COVID-19

An Interview With Erin Bromage

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For every extra body you take out of a room, you are lowering the risk that somebody infected is in there to start off with. Then assuming that someone in that environment is infected, there is a gradient of respiratory droplets from that person that radiates out. So, certainly, having people spread out more in enclosed environments is an important way to reduce infection, but it’s not the solution to controlling all infections. Having a restaurant at half capacity that is still enclosed and has no or very little air exchange is going to be just as risky, but to fewer people.

Memo to Self:

Add the concept of dose-time to your Covid-19 risk reduction strategy.

Add a link to the Medscape interview with Erin Bromage.

An Interview With Erin Bromage

Covid-19 Buzz Cut – Done – 05.31.20

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Getting WAY longer.  Note the Andy Rooney eyebrows.  The time had come to go back to my barber.

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Meanwhile in Oklahoma…we’re reopening but nearly nothing appears to be pre-Covid.  The outside world feels different from all of the behavioral changes.

SITUATION UPDATE: COVID-19

Screenshot_2020-05-31 COVID-19 Oklahoma State Department of Health

One of the changes at the barbershop was opening on Sunday mornings for cleaning and taking a few customers for haircuts by appointment only.  Business at the shop has been slow which tells me the customers here are still pretty much staying at home and sheltering in place.  They may have discovered the joys of cutting your own hair.  Or maybe money is tight, less frequent trips.  Or worse…

But for me this visit was about trust.  Trust in a man who has cut my hair for nearly fifteen years.  This is a man who would not put himself, his customers nor his business at risk.

Thanks Kevin.  I’ll see you again in a couple of weeks.

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Half of newly diagnosed coronavirus cases in Washington are in people under 40

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Half of newly diagnosed coronavirus cases in Washington are in people under 40

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Oops.

This shit is real and it is scary. COVID is taking patients down, and we do not know how to stop it. The images of overflowing EDs, overworked providers, patients who cannot breathe—these are real and it is happening. Do not let anyone tell you its not.

Rebecca Karb MD

This shit is real.  Don’t ever forget that.

More Drugs Please

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According to Ginger, an organization that provides mental health services to companies, compared to January and February of this year, prescriptions for psychotropics, most of which were antidepressants, were up 86% for the months of March and April.

The stress of unemployment, social isolation and health concerns are all cited by Americans who say the lock down is having a serious impact on their mental health.

Pharmacy group Express Scripts also revealed that prescriptions for anti-anxiety medications were up 34.1% between mid-February and mid-March, while prescriptions for antidepressants increased 18.6%.

Link to the source article.

Wow.

House Hunters International (Pandemic Version) – Mexico

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Citation: California Border Hospitals Hit by Surge in COVID-19 Cases From Mexico – Medscape – May 20, 2020.

Here’s the link:

California Border Hospitals Hit by Surge in COVID-19 Cases From Mexico

Here’s an excerpt:

Imperial County has registered fewer than 800 known coronavirus infections and just 15 deaths to date. Baja California, by comparison, has reported 3,458 confirmed COVID-19 cases and 134 deaths.  Two main medical centers in Baja’s state capital – Mexicali Hospital General and IMSS Regional Hospital 30 – are both “saturated” by the outbreak, Mario Cervantes, head of relief services for the Red Cross of Mexicali, told Reuters.  Some arriving ambulances have had to wait hours to deliver new patients, while others were turned away altogether, he said.  Baja health department officials said neither Mexicali hospital had exhausted its bed space, but Dr. Rafael Abril, president of the Mexicali College of Surgeons, told local news in April that half the IMSS hospital’s doctors were infected with COVID-19, which could lead to staffing shortages.

Coronavirus: Hamster Research shows Effectiveness of Masks

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Coronavirus: hamster research shows effectiveness of masks ‘huge’

Hamsters placed in adjoining cages with infected subjects were infected at a 66.7 per cent rate; the introduction of a barrier saw the percentage drop to 16.7%.

The study, which the team called the first of its kind, found the rate of non-contact transmission – in which the virus was transmitted via respiratory droplets or airborne particles – dropped by as much as 75 per cent when masks were present.

“I know wearing masks will be difficult during the summer time. My advice is especially when you are in an indoor or closed environment where there’s no free air exchange, in crowded places or on public transport, you must wear a mask.”

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Why I Follow Physicians on MedTwitter

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I follow physicians on the front line so that I can understand the risks of our new normal better and to periodically adapt my behavior to minimize those risks to my health and well being.  An example follows:

The credentials from Emory University School of Medicine:

Dr. Milad Sharifpour is an anesthesiologist and intensivist at Emory University Hospital. His clinical expertise includes perioperative care of patients undergoing neurosurgical and vascular surgical procedures, as well as postoperative care of patients undergoing cardiothoracic surgery in the intensive care unit. His clinical and research interests include perioperative stroke, perioperative fluid resuscitation, intraoperative mechanical ventilation, and postoperative pulmonary complications.

The May 15, 2020 tweet:

For those protesting social distancing (doubt they would read this) – a small group of my friends got together for lunch 10 days ago: 1 is on a vent, another admitted to a regular floor bed, 5 others are COVID + at home. You can be asymptomatic and have COVID19.

The state of Georgia started reopening a few weeks ago.

Yikes.

 

“We have a very large country and the dynamics of the outbreak are different, in different regions of the country.”

Anthony Fauci MD

We have better numbers in Oklahoma as the state enters Phase Two of our reopening and I still haven’t gone to a restaurant for a dine-in meal.

The YMCA has reopened and I’ve not gone for a work out yet.

My dentist called.  I haven’t called back yet.

I have been highly selective regarding which stores to shop at for essentials.

My barber has reopened and I have an appointment for May 31st.

It will be nice to get a real haircut.

 

 

 

 

Paediatric Multisystem Inflammatory Syndrome – (PIM-TS)

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Citation:
DFTB, T. Paediatric Multisystem Inflammatory Syndrome, Don’t Forget the Bubbles, 2020. Available at:
http://doi.org/10.31440/DFTB.25760

There has clearly been a lot of media interest in PIMS-TS but it is still an extremely uncommon disease entity in the context of all children presenting to emergency and acute care services. The vast majority of children, including those who were critically ill, have made a good recovery.