Last month the skeptical cardiologist asked Nicola Triglione, a native of Southern Italy who completed his cardiology fellowship in Milan to give us his perspective on the US and Italian health care systems. Since Italy is now at the European epicenter of the COVID-19 epidemic and second only to China in number of cases and deaths,…
via A Message From Italy On Coronavirus and COVID-19 — The Skeptical Cardiologist
I roll in my bed, unable to sleep. I listen to BBC talk about the craziness that took over the world, preoccupied with this one question. What question? It’s not: “Why, Corona?” For that, I already have more answers than I want. Scientists say that COVID19 is an animal virus. It spread to humans from…
I’ve been reading a lot of COVID-19 news articles. Here are a few of my favs.
In South Korea, public health officials screened about 100,000 people and detected over 7,300 cases. So far, the death toll is 50, which translates to a case-fatality rate of 0.7 percent. That’s still seven times worse than seasonal flu, but it’s far lower than the initial reports from China.
Impact of the epidemic in the U.S.
Now that new COVID-19 cases are being detected in the U.S. every day, it is too late to stop the initial wave of infections. The epidemic is likely to spread across the U.S. The virus appears to be about as contagious as influenza. But this comparison is difficult to make since we have no immunity to the new coronavirus.
How big will the coronavirus pandemic be? An epidemiologist answers.
Dr. Jennifer Nuzzo, a senior scholar at the Johns Hopkins Center for Health Security, is among those arguing hospitals need to change course. “It’s just not sustainable to think that every time a health care worker is exposed they have to be quarantined for 14 days. We’d run out of health care workers,” Nuzzo said.
Self-quarantines will lead to health worker shortagesSelf-quarantines will lead to health worker shortages
Fei Zhou, MD, from the Chinese Academy of Medical Sciences, and colleagues conducted a retrospective, observational, multi-center cohort study of 191 patients, 137 of whom were discharged and 54 of whom died in the hospital.
The study, published online today in The Lancet, included all adult inpatients with laboratory-confirmed COVID-19 from Jinyintan Hospital and Wuhan Pulmonary Hospital who had been discharged or died by January 31 of this year. Severely ill patients in the province were transferred to these hospitals until February 1.
Overall, 91 (48%) of the 191 patients had comorbidity. Most common was hypertension (30%), followed by diabetes (19%) and coronary heart disease (8%)…The average age of survivors was 52 years compared to 69 for those who died. Liu cited weakening of the immune system and increased inflammation, which damages organs and also promotes viral replication, as explanations for the age effect.
Click the link below for the full source article.
Risk Factors for Death From COVID-19 Identified in Wuhan Patients
Your daily dose of Covid-19.
The full article (link below) is worth reading.
Dr. Paul Sax is the clinical director of the Division of Infectious Diseases at Brigham and Women’s Hospital, Professor of Medicine at Harvard Medical School, and blogs on infectious disease here.
Infectious Disease Doctor: What Does (And Doesn’t) Scare Me About The Coronavirus
Update:
A reader informed me the link above isn’t working.
Madilyn and I waited for communication from her sister and were shocked that she landed in DFW, on a plane with 348 passengers with masks, and no one asked any questions about exposure or symptoms — there was no screening at all. She quickly realized her mask at DFW looked conspicuous, so she removed it and awaited her connecting flight home.
A physician’s chilling COVID-19 diagnostic journey
Here’s your daily dose on Covid-19.
If you are suffering from Covid-19 anxiety disorder please don’t read the full article.
Marler Clark is a law firm in Seattle Washington. Outstandingly proactive and quoted here for my readers to view.
I especially liked the generous financial contribution to the employees and the last item on the list to stock in your pantry.
Here is what I sent my staff late last week:
All, see symptoms below – if you are sick, please stay home.
https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html
I have asked Chris and Michelle to give me some ideas on recommendations on how to responsibly deal with this from a medical issue. We will give you all our thoughts early next week.
All, please email to Leslie all your contact information and a close contact too. Leslie, please share that with all.
All, please let me know if anyone needs any technology to work from home if necessary if this becomes a bigger problem. Think about what you might need to work from home for an extended period of time. What do you need to effectively do your job from home – computer, paper, pens, etc.? COVID-19 is not an excuse to work from home, but I want to be prepared and sensible.
Also, let’s look at travel schedules over the coming months to see if there are alternatives. Please shoot me your travel over the next 30-60 days.
All, take a hard look at your cases – what deadlines might be impacted by Court and other office closures, etc. I want us to be proactive and think ahead. I do not want deadlines missed.
Finally, not to be a “prepper,” but Kelli, please drop $2,500 (pre-tax) into everyone’s account on Monday to be used as they see fit to prepare for some disruptions. I have not thought of exactly what those needs might be, but there are probably a few websites that have suggestions.
Here are some ideas for being prepared for home:
All medications (over the counter *ibuprofen* , allergy, cold etc and prescriptions )
All household products you will need for two weeks (toilet paper, soap, paper towels, laundry detergent, cleaning supplies, etc)
Supply of water for two weeks
Food for two weeks
⁃ Chicken broth
⁃ Beans
⁃ Onions
⁃ Garlic
⁃ Potatoes – sweet, Yukon, etc
⁃ Pasta
⁃ Canned tomatoes
⁃ Steel cut oats
⁃ Peanut butter
⁃ Bread *freezer*
⁃ Eggs
⁃ Frozen meat
⁃ Canned fish
⁃ Jerky or dried meat
⁃ Dried nuts and fruit
⁃ Popcorn
⁃ Chocolate
⁃ Wine/booze of choice
The Internet Book of Critical Care is an online textbook written by Josh Farkas (@PulmCrit), an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.
This online source is highly technical and written for Emergency Medicine specialists. I only know about this source because of Project #1. But if you’re interested in a deep dive into Covid-19 this website offers fascinating reading.
My #1 takeaway:
It remains unclear what fraction of patients are hospitalized.
There may be lots of patients with mild illness who don’t present to medical attention and aren’t counted.
The vast majority of infected patients (e.g. >80%) don’t get significantly ill and don’t require hospitalization.
Stay calm.
Coronavirus Disease 2019 (COVID-19)
This is a link to virus updates from JAMA.
This suggests that the overall clinical consequences of Covid-19 may ultimately be more akin to those of a severe seasonal influenza (which has a case fatality rate of approximately 0.1%) or a pandemic influenza (similar to those in 1957 and 1968) rather than a disease similar to SARS or MERS, which have had case fatality rates of 9 to 10% and 36%, respectively.2
Click here to read the full NEJM Editorial.
I’m hoping the NEJM editorial gets read and shared widely. Clearly all individuals and businesses need to be prepared for the worst case scenario. If you manage a large company, go back and review/revise your disaster recovery/business continuation plans. I’d make absolutely certain your tele-commuting platform is A+ and working as well as possible. You may even consider expanding your remote work capabilities because every one of your employees might be using it. Soon.
lifeunderwriter.net 
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