FOR EVERYONE

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The current coronavirus is SARS-CoV-2.

The influenza from the virus is COVID-19.

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This is not medical advice.

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This plan is not for everyone.

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Consult your doctor for that.

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Surgeon General urges public to stop buying face masks.

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CDC advises wear a mask if you have fever or cough.

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Millions who have no health insurance or who have high deductibles are at highest risk to themselves and all of us. They may work several jobs and be homeless with no ability to wash their hands or buy supplies. We need socialized healthcare that leaves no one out. Their loss could kill you. Help others if you can. Small choices can have a big impact.

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It is said:

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Be humble, for you are made of earth.

Be noble, for you are made of stars.

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I don’t have COVID-19. This is my plan. I have a long list of inflammatory autoimmune medical conditions including lung disease plus creaky debilitating old age. For those above 80 the incidence of death is near 15% vs young with incidence of death 0.2%. If intubated, critically ill mortality was 82%.

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From University of Minnesota recapping JAMA’s study from China of 72,000 cases.

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Report of China WHO Joint Mission February 28 includes mortality rate by comorbidity, i.e. co-existing conditions. Mortality really starts to rise above age 60.

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COVID-19 and Health Care Resource Capability, February 25.

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Since January, I’ve studied and read every case I could find. This is my plan. I am a doctor, sometimes able to diagnose my own condition. I am not officially recommending anything medically to others but they may consider it. Underlying lung disease always grabs me but I prefer quiet peace to recover at home. Or die. I have been deeply blessed with a good life helping others. Pneumonia is the old man’s best friend. It really really is a sweet painless way to go. Death is a decisional process. This body recovers from so many decades and decades of severe flu that hit the lungs hard. I’ve been near coma near death for days on end w flu in past since the big one in 1957. Nothing new here. Do the basics.

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This is not an excuse for suicide – stop those thoughts immediately and get professional help. You will just make it harder for others.

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My affairs are in order. Tax forms finished. Healthcare power of attorney, done. The plan is to do everything to prevent being disabled from illness tho it prolongs this old body.

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Just went thru Christmas season w dry cough – lasting 3 to 4 weeks, lungs literally felt as if caked in cement. Lot of people had exactly same. Reallly wiped out first week, too sick to eat. O2 saturation always remained 97% to 98%. Severe sore throat. No sinus involvement. very strange, widespread in community. Muscles flaring every few days from underlying disease but not clearly from this.

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PLAN

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Most people with the flu do not need hospital care or medical intervention but they are contagious and can infect others even if having no symptoms. That is what makes this flu most dangerous, the risk to others.

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It is recommended to keep a safe distance of at least 6 feet possibly more from infected people. But who are the asymptomatic infectious persons?

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Get 3 months of medication supplies – pay for it if insurance won’t. Save receipt. Get reimbursed later if you can. Shortages of 200 drugs from China may last awhile even if flu lasts only a couple weeks.

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Everyone should have an oximeter to monitor oxygen and pulse – $18 bucks.

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If oxygen is dropping below 96% —- that’s the start of trouble. Likely Pneumonia.

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I plan to wear non latex medical gloves when I’m out, to remind myself not to touch face/eyes. Keep a box in car.

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Seasonal flu is in its second major spike. Get flu vaccine if you have not already. Hospitals are overloaded with it. Don’t count on a bed.

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Coronavirus vaccine will not be available for 18 months and government should offer free to those with limited income.

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Vaccine should be denied it to those who refuse measles vaccines. Measles has a high morbidity and mortality and is the most contagious known virus: if you step into the airspace of someone with measles who passed through 2 hours ago, it is still highly contagious. Not true of anything else. Those people put all of us at extreme risk and should be isolated.

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Isolate yourself if you have the flu.

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COVID-19 Symptoms

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COVID-19 is mainly transmitted from person to person through droplets from coughing or sneezing. Contact with fecal matter from an infected person may also transmit the virus, possibly also contact with urine and tears and contact with surfaces – see disinfection below.

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It’s in the community now. Those with no known exposure including one death so far in Washington of 59 year old man who had other risks. Males seem to get this flu more than females.

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No runny nose, no sinuses involved – at least in most.

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Begins as a dry cough, followed possibly in several days by fever as high as 103.5°F, tight chest, maybe muscle aches or not.  Some said the cough was so severe it caused severe muscle pain just from cough.

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Chest pain and shortness of breath may occur with COVID-19 pneumonia. Those symptoms warrant concern about heart attack. 

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If severe, call 911 and advise you have the flu so they can safely bring you in.

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If someone drives you to ER, telephone from parking lot so they can isolate you. You have contaminated the driver too.

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Don’t contaminate your healthcare personnel! Think about the lives of others.

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STOCK UP

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Stock up on chicken soup. I have chicken broth and a drawer full of various noodles including ramen. You need the salt when dehydrated, not just water. Everyone already has the usual dry beans and canned or frozen veggies, don’t they?

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Some people have 2 years of supplies. Really? That’s sick.

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Gatorade – my niece preferred DripDrop electrolyte powder for her athlete sons. Invented by MD on a relief mission treating life-threatening dehydration. Same sodium, potassium, dextrose, it also includes fructose, vitamin C, magnesium, zinc.

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https://dripdrop.com/collections/dehydration-relief

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Ready a thermometer.

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ALWAYS have supply of  Mucinex every 12 hr. Begin early. Don’t wait, continue well after, especially if dry cough. Avoid antihistamines that dry secretions. You need the opposite.

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Drink plenty of liquids to keep kidneys flushed and loosen lungs.

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Use a humidifier.

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.Sleep apnea machines can be used as a humidifier.

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When lungs are severe, boil 2” water in a large pot w eucalyptus leaves or oregano, towel over the head/pot to capture steam, breathe thru nose or mouth..

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Some like Vick’s plasters on chest but…..

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If urine is dark, drink a lot more fluid. A lot. Keep drinking especially during fever.

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A long hot bath with epsom salts is great for muscle aches and misery.

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Some people may be contagious without ever any symptoms and spread the virus to many others.

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In one study, coronavirus struck 14% of victims again 2 weeks later after recovery and after testing negative they tested positive again. Isolate for at least 14 days, possibly 28 days after your symptoms. They have not given recommendations on this. We simply do not have enough data.

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Do not trust negative tests, nothing is 100%.

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England has tested 10,000. We have tested 420. Faulty tests. CDC guidelines had been far too strict, limiting testing in keeping with lack of supplies. The White House had 700 vacancies at CDC by the first spring after inauguration, cut CDC budget, and gutted the entire pandemic response team in 2018 including the position of Rear Adm. Timothy Ziemer who abruptly departed from his post leading the global health security team on the National Security Council in May 2018. Money ran out on epidemic prevention activities in 39 out of 49 countries – that’s where these diseases can come from.

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Expect at times Fake News from the White House and their favorite media on radio, TV. Many people in power do not believe in science and are very adept at using mind control, flooding the media until millions believe false..

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KIDS

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It may be very mild in kids – isolate them though they feel well. It may be so mild in people, kids especially, they don’t even feel they have it.

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Schools right now, yes absolutely right now, should consider shutting down til end of flu season – talk to your schools early, before this rips through communities like wildfire. Kids are great vectors and some are at risk too.

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It may take forever, but some officials will figure out how to test us at home without exposing offices and medical personnel. Health officials will need to notify others.

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CT scan is unique and definitive.

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CT signs persist after symptoms resolve and should show shrinking lesions. If not, COVID-19 is flaring again or possibly a different pneumonia, e.g. bacterial, is going on.

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Someone pointed out a package dated years ago says coronavirus. There are other coronaviruses, SARS, MERS. This one is SARS-CoV-2. It appeared in humans late 2019.

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DISINFECTION

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It is not yet clear how this coronavirus, SARS-CoV-2, behaves. Other human coronaviruses can be inactivated using common disinfectants and may dissipate at higher temperatures.

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Human coronaviruses can remain infectious on surfaces for up to nine days at room temperature. On copper and steel, about two hours.

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The CDC says it may be possible for a person to become infected by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.

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The CDC said there is likely a very low risk of virus spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures.

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Anyone have more to add? Have I said this before, this plan is not for everyone. I have some ability to diagnose as it evolves. Many will die, just as they do every year but we are responsible for the health of others especially the poor, those without medical insurance.

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Why panic? It’s only the body. You’ve had the flu before.

Not much you need to do that you haven’t already done so many times in past.

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Be at peace. Go take a walk and shake the tension off.

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Breathe deeply and do a relaxation exercise.

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Be kind to yourself and others. Love yourself. Deepen your spiritual life. Find joy. Just be.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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You will likely get Coronavirus but most cases not life-threatening


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You’re Likely to Get the Coronavirus

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…Harvard’s Lipsitch predicts that, within the coming year, some 40 to 70 percent of people around the world will be infected with the virus that causes COVID-19. But, he clarifies emphatically, this does not mean that all will have severe illnesses. “It’s likely that many will have mild disease, or may be asymptomatic,” he said. As with influenza, which is often life-threatening to people with chronic health conditions and of older age, most cases pass without medical care. (Overall, around 14 percent of people with influenza have no symptoms.)

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…tests are still not widely available. As of Friday, the Association of Public Health Laboratories said that only California, Nebraska, and Illinois had the capacity to test people for the virus.

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… Fauci’s initial optimism seemed to wane, too. Last week he said that the process of vaccine development was proving “very difficult and very frustrating.” For all the advances in basic science, the process cannot proceed to an actual vaccine without extensive clinical testing, which requires manufacturing many vaccines and meticulously monitoring outcomes in people. The process could ultimately cost hundreds of millions of dollars—money that the NIH, start-ups, and universities don’t have. Nor do they have the production facilities and technology to mass-manufacture and distribute a vaccine.

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…Production of vaccines has long been contingent on investment from one of the handful of giant global pharmaceutical companies. At the Aspen Institute last week, Fauci lamented that none had yet to “step up” and commit to making the vaccine.“Companies that have the skill to be able to do it are not going to just sit around and have a warm facility, ready to go for when you need it,” he said. Even if they did, taking on a new product like this could mean massive losses, especially if the demand faded or if people, for complex reasons, chose not to use the product.

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… “If we’re putting all our hopes in a vaccine as being the answer, we’re in trouble,” Jason Schwartz, an assistant professor at Yale School of Public Health who studies vaccine policy, told me. The best-case scenario, as Schwartz sees it, is the one in which this vaccine development happens far too late to make a difference for the current outbreak….

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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COVID-19: 20-year-old Wuhan woman infected 5 relatives, showed no signs of illness – tested negative


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COVID-19: Case study of 20-year-old Wuhan woman traveled 400 miles, infected 5 relatives despite not showing any signs of illness – and tested negative.

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Published February 21, 2020 in JAMA

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There are reports that a person may be able to infect as long as 38 days, not two weeks. This case is an important example.

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Hand washing is more important than ever. Soap and water are more effective than hand sanitizers, alcohol disinfectants.

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Areas most frequently missed

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especially the thumb, tips of fingers, areas between fingers and back of hand.

 

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The material on this site is for informational purposes only.
.
It is not legal for me to provide medical advice without an examination.

.
It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

 

Please ignore the ads below. They are not from me.

..

.

The advertising below is not mine.

In exchange, this blog is less expensive.

 

 

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