Mean time in Spain

[Techdread]

Re: Mean time in Spain

It's extremely unlikely he's had Covid-19 if he hadn't travelled to Wuhan right before his symptoms.
Considering the exponential growth in infections that goes with community spread, the area where he lived would have been a hotspot of covid19 hospitizations by mid February.

It's hard to explain that this spreads so fast that is extremely unlikely that any one outside Wuhan China had this in January let alone December.

[jk]

Re: Mean time in Spain

i'm pretty sure my wife and i had covid-19 in feb. it was the sickest i'd been since having pneumonia about 30 years ago, but i had no significant fever, and kept going to work. my wife at one point had some mild breathing difficulties and low grade fever.

the last week of jan i had gone to az to meet an old friend to do some hiking together. he showed up appearing quite sick, but told me, no, he was a lot better than he had been in the prior few weeks. he had gotten ill about a wk into january- more ill than he remembered being for many years. he thought it was a bad flu. of course by the end of our trip i had started developing symptoms, and passed it to my wife when i got home.

what my friend just put together was that new year's eve and the first few days of january his son, and his son's girlfriend, were visiting him and his wife. the girlfriend was chinese and had what he thought was a mild cold. she had just returned from visiting her parents in hubei province. at the time he thought she'd left hubei "just in time" to avoid the virus. on second thought, it's likely the "cold" of that girl in her late 20's was covid-19.

i guess my only point is that, yes, people were getting the disease in january, but didn't know what they were getting.

[shiny!]

Re: Mean time in Spain

i'm pretty sure my wife and i had covid-19 in feb. it was the sickest i'd been since having pneumonia about 30 years ago, but i had no significant fever, and kept going to work. my wife at one point had some mild breathing difficulties and low grade fever.

the last week of jan i had gone to az to meet an old friend to do some hiking together. he showed up appearing quite sick, but told me, no, he was a lot better than he had been in the prior few weeks. he had gotten ill about a wk into january- more ill than he remembered being for many years. he thought it was a bad flu. of course by the end of our trip i had started developing symptoms, and passed it to my wife when i got home.

what my friend just put together was that new year's eve and the first few days of january his son, and his son's girlfriend, were visiting him and his wife. the girlfriend was chinese and had what he thought was a mild cold. she had just returned from visiting her parents in hubei province. at the time he thought she'd left hubei "just in time" to avoid the virus. on second thought, it's likely the "cold" of that girl in her late 20's was covid-19.

i guess my only point is that, yes, people were getting the disease in january, but didn't know what they were getting.

It's possible that this virus was spreading earlier and faster than is commonly believed. China (if we can believe anything coming out of China) is saying it began in mid-November.

If it was in AZ in early January, it just goes to show that most cases are mild enough to fly under the radar. The low population density out here would also slow the spread.

[jk]

Re: Mean time in Spain

It's possible that this virus was spreading earlier and faster than is commonly believed. China (if we can believe anything coming out of China) is saying it began in mid-November.

If it was in AZ in early January, it just goes to show that most cases are mild enough to fly under the radar. The low population density out here would also slow the spread.

my friend flew in from washington, dc, and i flew in from jfk. we met at the airport. so no evidence it was present in native arizonans at that time

[shiny!]

Re: Mean time in Spain

my friend flew in from washington, dc, and i flew in from jfk. we met at the airport. so no evidence it was present in native arizonans at that time

YOU brought it here! (kidding!)

[jk]

Re: Mean time in Spain

fyi -latest on unproven treatments in the outpatient setting

recommendations on ambulatory prescribing of medications with possible efficacy against COVID


Situation: Background:
Assessment:

Guidance on the outpatient prescribing of medications with possible activity against COVID-19 is required.
There are currently no FDA approved medications for treatment of COVID-19; but several readily available oral medications have demonstrated possible activity against SARS CoV-2 including hydroxychloroquine, HIV-1 protease inhibitors (e.g., lopinavir- ritonavir, atazanavir, tipranavir), and azithromycin.
None of these agents have been studied in large clinical trials (with or without placebo) to support their off label use in the ambulatory setting for the treatment/prevention of COVID 19 patients.


The use of these “re-purposed” medications in the outpatient setting is inappropriate, and will result in shortages, which will impact treatment of patients for whom these medications are indicated by FDA approval, established clinical experience, or for the severely ill inpatients with COVID-19.
Outpatient prescribing of hydroxychloroquine, HIV-1 protease inhibitors, and azithromycin should be reservedONLY for patients who have medical conditions where their use has been established and there are no other alternatives.
Recommendation as of March 23, 2020:
The prescribing of the outpatient medications should be limited as follows:

1) Hydroxychloroquine:
• Rheumatoid arthritis
• Systemic Lupus Erythematosus (SLE) & other collagen vascular diseases when appropriate
• Dermatologic manifestations of collagen vascular diseases (e.g., discoid lupus, dermatomyositis, etc.)

2) HIV-1 Protease Inhibitors:
• ART for patients with HIV-1 infection

3) Azithromycin:
• Community Acquired Pneumonia (CAP) in pregnancy or in children < 8 years of age (as doxycycline should be avoided in both groups).
• CAP therapy for patients who are allergic/intolerant to the following alternative options:
o Cefuroxime + doxycycline, levofloxacin, moxifloxacin
• Treatment of Group A pharyngitis in patients who are allergic to beta-lactams (allergic to penicillins and cephalosporins) and clindamycin
• Treatment of Chlamydia trachomatis infection
• Prophylaxis in COPD patients at risk for frequent exacerbations
• Prophylaxis in cystic fibrosis patients
• Treatment of non-tuberculous mycobacterial infections (e.g., MAC or MAI)
• Treatment / Prevention of Chronic Allograft Dysfunction S/P lung transplant
• Treatment of Bronchiolitis Obliterans Syndrome (BOS) in Patients S/P Allogenic Stem Cell Transplant

There may be additional indications for the use of these agents in other disease(s), but based upon the available evidence, the use of these agents for the treatment or prevention of COVID-19 patients is not appropriate.

We realize patients may be scared or confused given COVID-19 and the media reports of possible therapeutic efficacy of these drugs, but it is our duty to help guide our patients to the best of our ability during this challenging time.

[jk]

Re: Mean time in Spain

3/27 8 patients on vents
3/30 34 patients on vents
4/2 46 patients on vents
4/4 56 patients on vents
4/9 65
4/11 71

slowing but still rising

[Mega]

Re: Mean time in Spain

https://www.dailymail.co.uk/news/art...t-Hancock.html

[shiny!]

Re: Mean time in Spain

fyi -latest on unproven treatments in the outpatient setting

recommendations on ambulatory prescribing of medications with possible efficacy against COVID

jk: what's the source for this? Thanks.

[bpr]

Re: Mean time in Spain

jk: what's the source for this? Thanks.[/FONT]
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I reckon this is guidance to providers of a specific hospital group, not intended for general consumption.

[jk]

Re: Mean time in Spain

jk: what's the source for this? Thanks.[/FONT]
[/FONT][/COLOR]

prestigious nationally recognized medical center

[shiny!]

Re: Mean time in Spain

prestigious nationally recognized medical center

Thanks. I wasn't doubting you; just curious.

[LazyBoy]

Re: Mean time in Spain

3/27 8 patients on vents
3/30 34 patients on vents
4/2 46 patients on vents
4/4 56 patients on vents
4/9 65
4/11 71

slowing but still rising

How many vents do they have and how well distributed are they? In some regions, they may be out of vents.

Are these new people on vents daily or total?

[jk]

Re: Mean time in Spain

How many vents do they have and how well distributed are they? In some regions, they may be out of vents.

Are these new people on vents daily or total?

daily total in one 1500 bed hospital.

i don't know how many are new, how many successfully weaned from the vent, how many dead. these are the total number of patients on vents that day.