Covid-19 Update Aggie Physician

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La Bamba
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10:44a, 3/14/20
AG
Looks like the first testing station open to the public should be in San Antonio, followed by Dallas. Exact locations to be announced.

https://www.kvue.com/article/news/health/coronavirus/coronavirus-texas-abbott-drive-thru-testing-sites/269-17ae7bbc-74fa-42df-aa16-0d332c8a81a1
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hatchback
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In reply to La Bamba • 10:46a, 3/14/20
AG
However, these stations will not be open to everyone:
Quote:
According to a statement from the governor's office, the drive-thru facility "will serve first responders, healthcare workers, operators of critical infrastructure and key resources, and certain high-risk patients."
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Badace52
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In reply to hatchback • 10:52a, 3/14/20
AG
Not yet... Eventually they should be.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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ocag
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10:57a, 3/14/20
AG
Question I haven't seen asked yet....if the virus lasts on surfaces for hours to a few days, how important is the disinfection being done in schools, etc that are closed for a week plus?
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Reveille
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11:01a, 3/14/20
AG
People who keep asking me about the numbers being so low that is because the majority of people are completely asymptomatic and not tested. In addition somehow the media is not getting all of them either. But they are being reported to the appropriate authorities.

For instance this story has not been in the news yet but probably will. I know of a physician who tested positive. He was and still is asymptomatic. However, he and many other physicians who he contacted are now in self isolation. This creates more burden because it decreases are number of providers. In addition they are contacting recent patients he saw to let them know to isolate themselves and watch for symptoms. It does not mean they will all get the virus but they need to stay away from others until we know they do not convert to positive.

This will continue to happen as more patients and unfortunately even providers are identified with the virus.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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BiochemAg97
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In reply to Wheatables02 • 11:05a, 3/14/20
AG
Wheatables02 said:
BiochemAg97 said:
OaklandAg06 said:
Q for the Drs- how is information that has been coming out of Asia around treatments being put to use? I've heard a lot about remdesivir, HIV drugs, and hydroxychloroquine. I know we have a lot of red tape in our medical system and curious how we are putting lessons learned from other countries for treatment to use here.


CDC director's blog said we are doing trials of Remdesivir already. So yes, we are paying attention and using it to treat patients.

However, all I've seen on remdesivir is anecdotal so far. I haven't seen the results of the controlled study China was doing.

We have to balance treating all the patients with something that may not work and waiting too long to treat.
Michael Osterholm said on Joe Rogan that its being "expedited" but don't expect anything until a year from now until never. He used Zika as an example.....we still don't have one for that.


I think Zika is a poor comparison here. Remdesivir was effective against other coronaviruses (MERS and SARS). That is why everyone (China, Japan, US) tried it with COVID19 patients to apparent success.

The 81 yo critical patient in Washington it was used on recovered. One patient doesn't prove effectiveness, but when you add the successful outcomes in China, Japan, US, there is a lot to suggest it will prove to be effective. Probably not 100% because nothing ever is.

Now can Gilead make enough to supply the whole world? China media is already suggesting they could stop supplying ingredients for meds to the US, which I think is a ploy to guarantee a supply of remdesivir and/or whatever else we find to be effective.
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BiochemAg97
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In reply to ocag • 11:10a, 3/14/20
AG
ocag said:
Question I haven't seen asked yet....if the virus lasts on surfaces for hours to a few days, how important is the disinfection being done in schools, etc that are closed for a week plus?


Schools probably all need a deep clean disinfection anyway. Plenty of other things to get kids sick (flu, cold, strep, staph).

Plus it is CYA.
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thegoodolag15
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In reply to Badace52 • 11:12a, 3/14/20
AG
Thanks for the reply! I feel completely healthy right now, but I still want to be prepared in case of contraction. Honestly with the amount of school work I have I pretty much isolate myself from everyone anyways!
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CowtownAg06
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11:15a, 3/14/20
AG
I know our actual cases are much higher than we know do to lack of testing, but in cases like the rodeo in Houston, where a positive tested person was in large crowd, shouldn't we have seen an uptick of severe cases by now? That was 15-16 days ago, and I thought we'd see reports of ICUs filling up by now.

Are the people that were at cook off in the clear with no symptoms from that one exposure?

Also do we know how long a person with the virus remains contagious? Is it until all symptoms are gone?

Thanks to Rev and all the professionals on here.
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AgsMyDude
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11:20a, 3/14/20
AG
Are blood oxygen sensors worth having on hand, like this one?

https://www.amazon.com/dp/B019EKP19Q/ref=cm_sw_r_sms_apa_i_xqqBEbN75VD26
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deddog
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In reply to Reveille • 11:21a, 3/14/20
AG
Reveille said:
atag said:
My coworker is on dialysis and we work with the public. Is he at extra risk or does that have no effect? Thanks for your time!!!


Absolutely someone on dialysis should be considered very high risk. They should stay home and reverse isolation should be done to prevent him from catching it.
Have a teenager with VTach controlled by Mixcellitin.
I assume that he is high risk, and should be home?
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Zobel
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In reply to CowtownAg06 • 11:30a, 3/14/20
AG
Even if that guy seeded 30 people there, that's only time for a few "jumps". If each jump happens on four days and each of new person infects 2 people here on out, that means right now there are ~250 people out there from that event, and half of them aren't symptomatic yet.

Exponential growth is fast, but not that fast.

And even then the reports say time from onset of symptoms (+4 days from infection) to respiratory distress is 7-8 days. So +11 days from infection (4 days ago) would have been the first hospitalization, and it would have had to come from one of the initial 30.
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Badace52
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In reply to AgsMyDude • 11:42a, 3/14/20
AG
AgsMyDude said:
Are blood oxygen sensors worth having on hand, like this one?

https://www.amazon.com/dp/B019EKP19Q/ref=cm_sw_r_sms_apa_i_xqqBEbN75VD26


Probably unnecessary. If you feel short of breath to the point where your blood oxygenation will register as low you should just go to the ER to get evaluated. We have them there.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Badace52
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In reply to CowtownAg06 • 11:47a, 3/14/20
AG
It has not been long enough for us to really see the ICUs filling up and if people actually socially distance like has been proposed (which is not happening), hopefully they won't fill up. The incubation period before symptoms is an average of around 4 days but up to 14.

With some quick math we can see the entire course of disease may take over 28 days.

We are not entirely sure how long people remain infectious with this virus but it is likely that they are still infectious for several days after symptoms are resolved.

The current recommendation from the state health department for self isolation in people who believe they have symptoms related to Covid-19 is a MINIMUM of 14 days.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Badace52
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In reply to DTP02 • 11:53a, 3/14/20
AG
DTP02 said:
In terms of being ready to treat symptoms at home during a self-quarantine, what OTC meds would be ideal to have on hand:

Cough syrup- dextromethorphan or other active ingredient?

Is expectorant like guaifenesin helpful or not?

fever reducers

Cough drops

Anything else?


I kinda answered some of your questions in a previous post so I'm just gonna paste that response below. Some of it will not make sense related to your specific question.

"If you have no other co-morbid conditions and are currently not feeling short of breath to the point you feel you may need to be hospitalized, right now the answer is to self quarantine for at least 14 days and treat your symptoms with over the counter medicines. Also stay well hydrated with a 50:50 mix of water and electrolyte containing fluid (Gatorade, Powerade, propel, Pedialyte, etc...)

I generally recommend a regimen of Guaifensin DM, acetaminophen for fever, ibuprofen or naproxen for body aches/fever, pseudoephedrine for congestion (less common with Covid-19), and loratadine for seasonal allergy symptoms (which a lot of people are having due to all the tree pollen in the air independent of any viral infection.). Always check with your primary care physician if you take any type of daily medications or have any known medical conditions to make sure the above drugs are o.k. for you.

Soon there will be drive through testing centers you can go to where you stay in your car and they test you. These are not open yet. Once they are you could go there for testing."
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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BiochemAg97
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In reply to Zobel • 11:57a, 3/14/20
AG
k2aggie07 said:
Even if that guy seeded 30 people there, that's only time for a few "jumps". If each jump happens on four days and each of new person infects 2 people here on out, that means right now there are ~250 people out there from that event, and half of them aren't symptomatic yet.

Exponential growth is fast, but not that fast.

And even then the reports say time from onset of symptoms (+4 days from infection) to respiratory distress is 7-8 days. So 11 days ago would have been the first hospitalization, and it would have had to come from one of the initial 30.


Plus only 20% need hospitalization, ignoring the asymptotic cases. So of the 30 initial people, 6 people at most would need to be in the hospital.
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74OA
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In reply to Badace52 • 12:02p, 3/14/20
AG
Does this info jive with what you're seeing regarding how the virus is acting? RESILIENT
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Zobel
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In reply to BiochemAg97 • 12:04p, 3/14/20
AG
Right. And I should have said 4 says ago, 11 days from cook off. And even then hospitalized median age is skewed higher than average disease age, so if all 30 of the people at cookoff were young and healthy you'd expect even fewer people to need to be hospitalized.
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Badace52
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In reply to 74OA • 12:19p, 3/14/20
AG
Yes, that appears to be a pretty accurate article as to what we think we know so far.
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iluvpoker
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12:28p, 3/14/20
Will the transmission rate of this virus drop with warmer weather? If so, what high and/or low temp does this occur at?

Tia

Edit- looks like temp has little effect.
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74OA
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In reply to iluvpoker • 12:56p, 3/14/20
AG
iluvpoker said:
Will the transmission rate of this virus drop with warmer weather? If so, what high and/or low temp does this occur at?

Tia

Edit- looks like temp has little effect.
I read an article recently that said the virus prefers temps around 47F, as temps get warmer it does progressively less well.
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94chem
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1:08p, 3/14/20
Quote:
pseudoephedrine for congestion (less common with Covid-19)


I went many years thinking this was by prescription only, and only recently realized that all you need is a driver's license at the counter. Anyway, just in case somebody out there is ignorant like I was. None of that imitation phenylephrine junk works as well. Make sure you get the actual store brand pseudoephedrine from behind the counter, and not the placebo.
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Badace52
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In reply to iluvpoker • 1:14p, 3/14/20
AG
This is unknown, but what information we do have seems to suggest this virus does best at an average of 47degrees F and low humidity.

Most coronaviruses slow their spread at least somewhat at higher ambient temperatures. There is at least some hope warm weather will help to slow the spread.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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CowtownAg06
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In reply to Badace52 • 1:32p, 3/14/20
AG
It was a U if Maryland paper (I think posted by Reville). 47 ideal, 41-52 would thrive. It also like humidity between 49-79%. That doesn't mean it dies but will slow we hope.
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MRB10
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1:50p, 3/14/20
AG
I received the flu and tetanus shots at my physical yesterday, which was around 8:30a.
Wife is pregnant.

I started having some body aches last night and woke up this morning not feeling great. Temp was 97.6 at 8:30a today.

Felt a bit better after some breakfast and an airborne tablet. Enough so that I did some yard work this morning.
Showered/ate lunch 1-2 hours ago.
I've had that "fever" feeling for about 30 min and it's now 99.3. I also get season allergies around this time of year.

Any concerns? My wife being pregnant is my main worry. The CDC website said low grade fever and body aches are semi normal after a flu shot so I'm not too worried about me. I hadn't had a flu shot for at least 10 years before yesterday.
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Badace52
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In reply to MRB10 • 2:00p, 3/14/20
AG
While studies regarding pregnant women and Covid-19 are small in size and few. There is no data to suggest pregnant women are at higher risk of poor outcome from the virus than other people in their same age range.

It should also be noted that body aches while usually present with any fever to some degree, are reportedly much less intense in Covid-19 than with the flu.

Edit: In addition, mild fever and body aches are very common immediately after receiving vaccines and are indicative of the body reacting acutely to the vaccine material while trying to create antibodies to protect you against whatever you were just vaccinated against.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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Counterpoint
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In reply to MRB10 • 2:01p, 3/14/20
AG
BoilerAg10 said:
I received the flu and tetanus shots at my physical yesterday, which was around 8:30a.
Wife is pregnant.

I started having some body aches last night and woke up this morning not feeling great. Temp was 97.6 at 8:30a today.

Felt a bit better after some breakfast and an airborne tablet. Enough so that I did some yard work this morning.
Showered/ate lunch 1-2 hours ago.
I've had that "fever" feeling for about 30 min and it's now 99.3. I also get season allergies around this time of year.

Any concerns? My wife being pregnant is my main worry. The CDC website said low grade fever and body aches are semi normal after a flu shot so I'm not too worried about me. I hadn't had a flu shot for at least 10 years before yesterday.


I always feel a little weird (like you're describing) after a flu shot. But it's WAY better than the flu!
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jsc8116
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2:03p, 3/14/20
AG
Here in Utah....

Wife is an elementary school teacher. Her district has announced they are "soft" closing for next two weeks, Spring Break is 3 weeks away. Soft closing definition here is that teachers will still be required to go to school from 8am-1pm for next two weeks. District have said ideally students will stay home if they can to do lessons online, BUT for those students who have no computer/internet access at home can come to school OR whose parents cant take care of their kids at home because of needing to go to work can also take their kids to school.....crazy. Kind of pointless in my opinion.

Would imagine Unions will fight this over the weekend.
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Badace52
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In reply to jsc8116 • 2:05p, 3/14/20
AG
jsc8116 said:
Here in Utah....

Wife is an elementary school teacher. Her district has announced they are "soft" closing for next two weeks, Spring Break is 3 weeks away. Soft closing definition here is that teachers will still be required to go to school from 8am-1pm for next two weeks. District have said ideally students will stay home if they can to do lessons online, BUT for those students who have no computer/internet access at home can come to school OR whose parents cant take care of their kids at home because of needing to go to work can also take their kids to school.....crazy. Kind of pointless in my opinion.

Would imagine Unions will fight this over the weekend.


Definitely not ideal as far as transmission prevention is concerned.
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Reveille
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In reply to AgsMyDude • 2:17p, 3/14/20
AG
AgsMyDude said:
Are blood oxygen sensors worth having on hand, like this one?

https://www.amazon.com/dp/B019EKP19Q/ref=cm_sw_r_sms_apa_i_xqqBEbN75VD26


Yes those are helpful and I think now that they affordable every house should have one. Just remember if you do not see I constant pulse beat then it is but picking up correctly so the number is not accurate.

For a healthy person the reading should be between 95 to 100. Consistent readings below 92 requires possible hospitalization.

FYI most Samsung phones have a pulse ox reader but into it. So if you have a Samsung phone you can Google how to use it.
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Reveille
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In reply to AgsMyDude • 2:19p, 3/14/20
AG
AgsMyDude said:
Are blood oxygen sensors worth having on hand, like this one?

https://www.amazon.com/dp/B019EKP19Q/ref=cm_sw_r_sms_apa_i_xqqBEbN75VD26


Read my update from yesterday I addressed this
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Reveille
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2:23p, 3/14/20
AG
Just want to say thanks to Badace52 for helping answer questions. I appreciate it!
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3rd Generation Ag
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2:24p, 3/14/20
AG
Thanks for the heads up about phone. Never knew it was there.
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Player To Be Named Later
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In reply to 3rd Generation Ag • 2:31p, 3/14/20
AG
3rd Generation Ag said:
Thanks for the heads up about phone. Never knew it was there.


It's there, but of course now it's not working on my phone. Always has until now.
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Badace52
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In reply to Reveille • 2:43p, 3/14/20
AG
You are welcome... This is a great thread you started. You are doing a lot of good for a lot of people. Just trying to offer help where/when I can in this tumultuous time.
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