From Facebook

Here the latest on NSAIDs and acute respiratory infections from the The Centre for Evidence-Based Medicine at Oxford, not withstanding of the recent weasel worded sound bites.

"Verdict: there is a need for caution when using NSAIDs in the context of acute respiratory infections (ARI). Pre-existing medications and conditions need to be taken account of when deciding to prescribe NSAIDs for symptomatic ARI. The lowest effective dose should be prescribed for the shortest period of time. Parenteral use of NSAIDs during an ARI should be avoided.

NSAIDs do not significantly reduce total symptoms or duration of respiratory infections.

Does the use of NSAIDs worsen outcomes in respiratory infections?

We found five studies that link the use of NSAIDs to worsening outcome, all are observational and are difficult to interpret as they may suffer from confounding by indication. patients with more severe disease and more severe symptoms may take more NSAIDs which does not necessarily cause the disease.

All five studies suggest that NSAIDs worsen outcomes, which reinforces the need to take the lowest effective dose for the shortest period of time.

Do NSAIDs Impact on overall mortality in ARI? Answer available 18th March

Do NSAIDs increase renal problems and or hypertension in ARI?Answer available 18th March

Latest from Andi Burkert. US Doubling Time slowly starting to climb. Bigger is Moā€™better. 3 is roughly exponential-not good.

Our scary near future, if nothing changes. Do your part! Service grants citizenship (I wish!)

1 million infected in each European Country and the US at the beginning of April with more than 200,000 new infections every day.

10 million sick each country around April 12.

At a 1% mortality rate(case fatality rate), 100,000 will be dead per country. (CFR 3.4, over 5 in Italy)

At a projected 20% hospitalization rate will need 2,000,000 beds with around 400,000 ventilators (20%).

"The 2019 coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading throughout the world. In the United States, the disease is expected to infect 20-60 percent of the population before the pandemic finishes its course. The recent experience in Italy has highlighted the critical need to ensure adequate capacity of inpatient and intensive care beds for what is likely to be a surge of seriously ill patients.

To assess the capacity of U.S. hospitals to care for the impending number of hospitalized patients, we merged hospital infrastructure data from the 2018 American Hospital Association (AHA) Annual Survey and the American Hospital Directory. We calculated average inpatient and ICU occupancy rates from annualized inpatient bed days.

We used population estimates from the U.S. Census American Communities Survey to project likely numbers of infected patients, hospitalization rates and ICU utilization rates based on existing data from recently published reports.

We adjusted these rates across communities by proportion of people who were age 65 or over, as data suggests that hospitalization rates vary by age.

We used a middle-level estimate of COVID-19 infection rate of 40 percent and assumed lengths of stay based on published studies.

We calculated the capacity gap between current bed occupancy and anticipated COVID-19 demand assuming six, 12 and 18 month transmission curves. In our primary model, we made the very aggressive assumption that 50 percent of currently occupied beds could be freed up to care for COVID-19 patients.

Nationally, based on the lower 40 percent prevalence of COVID-19 over the course of the pandemic, we estimate that 98,876,254 individuals will be infected, 20,598,725 individuals will likely require hospitalization and 4,430,245 individuals will need ICU-level care. " [2]

1( in very 8 or 9 wonā€™t make it and any of the survivors of hospitalization with ARDS and secondary pneumonia will look at long term lung damage, heart damage, and/or kidney damage.

(Imperial College in London recently aggregated worldwide data to build estimates that may provide a truer picture of the actual fatality rate.

Their report estimates an overall fatality rate of 0.9%, which swells to 9.3% for cases involving patients 80 and older. They also calculated a 2.2% mortality rate for people in their 60s and a 5.1% rate for those in their 70s.

Make this clear to everyone!!! And take social distancing serious!

Wash your filthy hands, donā€™t cough or sneeze uncovered, and keep your sorry Typhoid Mary butts at home.

Because, you spread this particular virus for days before you know your sick!!

If we donā€™t knock it out cold now, it will be back this next winter with a vengeance.

[1] Flattening the COVID-19 Curves - Scientific American Blog Network

[2] https://www.healthaffairs.org/do/10.1377/hblog20200317.457910/full/

Our scary near future, if nothing changes.

1 million infected in each European Country and the US at the beginning of April with more than 200,000 new infections every day.

10 million sick each country around April 12.

At a 1% mortality rate(case fatality rate), 100,000 will be dead per country. (CFR 3.4, over 5 in Italy)

At a projected 20% hospitalization rate will need 2,000,000 beds with around 400,000 ventilators (20%).

"The 2019 coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is rapidly spreading throughout the world. In the United States, the disease is expected to infect 20-60 percent of the population before the pandemic finishes its course. The recent experience in Italy has highlighted the critical need to ensure adequate capacity of inpatient and intensive care beds for what is likely to be a surge of seriously ill patients.

To assess the capacity of U.S. hospitals to care for the impending number of hospitalized patients, we merged hospital infrastructure data from the 2018 American Hospital Association (AHA) Annual Survey and the American Hospital Directory. We calculated average inpatient and ICU occupancy rates from annualized inpatient bed days.

We used population estimates from the U.S. Census American Communities Survey to project likely numbers of infected patients, hospitalization rates and ICU utilization rates based on existing data from recently published reports.

We adjusted these rates across communities by proportion of people who were age 65 or over, as data suggests that hospitalization rates vary by age.

We used a middle-level estimate of COVID-19 infection rate of 40 percent and assumed lengths of stay based on published studies.

We calculated the capacity gap between current bed occupancy and anticipated COVID-19 demand assuming six, 12 and 18 month transmission curves. In our primary model, we made the very aggressive assumption that 50 percent of currently occupied beds could be freed up to care for COVID-19 patients.

Nationally, based on the lower 40 percent prevalence of COVID-19 over the course of the pandemic, we estimate that 98,876,254 individuals will be infected, 20,598,725 individuals will likely require hospitalization and 4,430,245 individuals will need ICU-level care. " [2]

1 in very 8 or 9 wonā€™t make it and any of the survivors of hospitalization with ARDS and secondary pneumonia will look at long term lung damage, heart damage, and/or kidney damage.

Imperial College in London recently aggregated worldwide data to build estimates that may provide a truer picture of the actual fatality rate.

Their report estimates an overall fatality rate of 0.9%, which swells to 9.3% for cases involving patients 80 and older. They also calculated a 2.2% mortality rate for people in their 60s and a 5.1% rate for those in their 70s.) [3]

Make this clear to everyone!!! And take social distancing serious!

Wash your filthy hands, donā€™t cough or sneeze uncovered, and keep your sorry Typhoid Mary butts at home.

Because, you spread this particular virus for days before you know your sick!!

If we donā€™t knock it out cold now, it will be back this next winter with a vengeance.

(Do your part! Kill Bugs!!.Service grants citizenship, Iā€™m doing my part! Do you want to know more ?(I wish!)) [4]

[1] Flattening the COVID-19 Curves - Scientific American Blog Network

[2] https://www.healthaffairs.org/do/10.1377/hblog20200317.457910/full/

[3] https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

[4] Starship Troopers, Robert Heinlein, 15 May 1987 978-0441783588,

8 posts were merged into an existing topic: Articles relating to COVID 19

I you sew, local EMS and hospitals may need your help. Critical mask shortage. CDC approves surgical mask for most applications.

Hey all yā€™all, wishing the best for you and your loved ones

-Raise your glasses with me, brothers and sisters.

-Hereā€™s to cheating. For if you cheat, may you cheat death.

-Hereā€™s to stealing. For if you steal, may you steal a fair ladyā€™s heart.

-Hereā€™s to drinking. For if you drink, may you drink with me!

-Hereā€™s to all those whoā€™ve gone to meet their Father. May He grant them everlasting peace.

-And finallyā€¦ hereā€™s to all of you! May you all be in Heaven half an hour before the Devil knows youā€™re dead.

SlƔinte !

ZDoggMD

It always seems too soon, until itā€™s too late. Have the conversation about YOUR wishes NOW.

Save your loved ones the pain and donā€™t force the medicos down a protocol you may not wish to endure.

Hereā€™s just one of many end-of-life planning resources online: Five Wishes.

https://fivewishes.org/five-wishes-covid-19

Watch this video about what actually can happens when you tell the doctors ā€œdo everything.ā€

And this music video about end-of-life decision-making.

And this Dr. Seuss poem about making your wishes clear.

Tim Boon and Dr. Zubin Damania,

Dr Seuss does Advanced Directives.

What Are Your Wishes?

So many patients, so few masks and ventilators and antiviral meds

13 to 26 Days from infections to symptoms. About 5 days in you are infectious. Takes 2 weeks to wiggle that curve. Patience Patients!

https://jamanetwork.com/journals/jama/fullarticle/2763485

Please remember to collect your childā€™s medications from school if you are planning to keep your child at home for an exteneded period due to COVID-19 or your childā€™s school is closing. Return the medication when your child returns to school.

Letā€™s have a parade like Mardi Gras, or big parties like Spring Breakers.

For Nurse Kerry Adams, R.I.P. , and all the nurses in harmā€™s way with marginal PPE.

Please keep these surface times in mind when you touch a grocery cart, gas handle, or even let your kids go to the park. It is going to take everyone to do their part to help eliminate this virus, it canā€™t just be healthcare workers. Think of barriers to utilize when handling certain things in public. Also, if you are wearing gloves it doesnā€™t do any good if you go touching everything else with those dirty gloves.

https://www.google.com/amp/s/www.technologynetworks.com/immunology/articles/amp/antigenic-drift-vs-antigenic-shift-311044

57-Year-Old Man With Flushing and Fainting

Rayya A. Saadiq, DO, and Elizabeth B. Windgassen, MD

https://www.mayoclinicproceedings.org/article/S0025-6196(12)00945-7/pdf