Inside Medicine. What Are You Seeing? [COVID-19 medical news]

NY (state) just blew the 0.1% overall death rate theory out of consideration. They just surpassed that in deaths per capita (meaning if every resident had the virus and no more deaths were to occur - neither of which is true).

That theory had been purposed by some who assumed most folks would get a mild or asymptomatic form and not be counted giving us a similar overall death rate to the flu (which is usually listed as 0.1% and is also harsher on older folks and those with other conditions).

So, if all of the residents of NY were put into groups of 1000, one in each group would have already died from the virus. This is without everyone in the state having had the virus. To me, the numbers are very sobering.

I’m wondering if NY has a more deadly strain or if the other states will follow at their own pace. (Time will tell.) NY was really slow shutting down IMO - esp for the density of NYC and number of cases in the area.

@emilybee That is the term they are using for overflow patients due to Covid-19. My facility was a State owned longterm care facility for individuals with developmental disabilities. We closed per a longterm state plan in February. We had a skeleton crew during what is referred to as a “warm shutdown”. A couple weeks ago we were told to prepare to re-open for Covid-+ Skilled nursing patients. I am not told a lot, but was told to prepare for at first up to 100 patients and then up to 250. Some will be individuals with developmental disabilities and I think some are from convalescent homes. We were told to prepare and then the military is coming in to help staff.

Our state just had 2 more deaths, bringing the state total to 12. 2nd day in a row with no new cases on our island of Oahu. I did see quite a few people out walking, jogging, running & biking this morning, none were wearing masks but everyone was social distancing and staying very far apart (>10 feet). No one was coughing or sneezing and everyone seemed very healthy.

Yes from what I read is that New York, Italy and China have a deadlier strain of the virus.

@Knowsstuff

Source please!

Just talked to a nurse at one of the major hospitals here in GA (she is my neighbor). She told me there are two strains of this. One causes mild cases and the other is the deadlier one. She is also saying that they are mostly seeing people between the ages of 30-50 with serious illness(very rare for someone under 30 to be hospitalized). She says that the treatments we have heard about work sometimes, but do have side affects There is also a few more treatments that might be coming soon. She says that they have not seen a downward trend and not sure why we are opening some businesses here statewide (versus just in certain areas).

https://worldisraelnews.com/coronavirus-found-to-mutate-against-immune-system-new-study-says/

We can post articles here right??

^The article says “The most aggressive strain has been blamed for causing the devastating amount of coronavirus infections in Italy, Spain, and New York.” I thought I read elsewhere that under this theory, the less aggressive strain from China may have ended up on the West Coast.

D2 is being floated more back in the cardiac cath lab and less in one of the Covid ICUs. Very good sign for all of us and much less stressful for her!

Also, her hospital is offering antibody testing to all employees starting next tomorrow.

@ucbalumnus -

Yes my daughter saw the NYT article as well and went on a shopping spree. I should be the recipient of either one or two pulse oximeter’s in the near future depending on whether or not DD is successful in canceling the initial order off Amazon. (apparently the first one was not FDA approved).

Whether it is necessary or not, DD wrote that it is a security blanket for her to buy me one.

Thanks for sharing the Consumer Reports article!

Google pulled up articles critiquing this (aggressive vs less aggressive).

I jumped in and asked about the source bc I don’t recall it coming up on TWIV.

Whatever that’s worth!

I follow a lot of what is coming out of Israel and especially Technion. They are doing some interesting work and a group is going for a patent then coming out with a vaccine in about 1-1.5 years. The group has 20 years on this virus and just had to redo some work to work on this type of CV.

Whether it is tied to specific strains or not, it is clear that fatality rates are significantly different in different regions. Other factors can come into play, of course – but I think the bottom line is that we don’t yet have enough information to know why. (You can easily compare the numbers at https://www.worldometers.info/coronavirus/ )

When my wife starting seeing more people in the ICU a few weeks ago all were under the age of 40. Luckily the number held steady and has declined. I’m not sure how many are there now. I don’t ask.

This just shows some of what is happening there. https://www.israel21c.org/30-israeli-medical-tech-solutions-to-help-fight-coronavirus/

That article is a short article about an article in the South China Morning Post:
https://www.scmp.com/news/china/science/article/3080771/coronavirus-mutations-affect-deadliness-strains-chinese-study

There is another related article:
https://www.scmp.com/news/china/science/article/3079491/deadly-coronavirus-comes-three-variants-researchers-find

This information came from a study led by Li Lanjuan of China which has not been peer reviewed. The study looked at how different strains of the virus behaved in a laboratory, not in patients. They extracted the virus from only 11 patients, and then let it replicate and exposed it to monkey cells in a lab. Viruses with certain mutations replicated faster than others.

The study hypothesizes that a viral strain that replicated faster in a lab and kills more monkey cells may be deadlier in humans. However, this setting is artificial, and lacks all the human factors, including the human immune system which plays a huge part in why the sickest Covid patients get so sick.

Also, all 11 patients who donated the viral strains lived, so I don’t see how that corresponds to finding a “deadlier” strain.

To cut to the chase, these scientists did not study Covid-19 in patients. They studied SARS-CoV-2 in a lab. Yes, the virus is collecting mutations. We knew that. But this research does not in any way prove that the mutations make a difference in the disease.

I would rather that energy and resources were focused on treating the disease, which has not been shown to be clinically different anywhere it goes. I’m sure the TWiV virologists will discuss this paper, so I will post what they say when they do.

Link to the study which has not been been peer reviewed: https://www.medrxiv.org/content/10.1101/2020.04.14.20060160v1

Explanation of what it means that the study has not been evaluated and why it would be “preprinted” despite this: https://www.medrxiv.org/content/what-unrefereed-preprint

In case people don’t have time to follow the link about what it means when research is not peer reviewed, here is a quote:

So there is much talk about using ventilators and their overuse and possibly wrong treatment. That this virus is actually lack of blood oxygen having to do with the heme in the blood and not a respiratory disease? Then mix that with the blood clotting in the lungs and now signs in the feet /hands. There are covid 19 USA physician groups discussing this.

Views?

@Knowsstuff re: ventilators and proning: “What Doctors on the Front Lines Wish They’d Known a Month Ago” https://www.nytimes.com/2020/04/14/nyregion/new-york-coronavirus.html