Announcement

Collapse
No announcement yet.

Medical Discussion of Coronavirus

Collapse
X
 
  • Time
  • Show
Clear All
new posts

  • So hello to all—sorry haven’t posted in a while, but have been super busy with call, along with some practice drama (one day I will post about that in another forum)
    Anyway, still seeing a few Covid pts per day, but definitely less frequent.
    Have had several more deaths—mostly those that have been on the vent for over 2-3 wks.

    Nothing new as far as treatment goes-still doing the usual stuff—however we have been using steroids more initially—will see what happens there. There are some good reports from some ID docs in NYC having luck with initial steroid use. A podcast I have been listening to is “This week in Virology “

    Never in a million years would I listen to stuff that has to do with viruses. Bringing out my inner nerd.
    haha.

    For those on call, hope it has been a good weekend.
    Thanks for all y’all do.

    Comment


    • remdesivir, anyone think this will be a game changer? Our ICU guys seem to think it might be. I don’t know, but some of our patients anecdotally seem to be doing better. Studies ongoing.

      Comment


      • Originally posted by Tangler
        remdesivir, anyone think this will be a game changer? Our ICU guys seem to think it might be. I don’t know, but some of our patients anecdotally seem to be doing better. Studies ongoing.
        I think the correct answer is that it's too early to tell. What I've read in the last week is that it may help a bit, but it's not really a "game changer".

        Comment


        • I'm curious about what all the older/vulnerable people here will do with regard to isolation. I assume things will begin to open up slowly before vaccine or effect treatment is available. But regardless of what everyone else does, you can always isolate yourself if you want. So what do you do if you are high risk, but you have the means to isolate indefinitely (i.e., plenty of savings and no need to work outside house)? What is your personal endpoint? Do you wait for the vaccine even if it takes a couple of years?

          Comment


          • remdesivir - helpful it seems as people were improving enough on the randomized trial that folk were guessing -- but who knows until the study is published -- probably now that we've seen improvement at the hospitalization arena,

            There will be a follow on with new sx COVID+ and treatment to reduce overall VL and ultimately hope on the cytokine response. -- I'm guessing it'll be like Tamiflu - +sx; +covid ; get remdesivir. <72 hours.

            Isolation - my parents - total home isolation and full mask/gloves when going out of the house since old AND with comorbid issues; my in-laws mother is younger and goes out a lot more - but full mask and gloves too. but go out and interacts with us too; so a lot more contact.

            Comment


            • Originally posted by Max Power

              If it is so essential to shut down the cities and healthcare to focus on basically nothing but Corona to prevent your anarchy scenario, then why are Tokyo and Cairo and Dubai and other cities bigger and more dense with international airports busier than NYC doing okay?
              Tokyo is definitely not doing 'okay'.

              Hospitals in Japan are increasingly turning away sick people as the country struggles with surging coronavirus infections and its emergency medical system collapses.




              Comment


              • Originally posted by AR

                Tokyo is definitely not doing 'okay'.

                Hospitals in Japan are increasingly turning away sick people as the country struggles with surging coronavirus infections and its emergency medical system collapses.
                Max Power - Shaka, when the walls fell

                AR - Sokath, his eyes uncovered!

                Comment


                • Originally posted by pulmccMD
                  So hello to all—sorry haven’t posted in a while, but have been super busy with call, along with some practice drama (one day I will post about that in another forum)
                  Anyway, still seeing a few Covid pts per day, but definitely less frequent.
                  Have had several more deaths—mostly those that have been on the vent for over 2-3 wks.

                  Nothing new as far as treatment goes-still doing the usual stuff—however we have been using steroids more initially—will see what happens there. There are some good reports from some ID docs in NYC having luck with initial steroid use. A podcast I have been listening to is “This week in Virology “

                  Never in a million years would I listen to stuff that has to do with viruses. Bringing out my inner nerd.
                  haha.

                  For those on call, hope it has been a good weekend.
                  Thanks for all y’all do.
                  Thanks for the hard work! I’ve been impressed with steroids and remdesivir and uncoupling PEEP from FiO2. Very unimpressed with hydroxychloroquine/zithro. Mixed results with tocilizumab.

                  Comment


                  • Originally posted by StarTrekDoc
                    Max Power - Shaka, when the walls fell

                    AR - Sokath, his eyes uncovered!
                    Yikes even I had to Google that one.

                    so remdesivir. Say it does show some promise. Is it something that can be obtained in large quantity? Sounds expensive.

                    Comment


                    • ^^^ I'm sure there is already a run on Remdesivir by pharmacies, hospitals, & doctors.

                      Gilead themselves are limiting distribution. To avoid running out during clinical trials.
                      $1 saved = >$1 earned. ✓

                      Comment


                      • Originally posted by Cubicle
                        ^^^ I'm sure there is already a run on Remdesivir by pharmacies, hospitals, & doctors.

                        Gilead themselves are limiting distribution. To avoid running out during clinical trials.
                        Hard to make a run on something that's not in production for therapeutics....unless it's Gilead stock

                        Comment


                        • ^^^ You're right. I was mistaken in reading another medicine was publicly available.
                          $1 saved = >$1 earned. ✓

                          Comment


                          • Originally posted by AR
                            I'm curious about what all the older/vulnerable people here will do with regard to isolation. I assume things will begin to open up slowly before vaccine or effect treatment is available. But regardless of what everyone else does, you can always isolate yourself if you want. So what do you do if you are high risk, but you have the means to isolate indefinitely (i.e., plenty of savings and no need to work outside house)? What is your personal endpoint? Do you wait for the vaccine even if it takes a couple of years?
                            Great question, which I have thought a lot about. I’m 61, though healthy with no other risk factors. I personally know more than 20 people with COVID-19, including 4 patients in my practice. There are a lot of cases in my area. I would like to live to a ripe old age, so my goal is a risk of as close to zero as possible. I am a psychiatrist doing primarily psychotherapy with some psychopharm, and all of my patients, mostly stable long term relationships, are continuing to see me through telemedicine. I get food delivered and have no need to go out. I live in the outer reaches of NY metro but my house borders a large beautiful forest where I hike daily.
                            If it were up to me, I would opt to stay home under these perfectly acceptable conditions until there is a vaccine or a highly effective therapeutic strategy.

                            Only one glitch. At some point, and I expect it will be long before there are very low risk options, the schools will reopen. I have a child in 11th grade. Refusing to allow her to return to school does not seem like an option. So I will not be able to remain isolated for the duration. I would if I could though. No question.
                            My Youtube channel: https://www.youtube.com/channel/UCFF...MwBiAAKd5N8qPg

                            Comment


                            • This is where intermittent serology screening in population and aggressive contact PCV-Swab testing would be beneficial. Get both you and her serology tested. HOPEFULLY, IgG positive already and if PPV is sufficient enough in your area, you're as good as possible situation beyond socially distancing from your own high schooler....typing as my current 11th grader snapchats 3 ft away on the same couch next to me.

                              Comment


                              • Originally posted by StarTrekDoc
                                This is where intermittent serology screening in population and aggressive contact PCV-Swab testing would be beneficial. Get both you and her serology tested. HOPEFULLY, IgG positive already and if PPV is sufficient enough in your area, you're as good as possible situation beyond socially distancing from your own high schooler....typing as my current 11th grader snapchats 3 ft away on the same couch next to me.
                                It’s a good idea, though we’ve been isolating since March 10 - none of us have been out at all - so I think it’s likely none of us have been exposed yet. I’m just crossing fingers that by sometime probably early this summer (she has a neuroscience research gig she really wants lined up), there’s some agent beneficial early in the course of illness that can reduce the severity and lethality somewhat. May be a pipe dream.
                                My Youtube channel: https://www.youtube.com/channel/UCFF...MwBiAAKd5N8qPg

                                Comment

                                Working...
                                X
                                😀
                                🥰
                                🤢
                                😎
                                😡
                                👍
                                👎