Coronavirus

[madodel]

COVID is having a profound effect on the practice of medicine all over the world.

COVID-19 Impacted Worldwide Diagnosis of Cardiovascular Disease

According to the study results, overall procedure volume decreased by 42%, and by 64% from March to April 2019. They also reported that the use of transthoracic echocardiography was down by 59%, transesophageal echo by 76%, and stress tests by 78%. Coronary angiography was decreased by 55% (P<0.001 for each procedure). There was a significant reduction in procedures in poorer countries that had lower gross domestic product (location in these lower-income regions was associated with a 22% reduction in cardiac procedures).

 

[TEG]

^^^ Which is why "excess death" statistics are important to track the total impact of COVID, not just deaths confirmed to be from COVID...

 

[TEG]

New coronavirus variant found in Bay Area | KRON4

COVID-19 Variant Linked to Several Outbreaks in Santa Clara County

 

[Rogue Synapse]

COVID is having a profound effect on the practice of medicine all over the world.

COVID-19 Impacted Worldwide Diagnosis of Cardiovascular Disease

According to the study results, overall procedure volume decreased by 42%, and by 64% from March to April 2019. They also reported that the use of transthoracic echocardiography was down by 59%, transesophageal echo by 76%, and stress tests by 78%. Coronary angiography was decreased by 55% (P<0.001 for each procedure). There was a significant reduction in procedures in poorer countries that had lower gross domestic product (location in these lower-income regions was associated with a 22% reduction in cardiac procedures).

This paper looked at March and April 2020 compared to the previous year. At the very beginning of the pandemic, most hospitals shut all non-essential stuff down, and the census of patients dropped precipitously. This was because they couldn't predict how tall the surge would be, and how reliable their supplies of PPE would be. My hospital was ghostly quiet for those first few months; it was eerie. Over the summer, most hospitals opened back up to some semblance of normal operations and started doing elective procedures again.

A similar paper looking at the practice of medicine this month would be starkly different. Every hospital is completely overwhelmed by COVID. The number of COVID patients we have at our hospital now is easily 14 times higher than the initial peak, and we've had to open multiple "overflow ICUs" out of regular hospital rooms converted to ICUs. The silent killer is.. all the non-COVID stuff that gets pushed to the side or doesn't have an empty bed to admit to. Strokes, heart attacks, traumas are all vying for the same critical care resources that are being frantically allocated to a never-ending flood of COVID patients. And my hospital is not in a "red zone"; we're much better off than most. The nursing staff in particular can't take too much more of this. Please for the love of God everyone, wear your mask whenever leaving the house and get the vaccine at your first opportunity. I got both doses of vaccine and only had mild side effects - don't let that deter you!

 

[cwerdna]

For those who might still be looking for N95 masks...

As I posted on Nov 29th in another forum:
-- begin --
I was able to order a box of BYD Care N95 Respirator Masks One Size 20PK - Office Depot last night for $49. Unclear if my order will get canceled. Hand sanitizer, masks & more says "Prioritized for Healthcare workers and first responders" whereas the listing says it's reserved for them.

They (model DE2322) are at the bottom of Approved N95 Respirators B Suppliers List | NPPTL | NIOSH | CDC. I can only see part of Chinese Electric-Car Maker Gets U.S. Approval to Supply N95 Masks due to a paywall. I was well aware of BYD and Warren Buffett's investment in them before COVID-19.
-- end --
(Them being at Office Depot will probably only help those in the US.)
I did receive them and each mask is individually in a sealed packet. I split up the box of 20 masks between myself and my parents.

They're back in stock at BYD Care N95 Respirator Masks One Size 20PK - Office Depot right now for $49.99. I've seen them go in and out of stock and the price varying. I think I saw them at $69.99 at one point and another time, they were back up to $109.99, I think.

I have enough for now and have no need to hoard them.

FYI for anyone looking for N95 masks, these are usually in stock whenever I check for $109.99. They're down to $59.99 at the moment.

I still have no need for any more so I'm not ordering any more. I've used them some of the time when I got out along w/sometimes some SupplyAID KN95 masks (no idea if they're any good, got the long ago when there were shortages of N95 masks). So far, I haven't had any bands break on either nor any tears/holes.

 

[nwdiver]

FYI for anyone looking for N95 masks, these are usually in stock whenever I check for $109.99. They're down to $59.99 at the moment.

I still have no need for any more so I'm not ordering any more. I've used them some of the time when I got out along w/sometimes some SupplyAID KN95 masks (no idea if they're any good, got the long ago when there were shortages of N95 masks). So far, I haven't had any bands break on either nor any tears/holes.

Have you considered a P100 half-mask? The mask is washable and likely lasts years. Even the filters could last for years. From what I've read they actually get more effective over time... just harder to breathe through. I was wearing a P100 half-mask installing solar due to close proximity to other workers. The mask was... gross after 6 hours. I just removed the filters and washed it with some mild soap... good as new.

 

[AlanSubie4Life]

From what I've read is that a COVID infection that starts in the eyes would initially display as conjunctivitis which doesn't appear to be very common with COVID patients.

It can, but my understanding is not necessarily. There is a direct path from the eyes to the nose, in any case. You don’t want coronavirus in your eyes. It’s far more of a risk than fomite transmission as far as I can tell (which seems pretty limited).

In any case, Fauci recommended it, months ago, and medical workers also invariably wear eye protection.

Additionally, it is very cheap - cheaper than quality masks.

I could be wrong about this being a common path, but I think it is well worth it. This is a contagious virus (and getting more contagious, apparently) and it’s completely reasonable to think that this mode of transmission is possible. I would guess if you are wearing an N95 or P100 respirator without eye protection, the transmission by eye may become significant relative to other means. But who knows.

 

[FoverM]

COVID-19 hit my entire household, even though we were cautious

Is this virus different from others in this regard? I ask because we've all read of these wildfire events where everyone gets it at one time. There was the funeral in south GA, the sisters in San Antonio, etc.

I personally know of two of wildfire/superspreader events. My wife's nephew got married in Dec in TX (we flew there to attend). The bride+groom come back from their honeymoon and the immediate family (mom, dad, brother, etc.) helped them move into a place for a few days. Bride goes to work and the next day her boss says his son just tested positive. Bride develops symptoms a couple of days later, after everyone had left. Over the next week, every single person involved (six total) tested positive. Symptoms ranged from nothing to a cold to the flu. All recovered.

 

[AlanSubie4Life]

Is this virus different from others in this regard?

It’s a novel virus so no one has any natural or pre-existing immunity (cross reactive tcells are not helpful here).

And additionally it seems to be inherently quite contagious. Hard to separate that from the novel part. But it’s not unusual for viruses to be different from each other in this regard.

 

[JRP3]

Have you considered a P100 half-mask? The mask is washable and likely lasts years. Even the filters could last for years. From what I've read they actually get more effective over time... just harder to breathe through. I was wearing a P100 half-mask installing solar due to close proximity to other workers. The mask was... gross after 6 hours. I just removed the filters and washed it with some mild soap... good as new.

One thing I noticed on Amazon were complaints of possible fake replacement filters so be careful where you order from. Some of the pink 2097 filters were suspect, I went with the grey 2297 which are supposed to be easier to breath through and were from the 3M store on Amazon https://www.amazon.com/gp/product/B009POHH94

 

[NikolaACDC]

This study is a preprint and has not been certified by peer review

Nearly a third of Covid patients return to hospital within 5 months - new study explained

"New research has found that almost a third of hospitalised coronavirus patients return to hospital within five months, while one in eight die.
The research, conducted by Leicester University and the Office for National Statistics (ONS), looked at the outcomes for 47,780 people who were hospitalised with coronavirus during the first wave.
Of this group, they found that 29.4 per cent returned to hospital within 140 days, with 12.3 per cent of the total patients dying.
The current cut-off for attributing a death to coronavirus is 28 days, so the findings may indicate that more people are dying of the disease than indicated by statistics.
“People seem to be going home, getting long-term effects, coming back in and dying. We see nearly 30 per cent have been readmitted, and that’s a lot of people.
...
Commenting on the study via Twitter, Christina Pagel, director of the clinical operational research unit at University College London said: “This is such important work. Covid is about so much more than death. A significant burden of long-term illness after hospitalisation for Covid.”

---
Link to pre-print study here
Epidemiology of post-COVID syndrome following hospitalisation with coronavirus: a retrospective cohort study

Conclusions: Individuals discharged from hospital following COVID-19 face elevated rates of multi-organ dysfunction compared with background levels, and the increase in risk is neither confined to the elderly nor uniform across ethnicities. The diagnosis, treatment and prevention of PCS require integrated rather than organ- or disease-specific approaches. Urgent research is required to establish risk factors for PCS.
-------------------------
More proof that it's a good idea not to get it, even if you're in a low risk group.

 

[nwdiver]

It can, but my understanding is not necessarily. There is a direct path from the eyes to the nose, in any case. You don’t want coronavirus in your eyes. It’s far more of a risk than fomite transmission as far as I can tell (which seems pretty limited).

In any case, Fauci recommended it, months ago, and medical workers also invariably wear eye protection.

Additionally, it is very cheap - cheaper than quality masks.

I could be wrong about this being a common path, but I think it is well worth it. This is a contagious virus (and getting more contagious, apparently) and it’s completely reasonable to think that this mode of transmission is possible. I would guess if you are wearing an N95 or P100 respirator without eye protection, the transmission by eye may become significant relative to other means. But who knows.

Viruses are.... weird. I read 'spillover' about animal infections crossing to humans. There's one virus 'Hendra' that is SUPER-lethal in horses and humans. Flying foxes are the carrier. Researchers discovered that horses can easily catch it from the foxes and humans can easily catch it from horses but no human has ever been documented catching it from a Flying Fox despite people working in rehab facilities with infected foxes... getting scratched... inhaling fomites laden with feces and urine... etc. Humans require a higher inoculum than horses and horses have a SIGNIFICANTLY higher viral load than foxes... So it's entirely possible that the lungs are really the only viable route for transmission because that's the only way to get a sufficient inoculum for a COVID infection to take hold.

 

[AlanSubie4Life]

So it's entirely possible that the lungs are really the only viable route for transmission because that's the only way to get a sufficient inoculum for a COVID infection to take hold.

I hope that's true, but we currently have no way to know. They should try infecting some monkeys via the eyes, I suppose.

Personally, I feel that it is likely that transmission can occur via the eyes - and apparently the experts at least think that it is possible, as well. Of course, physically, it's MUCH more likely that you will inhale a virus into your lungs - you're gathering a huge amount of air, whereas eyes will only serve as a path of infection if a virus happens to land in them. But once you cut off that path to the lungs...

The idea of minimum infectious dose and a certain inoculum is widely debated in the literature, from what I understand. I suspect it is probabilistic (what else would it be...everything is a probability...). But there may be some threshold due to natural innate immune responses...hard to know how the system really works. Of course, the more you get inoculated with, the more likely you are to become infected.

It's not a big deal to cover the eyes, in any case, so I just do it, and I recommend it to everyone. There's not much downside (they're about $2), and they're great, because if they fog up, that means your N95 mask is not fitted properly, so they also help check for proper fit of your PPE.

 

[Dave EV]

Everyone should be wearing N95 (with surgical over a vented N95 if that is all that is available). And good wraparound eye protection.

FWIW - even in hospitals, while there is 100% mask compliance, most are just wearing surgical masks and very few wearing face shields on top of that. The one I had to visit this weekend also had additional air filtration.

With the additional COVID safety measures in place, it was far safer than your typical store with questionable air filtration and circulation not to mention unrestricted hordes of people roaming around, but not risk-free.

 

[JRP3]

There's not much downside (they're about $2)

Which ones are you using, and do they fit over glasses?

 

[MXLRplus]

We bought a case of full face protectors.
Yes they fit over both glasses and goggles.
Easiest source = Amazon. Costco and Sam's Club used to have them as well.

However - Nobody wants to use them.

 

[AlanSubie4Life]

Which ones are you using, and do they fit over glasses?

I have a couple different types, but usually I'm wearing my P100 full-face (which is better). But when I go to pick up coffee from the drive-thru, I wear a pair from Harbor Freight, or similar (mostly because that gives me most of the desired protection, and it doesn't matter if they get scratched up). I wear contacts, so fitting over glasses is not a concern for me.

Glasses (or sunglasses) alone probably provide a significant amount of protection from droplets, but obviously that would depend on the style. It's really about degree of protection desired. Glasses are like an 80 or 90% solution, probably, which is huge. It's way better than not having anything to stop stray droplets. Obviously will do very little for true aerosols.

There's a huge variety on Amazon, with increasing degrees of wraparound protection.

FWIW - even in hospitals, while there is 100% mask compliance, most are just wearing surgical masks and very few wearing face shields on top of that. The one I had to visit this weekend also had additional air filtration.

Yes, but they do have substantial pre-screening questions, at least in my experience. I wonder about the protections in place at COVID wards - it's more appropriate to use that as the metric, if your intent is to avoid infection when you are in contact with someone with COVID. (I judge my level of PPE use assuming I am completely surrounded by people with COVID, similar to a COVID ward - that has to be the assumption - otherwise I'll slip into ineffective half measures.) I just assume every single individual I encounter has COVID and act accordingly. My objective is to have as close to zero chance of infection as possible.

 

[jerry33]

I have a couple different types, but usually I'm wearing my P100 full-face (which is better). But when I go to pick up coffee from the drive-thru, I wear a pair from Harbor Freight, or similar (mostly because that gives me most of the desired protection, and it doesn't matter if they get scratched up). I wear contacts, so fitting over glasses is not a concern for me.

Glasses (or sunglasses) alone probably provide a significant amount of protection from droplets, but obviously that would depend on the style. It's really about degree of protection desired. Glasses are like an 80 or 90% solution, probably, which is huge. It's way better than not having anything to stop stray droplets. Obviously will do very little for true aerosols.

There's a huge variety on Amazon, with increasing degrees of wraparound protection.



Yes, but they do have substantial pre-screening questions, at least in my experience. I wonder about the protections in place at COVID wards - it's more appropriate to use that as the metric, if your intent is to avoid infection when you are in contact with someone with COVID. (I judge my level of PPE use assuming I am completely surrounded by people with COVID, similar to a COVID ward - that has to be the assumption - otherwise I'll slip into ineffective half measures.) I just assume every single individual I encounter has COVID and act accordingly. My objective is to have as close to zero chance of infection as possible.

For around $200 plus $50 for the filters, you can get one of these Honeywell respirators. It appears glasses should be no problem, but they only protect you from others, not others from you.


EDIT: No idea why the font size is so large.

 

[madodel]

Yes, but they do have substantial pre-screening questions, at least in my experience. I wonder about the protections in place at COVID wards - it's more appropriate to use that as the metric, if your intent is to avoid infection when you are in contact with someone with COVID. (I judge my level of PPE use assuming I am completely surrounded by people with COVID, similar to a COVID ward - that has to be the assumption - otherwise I'll slip into ineffective half measures.) I just assume every single individual I encounter has COVID and act accordingly. My objective is to have as close to zero chance of infection as possible.

According to my wife if she has to see a COVID+ patient it is full PPE including a single use N95 mask, glasses/shield, gown, gloves. And the patient has to wear a mask as well. The problem is for patients who aren't tested or initially test negative but then later test positive. There is no way to treat every patient as COVID+ because there could never be enough masks/gowns/gloves. So far she has been notified 3 times of that happening. For non-COVID+ patients it is just both she and patient wearing a mask. Though she wears a surgical mask over a cloth mask all the time (EDIT: excepting when dealing with a COVID+ patient when she wears an N95, cloth and surgical mask. I don't know how she breaths.). And she received her second Pfizer dose last week so she now has "super powers". We shall see. Some how she has managed to be COVID- for 10+ months.

 

[AlanSubie4Life]

It appears glasses should be no problem,.

It’s a big problem. They break the seal around the eyes. And the way these work, they draw in breath from the eye piece (to prevent fogging), which normally comes in via a couple one-way valves from the filters. If you break that face seal, which the glasses ear pieces will do, you will get unfiltered air directly from the outside. The seal around the eyes is critical.

but they only protect you from others, not others from you.

Yes, I have found that with a surgical and good rubber bands I can create a seal around the exhaust which is tighter than a surgical would be on anyone’s face, and the exhaust would pass entirely through the surgical mask fabric. So that seems safe enough. However, they will not allow use in medical establishments. So there (on the rare occasions I have to go) I have to resort to N95 valved plus surgical, and safety glasses plus face shield.