Electrolytes: “COVID-19 severity is associated with lower serum concentrations of sodium, potassium, and calcium.” https://www.researchgate.net/publication/340511264_Electrolyte_Imbalances_in_Patients_with_Severe_Coronavirus_Disease_2019_COVID-19 (What I can’t figure out from the abstract, as a layperson: concentrations were lower in the severe patients compared to the less-severe patients, but were they lower than the normal range for labs? That is, would this necessarily be noticed.)
Do you mean https://www.vox.com/science-and-health/2020/4/23/21219028/covid-19-immunity-testing-reinfection-antibodies-explained ?
I was on a call today with a national medical team and it was mentioned that immunization visits for children birth - 2 (when the majority of immunizations are done) are down 40-50%. The trend currently is for pediatricians to continue to see those under age 2 in person for these critical immunizations but many parents are afraid to go. This could create another huge problem in our country, kids behind or just missing important immunizations.
The % numbers for teens was even worse. 
These are medical crisis offshoots of COVID.
It seems like either that study or the New York one which shows vast numbers of asymptomatic people with antibodies must be wrong.
Or the tests might not be reliable enough yet, or the antibodies didn’t last long enough for when tests were done, etc.
Science is dynamic and one study never answers all.
Understandable and I can’t blame anyone who doesn’t want to take their little person to the pediatrician’s office right now unless it’s really, really urgent and unavoidable. When my guys were little, even without C19 in the picture, I remember thinking how those places are petri dishes. Especially during flu season. It never made sense that you’d have to drag a very sick kid to an office where not only were they miserable but they were spraying their germs everywhere instead of doing a combination of telehealth and test kits that could be performed at home.
It would be a huge advance in public health if insurers continued being willing to pay for and doc offices continued being willing to offer telehealth after the coronavirus pandemic is under control.
S1 and DIL took their 5mo old for his last pediatrician visit to get his vaccines. S was a little concerned but the office already has separate entrances for healthy and sick kids, only allowed one family in at a time, and only allowed 1 parent/child.
They did this more than 3 weeks ago, so I guess everyone made it through the experience safely.
^To add, my D’s pediatrician is only doing well child visits if a vaccine is scheduled. She is really trying to keep vaccines from getting skipped. She has also stopped any hospital visits to cut down on her own chance of bringing the disease to her office. I believe she has the different waiting rooms, one family in at a time, etc. also.
As far as designated Covid-free hospitals, the Northwell system (23 hospitals, mostly on Long Island) just cleared out a hospital completely, transferring all patients to another of their hospitals. They deep clean the empty hospital and open it as “non-Covid“.
I agree that this is only likely to happen within a hospital system. Otherwise, what hospital is going to volunteer to be the Covid hospital among their competitors? A Covid hospital can’t schedule for the high revenue specialties (cardiology, neurosurgery, orthopedic, GI, heme/oncology, transplant etc.).
@Iglooo as far as Remdesivir, I’m no expert, but I think “inconclusive” data means it’s probably not a game changer. If Remdesivir made a huge difference, we would know by now. It would be unethical to continue with a placebo controlled trial, because it would be so obvious that it worked. (Trials are halted under those circumstances.) Instead, Remdesivir is in a gray area where it may have a preventative effect, but is unlikely to help those who are already severely ill.
Steroids and tocilizumab, on the other hand, are clearly saving lives (when given to the right patients with the right timing). Doctors are saying it is obvious in real time, to the point where it would be unethical to stop and do placebo controlled trials. Same with anti-coagulants. These drugs treat the effects of the virus, not the virus itself, and they are FDA approved for the conditions they treat (cytokine storm and clotting).
I think the take home message is that medical personnel are trying everything they can to save people without harming them (and even sometimes approaching that line in desperation with dying patients). They are not going to discount anything that makes sense to virologists/immunologists and/or obviously helps. Politics won’t matter if something works.
In my opinion, the most promising treatments to stop the virus from entering cells and replicating will be the ones currently under development, because they will specifically target SARS-CoV-2. May those researchers stay healthy, have all the support they need, and work as fast as humanly possible. And vaccine researchers too!
Within my system, five (5) of the hospitals in the system are designated COVID hospitals.
@abasket - yes, our local docs are raising the same alarms.
In TX, the governor recently lifted his restriction on elective procedures allowing them to be performed if they do not negatively impact the inventory of PPEs or the capacity of the hospital to care for COVID patients. Our partner hospital had to certify that they are maintaining the minimum number of PPEs and have the cability to care for COVID patients. This will allow us to resume care to patients needing a medically indicated elective procedure next week. The hospital is requiring that the patient have a negative COVID test prior to the procedure.
Hopefully this change will lessen the financial impact on the hospital and the physicians. The census has been down mainly due to not being able to perform scheduled/elective procedures but also because many people do not want to come the hospital even in an emergency.
Not sure if I should link it, but article in the WaPo today about people in their 30s and 40s suffering severe strokes, not even realizing they were Covid positive. Many had not exactly rushed to call 911 because of fears of going to the hospital now.
I mentioned it to H and he said that they had a Covid patient in their 30s in his hospital who was released about 2 weeks ago, and came back last night with a pulmonary embolus. A small one, but still. Scary. So much is scary, capricious, and unknown about this disease.
Perhaps in some people the presence of other antibodies that are not COVID 19 specific are protective? The analogy I would draw would be between a broad-scale antibiotic vs. specific antibiotic – and there must be thousands of different types or combinations of antibodies that any individual might already have floating around in their system. Combined with genetic factors, it just might be that for some people – the pre-existing antibodies in their body are capable of fighting off the virus successfully, so no need for the body to develop a Covid-19 specific defense.
The Vox article mentioned above – https://www.vox.com/science-and-health/2020/4/23/21219028/covid-19-immunity-testing-reinfection-antibodies-explained – seems to support this possibility. It explains the difference between the “innate” and “adaptive” immune systems in the body. (“If the innate immune system can’t get rid of the infection, the second movement in this orchestration begins: the adaptive immune system”)
If 30% didn’t have antibodies, then 70% would. 70% of asymptomatic people with antibodies could very well equate to “vast numbers”.
The takeaway would be that a minority (less than a third) of people with mild cases do not develop antibodies that are detectible in their system with the current tests.
But mild to moderate seems very different than asymptomatic. Maybe you could have lots of asymptomatic people with antibodies and others with moderate disease with none (which is pretty sick from what I’ve read) but that just seems odd?
While I agree about elective surgeries being the first thing to open up, I don’t think the PPE problem has been solved. Locally, I’ve heard that they are still “sanitizing” N95 masks and reusing them for a week at a time in the hospitals. This is for surgeons and healthcare workers alike.
Do surgeons wear N95 masks when doing surgery?
No. Surgical masks.
Really the anesthesia people need it mostly.
I guess whether that’s ok depends on the method. My daughters hospital started using the method developed by Duke U which seems well documented to be safe and effective method.