^Pernio has been seen in some patients, especially the young. Blood clots are a risk factor as well as a consequence of COVID-19. In the state of Hamburg in Germany, every single COVID-19 death was examined postmortem. All of them have other illnesses and all have blood clots.
Who are these āexpertsā and was that 10% metric formed when tests were scarce so are being prioritized by greatest risk? Intuitively it makes no sense to me that there be a goal for positive test rate, other than as a tool to ration tests. If weāre still rationing tests and donāt have enough to broadly test to know whoās infected, there can be no way to use contact tracing or quarantining to control the spread. If weāre testing enough to know who is infected to properly quarantine and control the spread, the positive test rate will almost certainly be less than 10%.
I echo the gentle request that this thread can be the place for actual medical observation. Iād like to see what the boots on the ground are observing, and not wade through the stuff that is what folks are reading and speculating about. Iām sure there could be a thread for that. 
I mainly remember from Dr Birx. She quoted what they do in AIDS which also transmit asymptomatically. I donāt think it is because the test is scarce. They basically said getting 1% positive would be wasted effort. To me, it makes sense since negative results donāt do much. Negative today doesnāt mean negative tomorrow. If negative, you didnāt learn anything. If you get 10% positive, you could think your efforts were useful 10%. Yes, some will fall through the crack but that may be good enough to sustain. Much like we canāt catch all criminals but if we catch enough, we can live peacefully. How much you would allow to fall through cracks will depend on the severity. If it is terrorists, youād catch everyone. If it is stealing, youād be ok with x%. I assume ~10% is the number they came up with. NJ testing more than 30% is clearly too many and not being tested enough. It is not what fraction of population is being tested. It is what fraction of tested come back positive. Testing 50% of people in Dakota is not the same as testing 50% of population in NY or NJ. You need to test more in NY, NJ than in ND. What you would need is to match the positive rate. If you test 50% of population and get 30% positive, you need to test more. If you test 20% of population and get 5% positives, you tested too many. No harm done other than using up resources of course but not necessary.
If anyone is interested, clotting was discussed this week on TWIV (podcast This Week in Virology)
@Nrdsb4 , my momās facility is on lockdown, with maybe a little less compliance from some of the independent living community members. But my concern remains that the virus will enter the facility from the staff, who go home to their families every night (or day, for the night shift.) Canāt do anything about that, though.
A Broadway actor at Cedars in LA had to have a leg amputated due to clotting. This was in the news. Not inside information.
I read an article on Sunday about the bruising in childrenās feet that pediatric dermatologist are seeing in the US. I sent it to my niece who has a 6 yr. old.
Alas, it appears one is not allowed on this site to post articles anymore about Covid-19ā¦
But just google and you will find it.
We have been allowing medical articles on THIS thread since people have remained civil. You can look back through this thread and find links.
This is one of the most informative āinside medicineā views Iāve seen yet (see what I did there?). Itās a must read.
https://www.nytimes.com/2020/04/20/opinion/coronavirus-testing-pneumonia.html
Basically, what this physician reports seeing is that COVID-19 pneumonia causing silent hypoxia may not cause the patient to feel all that sick with classic pneumonia symptoms for days, until it gets really bad. He suggests using pulse oximeters (which are not that expensive and available without a prescription) on COVID-19 patients and those with COVID-19-like symptoms (including people at home) to give earlier warning of silent hypoxia so that the patient can get medical assistance before it gets really bad.
Consumer Reports had an article on the subject at https://www.consumerreports.org/medical-symptoms/covid-19-pulse-oximeters-oxygen-levels-faq/ .
Been talking to a few relatives in medicine. Most are emphasizing that they are not just seeing older people in the ICUās. That itās more than you might hear, young previously very healthy people. They werenāt shocked, just trying to empathize to be very careful.
Lack of PPEās is real, Iām especially hearing that on the east coast. PPEās are locked up, and doled out as needed.
One of my relatives is a researcher, her team is going to start clinical trials. Not hearing anything about how those might go.
And unless you are dealing directly with COVID patients, things are really slow.
Thatās true in my area - SW Florida - as well. The lack of PPE is shameful. One of my close friends who is an ER doc was having to use a single N95 mask per week until another one of our friends who works for the local theatre company donated the woodworking departmentās supply to her.
I read that a number of physicians that have private practices are applying for the PPP and other SBA type loans, as they shouldā¦they have very little revenue coming in and many of the same overhead costs.
Exactlyā¦elementary to college age but mostly younger. Lots we just donāt know yet.
Count me with these private practice physicians. Not having an income stream is not fun to say the least. We have income from insurance companies that will billed out prior. Patients are going to have a problem paying their bills. Lots of them would pay their car mechanic on the spot but would want to pay us a little every monthā¦thatās not going to fly anymore (not really in my practice too much.).
So we are delaying our payments to supplierās when we can but we ordered stock right before all of this and are good right now. We canāt get any types of masks or gowns (I have a surgical OR as part of our office). We put in an order for other stock stuff and it says itās there but then gets bounced and canceled. We call our reps daily and they are on alert then if they get some items we need just ship them donāt ask first. At some point we are going to get like tons of things that we wonāt need anymoreā¦LOL.
Furloughed staff. Itās just me and my medical visitant coming in. Very few patients are coming in on the days that we are open. We sent out an email blast that we can do video visits and the one patient that wants it really needs to come in since she has an infection. She sent in some pictures first.
We have our rent in half for the next two months which was nice. The person we rent from is a pain doctor that is basically not seeing patients at all.
Good thing all our credit cards were fully paid off when this happened. I could go on and on.
All fun with two kids in collegeā¦its a blastā¦
OK ā¦done ventingā¦feel better.
At an SNF surge facility. We technically opened yesterday, but no patients yet. It is a good thing because we still have a few things to iron out. We have workers from several branches of the military and the state emergency teams. I am fairly low on the totem pole, so I donāt always know everything that is going on.
What is an SNF surge facility?
NYT had an interesting article a few days ago about the relatively old-school practice of proning vs ventilators.
I have to laugh
I just went to bank of America and they are all wearing crisp brand new masks including their guard
I need to find out where they get their supplies from. Lolā¦