Covid-19 Update Aggie Physician

1,276,289 Views | 3660 Replies | Last: 2 yr ago by tamc91
dermdoc
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Why is this news not all over the place?
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TyHolden
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dermdoc said:

Why is this news not all over the place?
your answer is probably on the polly board...
Pumpkinhead
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Rockdoc said:

I go to a gym 5 days a week to workout. And yeah I'm an old. I'm wondering how proactive the large gyms will be when it comes to closing down before it gets too bad. Perhaps that's all on me. Any feedback?
Everyone has their own decision to make, but once the schools closed in my area, I made the decision to stop going to the gym. I can jog and do workouts of various types at home. I couldn't justify to myself (or my children) continuing to go to the gym when it had been decided best to close all schools. Once this thing has passed and schools reopen and my kids are back in classes, I'll return to my normal routine.
Drip99
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Player To Be Named Later said:

Just got an email from my Chief at the PD. Without going into detail, they really seem to be planning on this getting pretty damn bad.

No mention of lockdowns, etc, but I basically need to start planning on the idea of being away from home for 14-21 days. And unless it's a critical call, don't plan on an officer showing up in person.

I don't get concerned or worried very easily at all, but I am.... this is about to get real.


Is this because very few are taking this seriously? According to a buddy, most of Frisco Is out and about ok the town tonite. Restaurants and bars are showing no signs of social distancing
RCR06
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With social media the way it is anyone can start posting anything. If it was a mess wherever don't you think people would be on facebook, twitter and instagram posting about it.
Player To Be Named Later
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JesusQuintana said:

Player To Be Named Later said:

Just got an email from my Chief at the PD. Without going into detail, they really seem to be planning on this getting pretty damn bad.

No mention of lockdowns, etc, but I basically need to start planning on the idea of being away from home for 14-21 days. And unless it's a critical call, don't plan on an officer showing up in person.

I don't get concerned or worried very easily at all, but I am.... this is about to get real.


Is this because very few are taking this seriously? According to a buddy, most of Frisco Is out and about ok the town tonite. Restaurants and bars are showing no signs of social distancing


I am working this weekend and have seen no noticeable difference in traffic/activity.

People seem to be out and about acting like normal.

It's pretty amazing. If I wasn't working, I wouldn't be out. Hell, Academy parking lot was pretty full.

People are going to have to be told how to behave, they won't do it on their own, sadly.
Pumpkinhead
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dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
dermdoc
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Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.
I get it. But the first reported case in Washington State was 1/21. First in Italy was the first week of February.

Why the apparent disparity in severity?

And fwiw, I trust info from Seattle a lot more than from Italy.
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Pumpkinhead
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dermdoc said:

Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.
I get it. But the first reported case in Washington State was 1/21. First in Italy was the first week of February.

Why the apparent disparity in severity?

And fwiw, I trust info from Seattle a lot more than from Italy.


I know one thing that happened in Italy was the first hospital or one of the first, didn't follow protocols and significant spread happened in the hospital. And then they lost control of it as people were walking around infected.

That Washington nursing home situation was actually lucky, because sure a bunch of people got infected in that nursing home but think about it...most of those people were not healthy enough to be moving around so the infection stayed mostly clustered. Awful for the residents of that nursing home, but for The surrounding area lucky it was a nursing home.

A far far worse scenario than a nursing home would have been say like a college dorm of 20 students got hit, they'd have some fever maybe but perhaps no idea they were infected, out still doing all their active regular routine and hitting the bars and clubs.

This virus, the elderly and compromised are at the most risk to die, but it is the younger, healthy people who are the most risk to be carriers and explode the spread.
Reveille
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This is exactly why the virus is so dangerous. So many people walking around asymptomatic and spreading the virus! The young healthy population dues not feel sick and thus they are out doing thier normal activities. Then they go visit grandma in the nursing home and she gets deathly ill. This is why they are more restricting vistors to nursing homes. Use video chat with high risk patients instead to limit thier risks!
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BiochemAg97
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k2aggie07 said:

We know they were having community spread before that by the number of mutations present in the virus that was sampled.

If you figure symptomatic transmission time per "jump" is 4 days median. R0 of 2 means each jump doubles base size.

Literature has been saying 7-8 days from symptomatic to respiratory issues / needing hospitalization. So 11 days from exposure. 15% hospitalization rate is reported, but some asymptomatic folks out there right? Let's guess 20%.

That works out to 8192 real infections by yesterday. Only 4096 are possibly symptomatic, and 3200 are just starting symptoms. Only 1024 are likely to have had it long enough for respiratory problems, and of those only 820 are symptomatic. 655 are minor. 122 need hospitalization. 40 are critical.

The math works out reasonably. And probably no one would notice that spread out in a state the size of Washington.

But by March 29 you have 3900 in hospital and 1310 ICU if you don't do anything.
The Wash patient 0 case returned from Wuhan 1/15 and into the hospital Jan 19.

I think your 4 days per is low based on the genetic analysis of the community spread case in Wash (Bedford), 3 mutations and 5 weeks later. Bedford said it was consistent with 7 days per (works if you assume 5 jumps), but is now saying maybe 5-6 per jump (works if you assume 6 jumps)

Bedford tweeted yesterday something about the spread of a mid Jan case being 2000 cases by now. That puts your calculations at 4x too high. It will get worse before it gets better because of the delay between infection and symptoms.

Bedford's tweets yesterday estimated total in the US at 10k-40k.
BiochemAg97
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Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
Where do you people get doubling every 2 days? The science is saying transmission every 7 days.
Pumpkinhead
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BiochemAg97 said:

Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
Where do you people get doubling every 2 days? The science is saying transmission every 7 days.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

See Chart 5: Daily Growth Rate of Cases Between 3/5 and 3/6 and the discussion around that regarding the countries that have most recently been showing an exponential growth rate in cases. Those countries are approximately doubling their cases every 2 days.
Capitol Ag
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Rockdoc said:

I go to a gym 5 days a week to workout. And yeah I'm an old. I'm wondering how proactive the large gyms will be when it comes to closing down before it gets too bad. Perhaps that's all on me. Any feedback?


I'm at risk but work at a gym. I'll go until we are told not to leave the house (if it ever comes to that. I also have the key to the gym and can go even if we shut down). But it depends on how you train. What your goals are and if that works for you at home. If it does, stay home. There's a lot you can do at home.






And as I stated on another thread, for those that haven't been training (my term for "working out") regularly yet, this is a fantastic opportunity to start from home. You'll have time on your hands, if you've felt out of place at a local gym, you won't at home where only your spouse, kids and family pets can laugh at you , and it really helps to reduce stress during these types of situations and while we are all cooped up together. You don't have to get dressed for the gym and drive there. Get habits going now and a lot of you may just continue this at a more advanced rate once this all passes in a few weeks. Don't sit around your house all day eating processed crap, getting more out of shape and being sedentary. Do something that will actually strengthen your immune system and make you stronger. There's a reason those that are fit tend to survive and get through these types of events.
roveram
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Feds now banned all visitors from nursing homes. The only exception is 'compassionate care situations', basically family hospice visits.

I've been an administrator for a long time. Haven't seen that before.
BiochemAg97
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Pumpkinhead said:

BiochemAg97 said:

Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
Where do you people get doubling every 2 days? The science is saying transmission every 7 days.
https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

See Chart 5: Daily Growth Rate of Cases Between 3/5 and 3/6 and the discussion around that regarding the countries that have most recently been showing an exponential growth rate in cases. Those countries are approximately doubling their cases every 2 days.
That is the number of known cases. I think the growth in testing drives that 2 day doubling more than the rate of infection.

A bit further down...
"Now, use the average doubling time for the coronavirus (time it takes to double cases, on average). It's 6.2."

And chart 18 says doubling time of 7-10 days.
Reveille
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BiochemAg97 said:

Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
Where do you people get doubling every 2 days? The science is saying transmission every 7 days.


Read this article and watch the animations this will help you understand how it spreads exponentially. It also demonstrates why isolation doesn't work and why social distancing does!

Article: Why outbreaks like coronavirus spread exponentially, and how to "flatten the curve"
https://flip.it/6Bfwum
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Reveille
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roveram said:

Feds now banned all visitors from nursing homes. The only exception is 'compassionate care situations', basically family hospice visits.

I've been an administrator for a long time. Haven't seen that before.


This is a great policy considering how the virus spreads and the fact that almost all nursing home patients are extremely high risks.

I suggest you have staff teach patients how to use Google Duo (works on all platforms) to communicate with thier love ones. This will still let them see each other and but put them at risk.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Stupe
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3rd Generation Ag
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I live in an older than 55 community and we, the residents, have discussed how important it is to stay in where possible to protect each other. That said one of the younger people (as in barely 55) and very healthy by the way, said in passing, as those of us who were visiting were putting ourselves at least six feet apart as per guidelines, as she came in from shopping. She said she had been to several stores in Arlington Highlands, at least three different grocery type places, including one that caters to the international market, and an eatery. I am no longer even going to to down to the amenities area. I worried and still do about bringing it in from school, but she seems to have no concern about the more fragile people who live here. So I wonder if the restrictions on nursing homes and assisted living levels need to be expanded to independent living and active 55 places. This is a nice lady who just thinks the entire thing is overblown by media and not a big deal.
mcca1359
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I have a trip to Charleston, SC planned with my wife and 6 family members. Rented a big AirBNB. Charleston has 1 reported case.

We leave Friday and fly out of Austin. Flight has 1 stop in Atlanta.

We are thinking as long as we practice extremely good sanitation that we should be fine.

Am I crazy?
Stupe
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Can we please keep this thread on subject as an information and question / answer thread by the OP?

We have an entire forum to post information and theories from other sources and personal anecdotes.

Reveille is taking time out of his very busy schedule to post his first-hand info as well as look for questions. The more posts that he has to scroll through, the more time that it takes for him to find them.

He's doing us a INCREDIBLE service on this thread and we should do our best to make it as easy on him as possible.
BiochemAg97
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Reveille said:

BiochemAg97 said:

Pumpkinhead said:

dermdoc said:

So instead of looking at Italy or Spain, I look at Seattle and Washington as they seem to be where we will be in a week. Take away the 20 nursing home deaths and it is very encouraging.


The cases you are see today is what was actually happening a week or more ago.

That is the danger with the spread of this virus. The data you have for today is actually what was happening in the past. You won't know what is really happening TODAY until several days from now, and if there were exponential growth rates then the number of cases have been doubling approximately every 2 days.

With an exponential curve, at first you are doubling small numbers so the increase is gradual. But once the curve takes off, the spread gets really extensive really fast.

That is why you see our own government now taking more and more actions, despite the harm to the economy. They see the trend line and the train coming and are now trying to more aggressively mitigate.
Where do you people get doubling every 2 days? The science is saying transmission every 7 days.


Read this article and watch the animations this will help you understand how it spreads exponentially. It also demonstrates why isolation doesn't work and why social distancing does!

Article: Why outbreaks like coronavirus spread exponentially, and how to "flatten the curve"
https://flip.it/6Bfwum
I understand exponential growth. We see it in a lot of place. Doubling of bacteria in a culture every 20-30 minutes, doubling of viral infections over the course of several days, doubling of the earth population over the course of a couple decades. But the time to doubling make a big different. Doubling every 2 days vs doubling every 7 days is drastically different in the implication of the number of currently undetected cases in places like Washington.

I find it interesting that the first patient that presented in Italy was Jan 20, about the same time as the first case presented in Washington. Yet, Washington isn't over run yet.
1) Washington patient 0 just came from Wuhan, so likely was the break through case there. In Italy the first patient hadn't traveled to China so was not the breakthrough case, but a community spread case. We didn't identify a first community spread case in Washington until about 5 weeks later. Was it already spreading in Italy for weeks before hand?
2) population density is a significant factor. If you change the number of dots in those models, the spread profile is very different. The region in Italy where the outbreak started is very high density population. Most of America has a much lower density while should slow the spread significantly. That doesn't help in big cities though.
Reveille
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3rd Generation Ag said:

I live in an older than 55 community and we, the residents, have discussed how important it is to stay in where possible to protect each other. That said one of the younger people (as in barely 55) and very healthy by the way, said in passing, as those of us who were visiting were putting ourselves at least six feet apart as per guidelines, as she came in from shopping. She said she had been to several stores in Arlington Highlands, at least three different grocery type places, including one that caters to the international market, and an eatery. I am no longer even going to to down to the amenities area. I worried and still do about bringing it in from school, but she seems to have no concern about the more fragile people who live here. So I wonder if the restrictions on nursing homes and assisted living levels need to be expanded to independent living and active 55 places. This is a nice lady who just thinks the entire thing is overblown by media and not a big deal.


Unfortunately, it is this type of selfish behavior that causes the virus to spread. Her ignorance of the virus will cause hate to others. There is way too many people with this type of mentally. You can have get read my update today which addresses this very problem.

https://m.facebook.com/story.php?story_fbid=2640812729535001&id=1998386763777604

You can only control yourself not others but you should encourage her to learn more about it so maybe she will change her way if thinking.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Reveille
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mcca1359 said:

I have a trip to Charleston, SC planned with my wife and 6 family members. Rented a big AirBNB. Charleston has 1 reported case.

We leave Friday and fly out of Austin. Flight has 1 stop in Atlanta.

We are thinking as long as we practice extremely good sanitation that we should be fine.

Am I crazy?


I don't think I would travel anywhere unless it was a secluded hunting ranch with no other humans around. Traveling right now is just increasing your chance of catching and spreading the virus. Remember it was travel that got us into this problem to begin with.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Pasquale Liucci
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Family vacation in Maui the last week of May. Definitely a bad idea or too far out to say?
hook60
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This is interesting. You can see social distancing is the way to go. I wonder if it was mandated that you had to wear a mask to go in public if that would be a form of distancing. I know a mask does not keep you from getting it, but seems to impact an infected person spreading it. https://www.washingtonpost.com/graphics/2020/world/corona-simulator/?fbclid=IwAR0BuVujsvvT7Ke0EdknwjfmzLXXOGZngGmF-BY0XtzbxAUG3DQFKx9Fsek
TitanAGGIE09
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Law361
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With the prospect of having my 3 young kids at home for the next several weeks, my wife and i are trying to put a schedule together to help them get out of the house. We know that walks are a good idea, but what about public parks? Not talking about playing with other kids, just playing on the equipment. How long can the virus survive on an outdoor surface that doesn't get regularly disinfected? Thanks.
dutch15
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Reveille,

I've been following the progression of the virus in China, South Korea, and Italy for the past 6 weeks. Something doesn't make sense in all the discussions going on as it relates to China. They have reported only 80k cases in a country of over 1 billion people. I realize they probably under reported significantly. However, lets say they had even a million cases to compensate for their under reporting. It doesn't correlate to the exponential growth we are discussing in the US. Also, they have supposedly flattened the curve and now are having people go back to work. Why are they not at risk of it ramping back up again. I have a hard time believing they have isolated all their cases. It seems like they know something we don't. What gives them the confidence to allow people to congregate again?





SW AG80
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mcca1359 said:

I have a trip to Charleston, SC planned with my wife and 6 family members. Rented a big AirBNB. Charleston has 1 reported case.

We leave Friday and fly out of Austin. Flight has 1 stop in Atlanta.

We are thinking as long as we practice extremely good sanitation that we should be fine.

Am I crazy?
We were going on March 31 but have cancelled. My wife's father is 91 yoa and she sees him daily. If we brought this virus back to him it would be a kill shot. Just because there is only 1 reported case in Charleston now doesn't mean there are many walking around who are asymptotic. And I would not get on an airplane right now. You need to think of others, not just your traveling companions.
PuryearFratDaddy
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Reveille, thanks for starting this and know managing it is like the virus itself...so thanks again for guiding!

One question, my wife's spleen was removed 5yrs ago. Does that put her in higher risk? She is 40.

I have not seen anything on internet except two differing opinions, so seems encouraging. What I have read is spleen focuses on red blood cells whereas covid-19 is focused in white books cells.
Gateman
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Thomas Ford 91 said:

Has anybody here actually communicated with a hospital worker in Seattle this afternoon? Earlier reports sounded like it was getting bad, then all the info kinda dried up.
I checked in with my Doctor connection working at County hospital in Seattle. He didn't have much info to offer because HE HAS BEEN OUT SICK past several days with typical cold/flu symptoms but no shortness of breath issues. Not tested for Corona and plans to return to work in a few days.
farmrag
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I have curbside scheduled for noon tomorrow. As long as I don't get within 6 feet will I be ok?
ADJME7002
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