Wyldnwoody44

My 9 months in Iraq in 2001-2002 will always be the craziest and most serious time I'll ever experience. I am unsure what this will be, I don't think the medical ramifications will be as bad as expected but the financial ones will turn out to be grave.

I was forced to clean shave, I look certifibaly 14 years old

The other aspect of this is my clinic in Africa, all of the kids have been sent home (back to our orphanage) all at once and it has been quite a big handful to deal with. We also have a close friend trapped there dealing with the US embassy in Uganda, as they closed transit out the other day and all the flights were full that day. I have been working closely with the ministry of health in that region to give proper advice on treating this as well as the importance of isolation as much as possible. In their culture, living basically on top of each other is the norm, so it will be a difficult change, they also don't have the US government and its resources helping out like we have. If I could have it my way, I'd be down in Uganda now doing work, but Alas, for now I am here.

Made some cream puffs from scratch, another bike ride, 22 miles, and dealt with shitheads at the hospital ??

In laymans terms, quinine essentially opens pathways into the RNA, this is where zinc is needed to inhibit a step of replication to basically kill off the virus. Azithromycin slightly modulates the immune system and also helps prevent further pneumonia/lung infection/ARDS, in mild to moderate cases. Vitamin D3 helps the absorption of zinc. Taking the plaquenil (quinine) needs to be accompanied by some form of zinc to really take hold. This has been true for the family of Corona viruses for decades. I don't understand why or how this is considered "moving mountains" or great reveals from the FDA. It's more complicated that this, obviously, but that's to put it in terms that are easy to digest.

His test kits have been this team, and they have failed before production

I appreciate this ?

I think the compliance buyouts don't have any penalties, with new CBA each team may get one. Skinner or Okposo though, I'm really hating that Skinner contract a lot, a super lot

An update from a colleague outside of Detroit, today they had to intubate 15 patients, many under 50 years old, due to suspected Covid. This is the first I'm hearing of such large numbers from a source that I am familiar with. I'll be keeping an eye out for what happens in the coming days.

We keep tripping over ourselves time and time again with this, especially with the local health dept actions, it's not streamlined in the least, and it's getting into dangerous medicine territory. I hope the world learns how to handle an actual pandemic from this, we'd surely all be toast if this thing was deadlier.

@nfreeman I'm with that professor, I don't see this anywhere near ebola or H1N1 in terms of actual disease illness and fatality. I wish I could more eloquently say what grasp I have on this, but I fail to at this time. I'm more worried about the economy and the potential fallout and depression from all of this, almost more than the medical side of it.

I had to shave, my beard isn't all that good, but damn, I look 14 years old now. Might as well keep it clean for a while. I'm still going hard on my triathlon training, as best as I can when I'm not at work. The cycling and running are pretty easy, but not swimming sucks a lot as it's the sport I need the most work on right now. The hotel I stay at, they closed the pool, but they will let me in, just me If I'd like, I may take them up on the offer, but the pool is not big and I certainly can't do laps in it.

I look at this thread and realize that I'm still playing NHL 15 because I'm too cheap to upgrade from my old 360 to Xbox one ?? Give me old school Legend of Zelda on Nintendo, and I'm good to go

@PASabreFanwhen it comes to telemedicine, there are a few companies out there that are ramping up in general, but more so now. We have just signed up for it in case we get quarantined, then we can still do telemedicine from home, this is all Hippa compliant. As stated above, make sure to take your zinc, zinc has been long proven to help against many viruses over the decades. I wish you best of health in these tremulous times!

I went for a nice 25 mile cycle yesterday, it was good to get some fresh air. The number of people/traffic out was nearly the same as before COVID, this comes after a state of emergency was just issued down here. Im not expecting society to completely shut down, but I was expecting to see a little difference. Maybe those side conversations with people walking their dogs wouldn't be so apparent, maybe enforce a 6ft rule outdoors, small things to help while people are out keeping their sanity. No new crazy updates from the hospital yet, we got an email about not canceling shifts it's against the oath we took, etc etc. Many providers have been getting caught up in this and are calling off, sadly, this is not the time to do that as the stress level is already high, being any more short staffed would indeed cause more chaos. I'm back at it tomorrow for a few days, so I'll try and update this place with anything that seemed relevant and unbiased ?

Gurley and Matthews released by the Rams. Gurly on social media says "I got fired on my day off?" #quarantineandchill

Confirmed cases at my main hospital, I have had some symptoms this week, but no fever, my inhaler seems to be helping. I had to intubate a patient with B/L pneumonia that went to the ICU, was low risk but then we found out he had visitors from New Rochelle recently, my guess is that his patient had it, I had the right mask on, but still suspicious. I liked what Cuomo said this morning about keeping calm and how we've already had it most likely, he's not my favorite but I appreciated his speech.... Until he compared this to 9/11, then I stopped listening (please don't make this political) it was just a good speech about not panicking and that many people probably have already healed from it. I realize it's not a scientific speech, but one I think we all may need to hear at this time.

As @Brawndo stated the quinine and azithromycin route appears to have some good findings as of now. Quinine has historically been used in the family of Corona viruses for quite some time now. Also Brawn, I sent ya a PM @darksabreindeed the virus spreads more from respiratory droplets in the air and less than fomites, and direct droplet exposure increases inoculation and therefore symptoms, but it can live on surfaces for some time. The virus is very susceptible to many over the counter cleaners. @Claude_Verretas far as I know, we have no other plans for testing except to suspend influenza testing until we come up with a plan B. Lastly, I'm off today, I'm going to go on a cycle, get some fresh air. The 6ft rule is a good one, that's a safe distance for the respiratory droplets to not really reach if an inadvertent cough was heading in your direction, it's not 100% but it's a decent rule. The amount of people out and about here in the southern tier is saddening, stores full, a ton of traffic, it's like they are ignoring it all. I promise you they will have everything as quarantined as possible, and that OR will be the cleanest it's ever been, ever.

I know man, it's just crazy, the person that ordered that to happen doesn't even really work clinically, so obviously we have a issue. We refused, but if we have no masks we don't have a choice. We do have some papers in the decon room if we absolutley need to use them. The number of people I've seen wearing them incorrectly makes me want to institute a 361 day school year.

Aw Shucks, I'm not adding that much to this, a touch of cynicism and some stories from inside the hospital. Sadly the media doesn't quite portray what it's actually like inside the walls. What happened today was concerning a bit. We are ordered to no longer test for influenza and rsv as it uses the same medium that we use to test for covid-19, this is because we simply don't have enough media and tests. The caviat however, is that we are also supposed to rule out influenza first before testing for Corona. Those with positive influenza are currently considered "low risk" for Corona at this time. But we can't even do that, I am having a difficult time wrapping my head around the way things are unfolding, and they are nowhere near their peak. Also, to just add to it all, we don't have enough N95 masks, they are telling us that they want us to reuse them and put them in a ziploc bag, which is a f*ucking travesty. Talk about not being prepared for anything.

Well.... In that case.... You're screwed ?

It affects it, but doesn't guarantee that you'll be left incapacitated. Just make sure you wash your hands and just use some common sense is all ?

I saw a big influx in the hospital in January/February of patients with flu like symptoms, very classic influenza but yet tested negative and it was just attributed to a general viral illness. With zero tangible proof, just my own personal opinion, I do believe it has been here since about Christmas. It's part of the reason why I still feel the overreaction is a bit more than needed. But, it's all an evolving thing

I think there is some overreacting, yes. But I've softened a bit on my original stance, especially since being back in the thick of the hospital. I think social distancing is mostly good, it's probably even necessary, but social distancing can be done in a different manner (or, it should be able to be done without all of this) but maybe us as human are incapable without all the shutdown. It's just so unique, H1N1 killed a lot of people and the response there was nowhere near the same as it is now, I'm still having a difficult time wrapping my head around the stark differences.

Some medical tidbits and thoughts from my brain. The virus affects the ACE (angiotension converting enzyme) in the body, so those on ACE inhibitors (lisinopril, etc) are at a higher risk of a more aggressive response to the virus, causing much worse symptoms and attacks on cardiovascular and pulmonary health. The same theory applies to smokers, due to mainly hypertension and the previous affects and damage from smoking. Innoculation size matters, a person infected from small contact on then hands and then rubbing their eyes, will not have the same response as someone that gets a cough in the face, the severity is directly linked to initial viral load and that is why Healthcare workers are at an extremely high risk. The virus is bigger than most, but still small, 3 covid-19 virus could line up side by side and still go through an N95 mask, so it's helpful but it's not quite as good as it needs to be. Lastly, we are not testing as well as many think, the health department yesterday changed their stance multiple times and requested that we Don't test unless certain criteria were met, seems counterintuitive, but we simply don't have enough tests and we need to be selective in who we swab for this virus, if we do test the turnaround time is 3-10 days for a result at this moment. I'll also add this, we are grossly unprepared for any pandemic, I'm utterly shocked and saddened by seeing this first hand, if this was more deadly or something like ebola, we would be in super big trouble, I don't know what this will be in the future, but we need to get our crap together as a nation.