General Coronavirus chit chat thread - non-travel specific

[Flashback]

I think it’s a mixture of people getting used to the virus and starting to think it’s not that bad and also natural “it won’t happen to me”. Seeing it here in Australia where people seem to think it’s all over . Of course much worse over there

it’s going to be a long miserable winter for the Northern Hemisphere but hopefully in a few months the vaccine will make a difference and Spring and Summer will be normal. Stay safe just for a few more months!

Just found out another 2 people in my immediate circle have tested positive in the last few days. It's spreading like wild fire now. Fortunately, they seem to be relatively OK so hopefully that doesn't change.

 

[Pushka]

Just found out another 2 people in my immediate circle have tested positive in the last few days. It's spreading like wild fire now. Fortunately, they seem to be relatively OK so hopefully that doesn't change.

I'm waiting for similar news from son, given they live in Kent county where this wildfire one started. Occurred to me that's the entry from Europe by truck so maybe it just didn't start in the UK.

 

[Flying mermaid]

Just found out another 2 people in my immediate circle have tested positive in the last few days. It's spreading like wild fire now. Fortunately, they seem to be relatively OK so hopefully that doesn't change.

The good thing is they know so much more about how to treat it and stop things like the Cytokines storms that were killing people early on. Still rather not get it as people are still dying, but at least outcomes are better now.

 

[Flying mermaid]

I'm waiting for similar news from son, given they live in Kent county where this wildfire one started. Occurred to me that's the entry from Europe by truck so maybe it just didn't start in the UK.

UK and South Africa are doing much more in the way of genomic analysis so they are the ones finding the variants and then being blamed for it!

hope your son stays safe. I am counting days until Dr FM gets her vaccination and just been hassling son in San Francisco about being careful

 

[Flashback]

The good thing is they know so much more about how to treat it and stop things like the Cytokines storms that were killing people early on. Still rather not get it as people are still dying, but at least outcomes are better now.

Hospitals are under pressure again with Ambos lined up all the way out the usual waiting spots. Part of the issue may be reduced capacity due to spacing beds further apart for social distancing purposes.

 

[Flying mermaid]

While they know a lot more about the virus, the treatments have not really changed, and any changes in clinical management have really been "tinkering at the edges".

There are no new treatments for Covid which is based on strong evidence. At best any evidence is at the level of A3: "Strong expert opinion". Mostly B3 which is moderate strength expert opinion (which means there are some disagreement)
Nothing in the A1 category which is Strong evidence from one or more randomised controlled trials with clinical outcomes/lasboratory endpoints.

...........

Does it have height position memory settings?

I was looking at ergomotion.com.au

What about things like using steroi_s to stop the cytokine storms? There were people dying from strokes early on and I understood the steroi_ treatments helped with that. Is Remdesivir used in Australia? I remember at the Melbourne briefings the CHO saying Australia had obtained Remdesivir and that could be used when necessary?

while there may not be any silver bullets, the understanding of the disease and how to treat it has improved exponentially since April and you would hope is resulting in better outcomes. Or so Dr FM tells me from London.

 

[Quickstatus]

What about things like using steroi_s to stop the cytokine storms?

Cytokine storms have been around for other illnesses - See 1918 influenza pandemic. Also seen in SARS 1, MERS and Bird Flu and many of the annual deaths from Influenza.

steroi_ management of cytokine storms has also been around for a long time as well.

New anticytokine storm meds (anti-cytokine receptor blockers) are all in R&D at the moment.
Nothing new that is being used widely at the moment. Whatever is being used is Mainly experimental

Basically a cytokine storm is a massive overreaction by the immune response.

the understanding of the disease and how to treat it has improved exponentially

Apart fro a better understanding of the disease, the Improvements have been mainly in the formulation and streamlining of treatment regimes. Essentially the treatment is more proactive instead of reactive and therefore a little ahead of the curve - with whatever treatment is available.

 

[Flying mermaid]

Cytokine storms have been around for other illnesses - See 1918 influenza pandemic. Also seen in SARS 1, MERS and Bird Flu and many of the annual deaths from Influenza.

steroi_ management of cytokine storms has also been around for a long time as well.

New anticytokine storm meds (anti-cytokine receptor blockers) are all in R&D at the moment.
Nothing new that is being used widely at the moment. Whatever is being used is Mainly experimental

Basically a cytokine storm is a massive overreaction by the immune response.

Yes I know, but when this first hit they lost a lot of people - particularly at the younger end - to strokes and now they seem aware of it and can manage it better. Hence my statement about better outcomes. Goodness me, lets have some positivity and optimism here. It all so gloomy we need some optimism that things are getting better!

 

[HappyFlyerFamily]

And hubby went to RTA to redo his drivers license today and they dont take a new photo. They use the old (5yr) photo from his current license - weird.

Theyre also taking temps at the RTA now, I was there about a month ago and it was no requirement for masks, I was one of the few inc staff wearing one.

I guess you are in NSW

If what is foreshadowed yesterday becomes reality with possibly 3 unknown cases scattered across Sydney/Wollongong there might be a change in that policy.

 

[Quickstatus]

Goodness me, lets have some positivity and optimism here

I don't think at the coalface there is much optimism especially when the services are stretched.
The most important factor in coming out of a Covid infection is Time. Basically all Covid treatments are just buying Time. For most people its time in quarantine and self isolation so the body can develop the antibodies. For others who require ICU, the ICU buys time (ventilators, steroi_s, other treatments) until such time as the patient is rid of the infection or dies.

The problem with time is that it depends on supply of such treatments outstripping demand. Currently in a lot of places these services are being stretched. Alberta Canada is activating their military to build field hospitals.

The overall result is as you say a bit more positive with a But.
The overall mortality in % terms for ICU admitted Covid pts month on month seem to be improving but the data for that that I have preceded this "second wave". Essentially the improvement was in May June July, Summer months in NH and also the quiet period between First and second waves.

 

[Quickstatus]

Re Remdesivir
The Jury is still out on this one. Some optimism though
Problem is the evidence is so abbreviated and some of the statistical analysis was designed post hoc (which is problematic)
Many evidence is conflicting. China evidence says yes but other evidence says no.
Some studies point to harm
Other studies do not reach statistical significance

Currently not recommended for pts who don't require respiratory support.
Used in the rapidly deteriorating pt and may be of benefit if given early enough.

better outcomes

Apart from what I said previously, the data/evidence is not out for "better outcomes" (especially those admited to ICU) with the current second wave. Will have to wait several months for that. Outcomes are essentially statistical numbers based on hard data. So we really cannot say what the outcomes are (whether better or worse) until the data is crunched.

 

[Pushka]

Re Remdesivir
The Jury is still out on this one. Some optimism though
Problem is the evidence is so abbreviated and some of the statistical analysis was designed post hoc (which is problematic)
Many evidence is conflicting. China evidence says yes but other evidence says no.
Some studies point to harm
Other studies do not reach statistical significance

Currently not recommended for pts who don't require respiratory support.
Used in the rapidly deteriorating pt and may be of benefit if given early enough.


Apart from what I said previously, the data/evidence is not out for "better outcomes" (especially those admited to ICU) with the current second wave. Will have to wait several months for that. Outcomes are essentially statistical numbers based on hard data. So we really cannot say what the outcomes are (whether better or worse) until the data is crunched.

Sometimes hope, even if seen with somewhat rosy glasses, is what people need just to hang in there, during periods when close family members are at risk.

 

[Flying mermaid]

Sometimes hope, even if seen with somewhat rosy glasses, is what people need just to hang in there, during periods when close family members are at risk.

Totally agree - it’s all very well being miserable and gloomy and saying everything is terrible, but when you have a daughter working in a London hospital and a son in California where hospitals are on the point of collapse a bit of optimism about better outcomes is the only thing that keeps you going.

edit and a brother in his mid 70s about to fly back to the South African disaster

 

[tgh]

It is not often that I feel powerless as there is a solution to almost everything.
There is no sensible solution to #1son+2 locked down in SFO with the wheels falling off.
I guess he could buy a yacht, sail it home to brisvegas and dare them to send him back…

 

[Flying mermaid]

It is not often that I feel powerless as there is a solution to almost everything.
There is no sensible solution to #1son+2 locked down in SFO with the wheels falling off.
I guess he could buy a yacht, sail it home to brisvegas and dare them to send him back…

I know exactly how you feel . Did you listen to the interview with an Australian doctor volunteering at a hospital LA? He had come out of retirement to help. His description of the state of the hospital, run out of Ventilators, having to start just providing palliative care etc, was very sad. Fortunately the San Francisco area is a little better than Southern California and the people in that area are more likely to wear masks etc. Latinos are being particularly badly hit because they are the ones still providing services

 

[tgh]

Of course my concerns are just those of an old worrywart parent and to that end worth nil.
They are both still working , careers intact and very well paid.
I suspect he would choose to sit tight even if he could come home...

 

[Quickstatus]

Sometimes hope, even if seen with somewhat rosy glasses

For sure. Medicos would rather say it looks bad and the patient “defies the odds” rather than the other way round.

 

[drron]

The best you can say with Remdesivir is that it shortens tine in hospital but even that is not universally accepted.There is very little evidence it reduces mortality or the need for a ventilator.
here is a summary in the BMJ a month ago.

Covid-19: What now for remdesivir?

The spectre of past pandemics looms large over remdesivir, one of the first drug treatments for covid-19. With a WHO trial finding little benefit, Jeremy Hsu asks if the expensive drug is just Tamiflu redux? It’s a cautionary tale worth remembering amid the coronavirus pandemic. Starting in...

www.bmj.com

 

[Flying mermaid]

Just seen a congressman elect from Louisiana has died of COVID. He was only 41. He announced he was positive on the 18th and was due to take his seat on Sunday.

Louisiana has fared very badly with Mardi Gras being an early super spreader event

 

[Quickstatus]

Yes I know, but when this first hit they lost a lot of people - particularly at the younger end - to strokes and now they seem aware of it and can manage it better.

Wasn’t sure about this one so I did a “phone a friend”

There is little consensus as to the cause of stroke in the younger ICU population with Covid. They don’t have the usual diseased arteries of the older population.
There are theories: cytokines storm or a pro inflammatory statements being one of them, other include an increased tendency for blood clots to form, another is injury of the blood vessel walls by the virus.

Each treatment is different including antivirals, anti clotting, anti inflammatory (anticytokines or steroi_s).

I get that people want to hold on to whatever morsel of good news there is. But I would caution that a lot of “news” are not based on robust analyses.