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

Wow, @MomOf3, that’s interesting, way to know the data.

The Israeli scientist mentioned above is still months away from even starting to test.
https://www.jpost.com/health-science/tau-professor-were-two-thirds-of-the-way-developing-covid-19-vaccine-625129
I’m more excited about the Oxford scientists who started clinical trials and say they may have a vaccine ready to use in September.
https://www.sciencealert.com/oxford-university-has-just-launched-a-human-trial-of-a-potential-covid-19-vaccine

There is also a trial of Moderna’s vaccine ongoing here in my neck of the woods…

Here is a list of Northwell’s hospitals with # of hospitals and county location:

5 Nassau County
5 Suffolk
2 Queens
2 Staten Island
2 Westchester
1 Manhattan

The way the Northwell study is being reported, it could seem to readers that their hospitals are all in NYC, so I wanted to clarify the locations. Manhattan has much lower obesity rates than the rest of those counties and boroughs.

It is true that obesity is associated with chronic low-grade inflammation and elevated pro-inflammatory cytokines, but it looks to me like the jury is still out on whether it is a significant risk factor.

Spoke at length with D1 who is an ER doc at major academic institution that is doing a great deal of Covid-19 research. One of the most interesting things she had to say is that anecdotally ~15% of their recovered Covid-19+ patients are not testing positive for antibodies. The researchers not sure why this is. It could be:

–the current state of the art FDA-approved antibody tests are returning a high rate of false negatives
–a significant minority of recovered patients are not developing immunity to disease
–something else as yet undetermined.

If it is the second, then it means it’s theoretically possible to catch the disease more than once.

BTW, for other serious coronavirus diseases (SARS, MERS) surviving the disease does not confer lifelong immunity. Immunity fades over time. For SARS, immunity only lasts 3-4 years.


Also for anyone who read my earlier posts--she found an OB (MFM specialist)  willing to take her on as a patient. She finally did get her ultrasound and blood work this week.

@WayOutWestMom That’s good news for your daughter!

@3SailAway What is your thought on Remdesivir? Here’s a colorful statement from Jim Cramer, stock market guy.

This is anecdotal but my mom was talking to a person involved in hospital admissions in her small town in Tennessee. They told her they are going to start doing testing and non COVID procedures on Monday. They have not had one COVID patient.

My MIL told me that in her small rural Michigan hospital, they currently have one COVID patient.

These hospitals are not going to survive if they don’t start doing non COVID tests, surgeries and procedures. And the last thing that you don’t want to happen is for small town hospitals to fold. As it is, you have a hard time getting physicians to even come to small towns. If they don’t have a hospital to visit or to do surgery or procedures, the market will dry up even more.

It will be interesting to see how governors can balance the coronavirus epidemic and the medical “business”.

Around here, a lot if the elective surgery takes place at day surgery centers…which have been closed. I would imagine that when the gradual lessening of restrictions happens, those places will be opening again but with restricted numbers of folks scheduled, and no hanging around in the waiting rooms.

I wouldn’t be volunteering to undergo an elective procedure. As long as ER and ICU staff need to use the same PPEs all shift, will the procedure room staff be doing the same?

Could we segregate hospitals? Some hospitals designated for CV only?

That’s an excellent question - I see how reusing PPE might continue to protect the worker, but it certainly isn’t good for the subsequent patients.

(It reminds me of the old logic puzzle with two pairs of gloves for one doctor and three patients, and its partial solution that protects only the doctor. Of course, there is also a fully protective solution in that particular puzzle.)

Even though a procedure may be deemed elective it may be essential.

If you are in atrial fibrillation, a cardioversion may not feel elective to you. There are so many procedures that aren’t emergencies but are certainly helpful to your well being. Also pacemaker surgery.

So it’s something that each person needs to weigh. There’s an infinite list of things you can think of that weren’t “essential” during this crisis. This isn’t as easy as postponing a colonoscopy or teeth cleaning.

I know a person who was to have a stem cell transplant done that was postponed due to coronavirus. It’s pretty lifesaving as are many cancer treatments.

Editing to say that I hoped I spelled all the medical terms correctly and if I didn’t, I apologize

Some doctors own their own operating rooms in certain states. Elective surgery is still going on but tends to be more essential surgery then not. Broken bones, ligament /tendon rupture that could impede walking if put off etc. Not all surgery happens in hospitals.

I think doctor’s offices and elective surgeries should be the first things to reopen - not bowling alleys and gyms. Some people will die or further harm their bodies by not getting their knee surgeries, hip replacements, etc… These places should be ramping up to see patients - especially since the PPE situation is improving.

I’m reading that a lot of epidemiologists are guessing this is a testing problem. It doesn’t make sense that someone who has successfully fought off a given infection would not have antibodies against it-that’s how they fought it off. They just might not be detectable by a given test.

^^^this. It seems there are a lot of imperfect tests on the market right now. Lot of false negatives out there

They are as far as I know. Maybe they aren’t reported in the media since that’s kinda no news compared to opening bowling alleys?

Can those antibodies disappear over time?

In Georgia, they are reopening at the same time (today) as the non-essential places. My point is, for phased reopening - doctors offices should be part of the first phase, while other non-essential businesses can be phased in during the second or third wave.

I think you can segregate hospitals to be COVID vs non-COVID - but most likely only in the same health system. So a health system with 3 local free standing hospitals might do that but (here anyway) competing/separate health systems are not likely to segregate that way.