Covid-19 Update Aggie Physician

1,249,038 Views | 3660 Replies | Last: 1 yr ago by tamc91
Reveille
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Today's post!

https://www.facebook.com/1998386763777604/posts/2665433577072916/?sfnsn=mo
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Not a Bot
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Thanks for the updates. Look forward to reading them every day.
LostInLA07
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REMAP sounds like a potential game changer.
BiochemAg97
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LostInLA07 said:

REMAP sounds like a potential game changer.
Would be great if they could roll that out more broadly. Across UPitt is great, but need to apply it across the rest of the country too.

Would also be cool if they could apply the similar AI to other issues in the future. Not necessarily for only for clinical trial drugs, but predicting which treatments work best for an individual, especially in a complex disease such as cancer or a multifaceted ER presentation.
Reveille
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BiochemAg97 said:

LostInLA07 said:

REMAP sounds like a potential game changer.
Would be great if they could roll that out more broadly. Across UPitt is great, but need to apply it across the rest of the country too.

Would also be cool if they could apply the similar AI to other issues in the future. Not necessarily for only for clinical trial drugs, but predicting which treatments work best for an individual, especially in a complex disease such as cancer or a multifaceted ER presentation.


I believe they do plan on using it for many other conditions in the future. I agree that with the world being connected, they hopefully will integrate this across the country. That will save a tremendous number if lives!
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Mark Fairchild
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Blessed EASTER to you, your families, all in your profession, and their families. What you have given to us in this forum, is a great sevice to your fellow man. In BIBLICAL terms , you have "Loved your neighbor"!!!
Gig'em, Ole Army Class of '70
Chase
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Reveille said:

Today's post!

https://www.facebook.com/1998386763777604/posts/2665433577072916/?sfnsn=mo


My sister's hospital in Tyler started doing antibody testing Wed of this week so some are doing it. I don't know much about this stuff but was told this Thurs and thought it wpuld be of interest to you.
pantherag
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Chase said:

Reveille said:

Today's post!

https://www.facebook.com/1998386763777604/posts/2665433577072916/?sfnsn=mo


My sister's hospital in Tyler started doing antibody testing Wed of this week so some are doing it. I don't know much about this stuff but was told this Thurs and thought it wpuld be of interest to you.

Which hospital system?
murse
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Christus Trinity Mother Francis, I think other Christus hospitals may be doing it as well.
Reveille
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Today's update! Happy Easter Everyone!

https://www.facebook.com/1998386763777604/posts/2666315833651357/?sfnsn=mo
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Not a Bot
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Hearing Christus doing antibodies on some inpatients (I have friends at TMF) to help with diagnosis due to swab delays. Thought is that most patients with symptoms will have been infected > 10 days and will have antibodies. May not be as useful down the road for differentiation but seems to be helping them sort/treat for now since results are much faster. Still swabbing as well. Just another data point.

Not doing this where I am.
murse
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I work in surgery so I'm not in inpatient care anymore but we, Christus, are supposed to have a rapid PCR and rapid antibody test. The patients I've seen have had results back at least the next day instead of the week it was taking before.
DadHammer
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Great news, wil you be offering to the public soon so we can get back to work pronto?
Player To Be Named Later
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murse said:

I work in surgery so I'm not in inpatient care anymore but we, Christus, are supposed to have a rapid PCR and rapid antibody test. The patients I've seen have had results back at least the next day instead of the week it was taking before.
PCR?
zooguy96
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Player To Be Named Later said:

murse said:

I work in surgery so I'm not in inpatient care anymore but we, Christus, are supposed to have a rapid PCR and rapid antibody test. The patients I've seen have had results back at least the next day instead of the week it was taking before.
PCR?
PCR = Polymerase Chain Reaction, or a method to quickly make millions of copies of a particular strand of DNA.
I know a lot about a little, and a little about a lot.
Player To Be Named Later
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So a test to see who currently has it, or similar to antibodies test to see who had it?
zooguy96
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No clue, I'm not a doctor, just a Biology Teacher who knows what PCR is used for.
I know a lot about a little, and a little about a lot.
Badace52
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Player To Be Named Later said:

So a test to see who currently has it, or similar to antibodies test to see who had it?


Currently has it... PCR looks for viral RNA.

Edit: to be more precise, PCR replicates DNA so I assume this test is actually at RT-PCR which reverse transcribes (RT) DNA and then a polymerase chin reaction (PCR) multiplies that DNA into millions of copies that can then be detected using the molecule's known molecular weight and diffusion distance through a gel substrate.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Player To Be Named Later
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Thanks, an accurate rapid test would be a game changer IMO. Especially if HCQ shows any kind of legitimate hope when used early.
DadHammer
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Player To Be Named Later said:

Thanks, an accurate rapid test would be a game changer IMO. Especially if HCQ shows any kind of legitimate hope when used early.
Totally agree. Plus a fast test for antibody showing your immune.
Big Al 1992
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Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
AggieAuditor
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I think so. There is no other option. I don't think we have the stomach for letting people get it and developing herd immunity. We just need to really really hope we get some luck and nail down a vaccine that works, and soon.
Reveille
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Big Al 1992 said:

Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
That is probably very realistic and that would still be a huge number as only 0.17% has tested positive so far. If we have 10% that would definitely slow this disease down. It would not give us herd immunity as that will likely not occur to 60-70% but it would go a long way towards slowing the spread. Thus, making things significantly safer for many people. I am sure some statistics major could run the numbers on that. So that is not all bad, combine that with all we have learned about treating this virus and it should make you feel a little better.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
John Francis Donaghy
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AggieAuditor said:

I think so. There is no other option. I don't think we have the stomach for letting people get it and developing herd immunity. We just need to really really hope we get some luck and nail down a vaccine that works, and soon.


An effective treatment protocol to reverse the cytokene storm in severe cases would do wonders for a return to normalcy as well. If doctors have an effective method of treatment that drops the mortality rate to near zero, and gets the severe cases better and out of the hospital quicker, this thing becomes much less of a threat, and much less of strain on healthcare infrastructure.
Bruce Almighty
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10% may slow the disease down as long as 90% of those aren't all in the NE.
Reveille
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Bruce Almighty said:

10% may slow the disease down as long as 90% of those aren't all in the NE.
That is very valid point. What is most important is the percent in your area rather then the whole United States! And from what we are seeing New York and New Jersey may have a huge amount with antibodies while here in Texas it could be very low.
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California Ag 90
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Big Al 1992 said:

Interesting that Dr Gottlieb said today that once they have widespread antibody testing - data shows that he only expects 5-10% of entire US population will have it the antibodies in their system - contradicting what a lot of us have thought - that a lot of people are gonna find out they had it and already have the antibodies. If only 5% are "immune" that would stretch this thing further out, correct?
what is he basing this on? he states that we don't have widespread antibody testing but then speculates on antibody distribution based on what 'data shows'.

what data is he referring to?

i'm getting to a point that i don't and won't believe anything any epidemiologist says until we see widespread antibody testing. everything is conjecture until then.

We're from North California, and South Alabam
and little towns all around this land...
Zobel
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You can estimate from genetic testing (really inexact) and a time+distance model of spread (also inexact). I didn't see what he said directly but he's probably saying those kind of data tell us something, blood test will be the way to get a better estimate.
California Ag 90
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k2aggie07 said:

You can estimate from genetic testing (really inexact) and a time+distance model of spread (also inexact). I didn't see what he said directly but he's probably saying those kind of data tell us something, blood test will be the way to get a better estimate.
helpful. thanks.
We're from North California, and South Alabam
and little towns all around this land...
BiochemAg97
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Badace52 said:

Player To Be Named Later said:

So a test to see who currently has it, or similar to antibodies test to see who had it?


Currently has it... PCR looks for viral RNA.

Edit: to be more precise, PCR replicates DNA so I assume this test is actually at RT-PCR which reverse transcribes (RT) DNA and then a polymerase chin reaction (PCR) multiplies that DNA into millions of copies that can then be detected using the molecule's known molecular weight and diffusion distance through a gel substrate.
Actually don't need to do the gel thing anymore. The quantitative PCR machines have florescent tags and can measure the amount of amplified strands at each cycle, thus generating a curve to tell you how many copies you started with. The really cool ones use multiple florescent tags so you can monitor several different products in the same well.

Big Al 1992
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Here's what Dr Gottlieb said about those with antibodies ...

SCOTT GOTTLIEB: Well, it may be widely available, but I think it's of marginal utility and impact for these kinds of discussions. What serology tells you is if you have circulating antibodies in your blood, if you've been exposed to the virus and you've developed some level of immunity. But I think when we actually do serology on the population, we're going to find the actual level of exposure across the population is very low, somewhere between maybe two or five percent, and I'd put on the low end of that range. That's certainly the modeling, the data coming out of Europe where they have anywhere from two to five percent of their populations exposed. If you look in certain professions, healthcare workers, police, people who work on grocery checkout lines, flight attendants, TSA agents, people who come in contact with a lot of people as part of their work, the rates may be higher, maybe on the order of ten percent that have been exposed and developed some immunity. So you can make decisions in those professions to preferentially return certain people or put certain people on the frontlines right away. But on the whole, we're going to find that a very small percentage of this population, certainly in the single digits have actually been exposed to this infection. So the perception that there's thirty or forty percent--

MARGARET BRENNAN: Mm-Hm.

SCOTT GOTTLIEB: --that have been exposed and developed immunity, it's not going to be the case.
Reveille
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Today's update! Happy Easter Everyone!

https://www.facebook.com/1998386763777604/posts/2667205700229037/?sfnsn=mo
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
emando2000
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Contact Tracing System

Do we really think this is the way to go?
Chase
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murse said:

Christus Trinity Mother Francis, I think other Christus hospitals may be doing it as well.


Correct...the one with 30 names. lol

BiochemAg97
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emando2000 said:

Contact Tracing System

Do we really think this is the way to go?
The whole thing seemed like a big privacy issues to me initially, but some deeper analysis, Google/Apple's implementation is fairly reasonable from a privacy standpoint. Your phone would receive a code from everyone you come in close proximity to. If someone tests positive, they are added to the database of known infections, and your phone checks the database periodically and looks to see if you have been in proximity to anyone on the list during the time they were infected.

So, it isn't storing everywhere you went and everyone you came in contact with in some big database, although we know your phone company, Apple, google, Facebook, and everyone else seems to already have the location data and other countries are just using that to cross reference everyone for contact tracing.

Also, through some fun cryptography tricks, the code given to your phone can't be traced back to the individual, but when someone is added to the sick database, they add daily codes for the days they were infected. The daily codes can be used to determine if the codes your phone received are a match, but can't be used to identify the individual either as there is another layer of crypto to get back to the identifying code for the phone,

Finally, it appears the intent is for people to voluntarily identify as infected. Probably has to be that way because of medical privacy laws, but if we don't have most people voluntarily identifying, then it won't do much good.
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