Friend’s sister was furloughed from her trauma hospital, and says the C-19 emergency overflow sites are totally empty. That area never had to put in use their emergency response teams either. “Elective” procedures are resuming. I say it in quotes because they put a pause on a friend’s chemo but it restarted. That’s not so “elective” in my book.
Sounds to me like they flattened the curve very well in her area. Folks are itching to start easing up on restrictions. - Ohio.
Reusing N95s is not a bad thing. They said at peak in NY, they used one million masks a day in ONE hospital. Can you imagine all the waste it generates even if we had enough?
Observations from surge facility. Watching the various organizations work together is kind of fascinating. We have state emergency teams, army, navy, etc… lots of “cooks in the kitchen” and lots of “chiefs” but it seems to be working out. We also have registry personnel that my facility is hiring. A lot of the registry personnel are healthcare workers who have been furloughed. Our facility is considered skilled nursing. We accepted our first patient today. She is in her 80’s with multiple med issues (diabetes, hypertension,maybe cancer…) Evidently she was hospitalized and has recovered but is still testing positive so can’t go home (she lives with her husband who is also elderly). We are supposed to get another today. The “hot zone” is guarded by military personnel. Anyone who enters must be in full PPE. My job does not require me to go into the hot zone.
We are reusing N95 masks following the protocol below:
We were also told that when masking, everyone must wear the same level. You cannot have the faculty wear an N95 and the resident wear a surgical mask.
A relative who is a nurse in a hard hit area says she can’t spend as much time with Covid patients as she feels she should (I’ll comment here that most hospital are in normal times staffed at a level that makes this the case.) In particular, she can’t get them out of bed and moving around as much as she’d normally want to, leading to loss of muscle and sometimes bed sores. She does say proning helps quite a lot with oxygen levels.
I don’t know who “they” is, but I don’t believe that. Suppose there are ten thousand workers in a hospital. Then workers would average a hundred masks a day. That sounds implausible.
The study that was mentioned about 30% of people with mild or moderate symptoms not having antibodies would only make sense in the context of people who had been known to have been infected at some point. So by definition it wouldn’t include the asymptomatic. (It’s tricky, because the person who posted about that didn’t have a citation, so we don’t even know if that’s an accurate recounting of the study). But the point is, MOST asymptomatic people don’t have Covid – the only possible way to identify an asymptomatic person as having Covid is through a positive test at some point – either at the time of infection or through antibody testing down the line.
Math is math. The numbers of asymptomatic Covid infections might be as high as 50% of all infections. If we go back to the Diamond Princess, 19.2% of the 3711 were infected, and of those, 46.5% were asymptomatic. (numbers from https://www.mdedge.com/dermatology/article/219539/coronavirus-updates/high-rate-asymptomatic-covid-19-seen-cruise-ship) So from that group, there would have been 712 infected passengers, including 331 who had no symptoms. There were 13 deaths and an additional 54 still reported to have active cases (from https://www.worldometers.info/coronavirus/) with 645 listed as “recovered”. I’ll assume that the 54 sick ones are NOT moderate/mild cases-- and for now I’ll assume that the “recovered” ones fit the moderate/mild category. So let’s assume 314 moderate/mild. If hypothetically 30% of that group didn’t have evidence of post-infection antibodies in their blood, that would be 94 people known to have Corona virus-- far less than the overall number of asymptomatic people. (Of course, some of that 314 probably was sicker, but hypothesizing a smaller number of mild/moderate only reduces the overall number of mild/moderate who don’t show post-infection evidence of antibodies).
Now let me go with another hypothetical – assume that only 50% of the asymptomatic group has antibodies, less than the 70% of the mild/moderate. You would then have 166 asymptomatic people with antibodies, and 94 mild/moderate without any antibodies. So even with that assumption, you still have a bigger number of asymptomatic + antibodies than mild/moderate without.
–
I’d note that I think the main problem is simply that antibody testing is probably not that reliable at this point — but I’m just saying that a fairly large minority-level fraction of infected people who don’t have evidence of antibodies is not in any way inconsistent with a large number of asymptomatic people who do.
This was reported in the media but it has medical details from autopsy of the 57 year old woman who died of Covid 19 on February 6 in California - https://www.sfchronicle.com/bayarea/article/Exclusive-Autopsy-report-of-first-known-15226422.php
She died due to a heart rupture. She was mildly obese (BMI of 31) but no other underlying health conditions. Death was found to be due to Covid, with the autopsy showing evidence of damage throughout her body.
Very sad. And many people with a BMI of 31 don’t think of themselves as “ obese” even though they are absolutely are and are at high risk.
^^ sad - and frankly, a little horrifying.
Her family described her before the autopsy as someone who “ ate well and excercised” I’m not saying she didn’t. But I think we as a society are very bad at recognizing when someone is unhealthily overweight.
Well, “ate well” is not necessarily inconsistent with being overweight. I included that fact only because obesity s recognized as a risk factor for more severe complications of Covid - and that was the only known risk factor in her case. (CDC lists BMI over 40 as the risk factor). A NY doctor reported that " patients under 60 with a BMI over 35 were at least twice as likely to be admitted to the ICU for coronavirus" (https://www.sciencenews.org/article/coronavirus-covid19-obesity-risk-factor) — "a BMI of 30 is essentially the cutoff between “overweight” and “obese”.
But I’d note that the article I linked to didn’t give BMI – it characterized the decedent as being “mildly obese” and gave the height & weight – I used a standard BMI calculator to arrive at #31 — but of course that doesn’t tell us anything about the distribution of weight between fat & muscle, so we really don’t know if her weight was all that unhealthy.
I think that the real takeaway is that the number of Covid 19 deaths might be a lot higher than reported, because of people who died of atypical symptoms and thus were not tested or counted — particularly for people who die outside of the hospitals.
The autopsy itself gives Ms. Dowd’s BMI as calculated by the medical examiner: 31.2. As @calmom says, that’s barely obese. She had a mildly dilated heart, but no other signs of chronic illness, and her heart burst open. This is not a normal consequence of obesity.
The County of Santa Clara has now reclassified nine people who died of flu-like symptoms; the nine, including Ms. Dowd, now are classified as COVID-19 deaths.
“Ate well” and “exercised” can have very flexible definitions.
On the other hand, heart rupture is very unusual, regardless of obesity, diet, or exercise.
I personally don’t feel that BMI is a great indicator of obesity. It doesn’t take into indication muscle mass among other things.
The woman who died was certainly a little overweight. I’m not sure she was obese.
I would agree with you more for men. My H lifts and is always in the overweight category, but he is still in the mid 20s. But we are almost the same height and according to all of the BMI charts, we should weigh the same. Really? Men are on average going to weigh more due to a larger frame and more muscle mass. And yet, women’s definition of obesity is the same as men.
I didn’t see the woman’s numbers, but at 5-6, a woman with a 31 BMI would weigh 195 lbs. Unless she is an avid bodybuilder, that is severely overweight/obese and can’t be healthy.
And people’s definition of exercise can vary widely. I remember my mom recounting a doctor visit with her mom. When the doctor asked if she exercised, she said yes. My mom’s jaw dropped to the floor. The woman never left the house or moved. My grandma stated that she walked. My mom asked WHEN? she said she walked from the den to the kitchen and bath room. An extreme example, but it happens all of the time. Just like all those people you are at the gym who do 1 set every 10 min or walk on the treadmill so slowly it’s barely moving while talking/playing on the phone.
I guess we all have different ideas of what morbidly obese is, I’m not sure if I saw a 5’6” 195lb woman, that I would call them morbidly obese. Heavy, yes. Morbidly obese, no.
My husband had a BMI of 31 a couple of years ago. He was heavy, and needed a diet. But in my opinion, not morbidly obese.
But I’d like to get off this subject, nonetheless
Shoot, I’d like to amend my comments and take the morbidly out of it. Just obese, not morbidly.
I can’t edit my post anymore. Thought about it and I wasn’t talking about morbidly obese. Sorry
I thought BMI was not meant for individuals but populations…at least that is what made me feel better since I am what would be described as short and stocky…
https://www.ncbi.nlm.nih.gov/books/NBK535456/
Adolphe Quetelet is responsible for the development of BMI. He was a mathematician, statistician, and worked in sociology as well. Quetelet was searching for a way to relate an individual’s height to their ideal weight, as a tool for studying populations. The quotient was first cited in 1972 in the Journal of Chronic Diseases. The article discussed BMI as useful in population studies, or “social physics,” as Quetelet called them. It was specifically mentioned that this measurement was not useful to study an individual. However, due to the simplicity of the equation, it remains the most commonly used anthropometric analysis.