It would seem that ‘emergency use’ can have several different meanings.
DS was at UCSB during the 2013 meningitis B outbreak. The FDA had not ‘approved’ the meningitis B vaccine - even though it had been in use safely and successfully in Europe for years. “Emergency” approval was given for Princeton and UCSB to use the European vaccine ( I think it is now officially FDA approved ).
IMO there is a universe of difference between the use of the term ‘emergency approval’ for a vaccine that is new, unproven and with no long-term data - and the use of the term in a situation where our FDA is simply stuck in goodnesses knows what Mobius loop of politics and lobbying efforts.
@compmom, this has nothing to do with not believing you! I’m just stating that it’s very difficult to believe a nurse who says she has never encountered a type 1 diabetic in a 30 year career. Type 1 diabetics can be found in every unit. Management of ketoacidosis would most likely be assigned to an ICU, so that drove my question of this nurse maybe being new to the ICU specialty.
As already stated, I can certainly believe that many medical personnel, depending on specialty, may not have adequate training in type 1 management, particularly for a patient who is extremely brittle and experiencing multiple co-morbidities. Also already stated, I have no trouble believing a parent or patient might well understand their own disease better than many medical professionals. But type 1s are not so rare that one could work in an ICU for 30 years and never encounter one! A neuro ICU might see less of them, but type 1 diabetics also have neurological conditions just as the population at large get them. It’s the nurse I am questioning, not you.
Back to “Inside Medicine,” in talking to coworkers and reading my nursing forum, there is a lot of hesitation about a fast tracked vaccine, even among those strongly pro-vaccine. It’s a little scary talking about mass vaccination with any vaccine that has not been adequately vetted for safety.
As much as I have been hoping a vaccine can be developed sooner rather than later, we still need to make sure that safety is primary. I’d be a little scared to step up too early. Kudos to the volunteers who put themselves at risk for the greater good in all of these clinical trials.
About a week ago there was a link in the Washington Post for signing up for the vaccine trials. I signed up and got a couple more people to do so as well. I haven’t heard anything back yet but I am not surprised. I am sure they are trying to craft a representative cohort.
@nrd agree totally. This is such a stupid move. Why and what would the fed gain by doing this. Does federal government wants to hide data? I hope they outline the reason for this move in public forum and let post pros and cons of the move for public to view it.
I am pretty sure that hospital systems (successful large ones, not your local dumping ground public hospital) will be happy not to publish data either. For example, TMC thought that all that data sharing was reassuring when it looked great and Texas thought it has missed the bullet, but when it was being used as a tool to indicate what a nightmare was unfolding it seemed less of a good idea. The fact hat so many eyes were on that site when they suspend important data is a testament to how data is such a great double edged sword.
Rash inside the mouth might be Covid-19 symptom, preliminary research suggests
From CNN Health’s Jacqueline Howard
Preliminary research now suggests that skin rashes and rashes inside the mouth might be a symptom of coronavirus infection — but more study is needed.
The research, published in the medical journal JAMA Dermatology on Wednesday, found that among 21 patients in Spain who were confirmed to have Covid-19 and a skin rash, six of those patients or 29% had enanthem, or lesions or rash in the mouth.
The mean amount of time between the onset of Covid-19 symptoms and developing enanthem was about 12 days among the patients, according to researchers from the Hospital Universitario Ramon y Cajal in Madrid.
Specifically, the researchers found that one patient developed enanthem 24 days after the onset of symptoms; two patients developed enanthem 19 days after; one developed enanthem 12 days after; one developed enanthem two days after; and another developed enanthem two days before.
“This work describes preliminary observations and is limited by the small number of cases and the absence of a control group,” the researchers wrote, adding that their findings still suggest enanthem to be a possible Covid-19 symptom and not a reaction to medications, for instance.
“Despite the increasing reports of skin rashes in patients with COVID-19, establishing an etiological diagnosis is challenging,” the researchers wrote. “However, the presence of enanthem is a strong clue that suggests a viral etiology rather than a drug reaction.”
The story of the two Missouri stylists is definitely the story of masks working.
Stylist A was an infectious person. She infected Stylist B, presumably in the unmasked encounters the two had between dealing with clients. She also infected her husband who lived with her, and her daughter, son-in-law and another relative who didn’t live with her.
Both Stylist A and Stylist B continued working while having symptoms. All of their clients wore masks, almost all of them plain cloth masks like we all wear. No clients reported covid symptoms. About half were tested; none tested positive.
Do we know what types of masks the stylists were wearing? The photo along with the article shows a stylist with mask + face shield – but I am guessing that is a stock photo, not a picture of the actual stylist.
ICU deaths from coronavirus are lower than we thought, study finds
From CNN’s Maggie Fox
The reported death rates of patients being treated for coronavirus in intensive care units around the world have fallen by almost a third since the beginning of the pandemic, from 60% of patients to 42% at the end of May, according to new research published Wednesday.
It doesn’t appear that there’s been a dramatic change in the virus or specific treatments for patients that lowered death rates, and it could be that hospitals were reporting only the worst outcomes at first, British researchers reported in the journal Anaesthesia.
“Our analysis is reassuring in that in-ICU mortality is lower than early reports suggested,” Dr. Tim Cook of Royal United Hospitals in Bath, UK, and colleagues wrote.
“This is the first systematic review and meta-analysis of outcomes of patients admitted to ICU with COVID-19."
The researchers looked at the data from 24 observational studies, including 10,150 patients in Asia, Europe and North America. They reported mortality rates of between 0% and 85% for coronavirus patients treated in the ICU.
“Sub-group analysis by continent showed that mortality is broadly consistent across the globe,” they wrote. But it has changed over time.
“As the pandemic has progressed, the reported mortality rates have fallen from above 50% to close to 40%” as of May 31, they wrote. Yet no specific treatment for coronavirus was found over the time. There is still no cure, and doctors are applying various cocktails of drugs – including steroids and blood thinners – to keep patients alive.
“There are several explanations for this finding. It may reflect the rapid learning that has taken place on a global scale due to the prompt publication of clinical reports early in the pandemic. It may also be that ICU admission criteria have changed over time, for example, with more non-invasive ventilatory management outside ICU,” they wrote.
“There is a possibility, too, that early studies, which were smaller, were prone to overestimating mortality,” they added.
Didn’t last week or the week before the Italian doctor attributed the decreased mortality rates to people having lower “doses” of the virus due to social distancing and mask wearing. My guess is it is a combination of everything.
“ Stylist A worked with clients for 8 days while symptomatic, as did stylist B for 5 days. During all interactions with clients at salon A, stylist A wore a double-layered cotton face covering, and stylist B wore a double-layered cotton face covering or a surgical mask.”