Covid-19 Update Aggie Physician

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hatchback
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https://texags.com/forums/84/topics/3099779

Quote:

...aiming to consolidate accurate, helpful information about the coronavirus and the various public health implications now impacting all of our lives.

...

To be clear: This is not a place to post your opinion as fact or to post information not rooted in clear facts. This is not a place to have political arguments or to detail your opinions about how well or poorly the government is handling the issue. This is not a place to rant about media conspiracies. This is not a place to critique other people for their level of concern or efforts to prepare. There are forums for (some of) those conversations, but they don't belong here.

Again, our goal is to highlight some of the helpful information from doctors, public health experts, and others that is already appearing in other forums and to give our community a specific place to ask questions and get helpful, accurate answers.
Reveille
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Lester Freamon said:

Family vacation in Maui the last week of May. Definitely a bad idea or too far out to say?


Too far out to say but hopefully by then we have flattened curve by that time.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Mantis Toboggan MD
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PuryearFratDaddy said:

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.
Your spleen deals with all blood cell lines, white cells, red cells, and even platelets; with it's two primary functions being 1) Clearance of "bad cells" from the blood stream (either old ones or cells that have been targeted by the immune system) and 2) Production/maturation of white blood cells. White cells produced by the spleen are primarily involved with antibody production (e.g. humoral immune system), which play a more central role in the immune response to bacteria (particularly encapsulated bacteria like pneumococcus, heamophilus influenzae, and meningococcus). This is in contrast to lymph nodes, which play a more central role in the immune response to viruses, like COVID-19.

With that being said, having a splenectomy in and of itself does not significantly increase her risk of a viral infection like COVD-19, but it does put her at risk for certain bacterial infections that could develop as a sequelae of any viral respiratory infection, like COVID-19. Because of this and depending on her age, I would consider her at higher risk. Because of this risk, splenectomy patients can sometimes be prescribed a supply of antibiotics to have on-call and are to be initiated at the first sign of infection, so I would speak with her doctor to see if she would be a candidate for some at this time. But aside from that and ensuring that she is up to date on her vaccinations, particularly pneumococcal, I don't think anything beyond social distancing and standard precautions is warranted.
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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S
Edit: Looks like mods took out the trash.
AgsMyDude
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Stupe said:

Edit: Looks like mods took out the trash.


Another user added to the permanent ignore list
aggierogue
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What is the likelihood of contracting the virus twice? If someone gets the virus and recovers, are they in the clear for this cycle/season?
BiochemAg97
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aggierogue said:

What is the likelihood of contracting the virus twice? If someone gets the virus and recovers, are they in the clear for this cycle/season?
Generally yes. I haven't seen anything credible to suggest this one is any different.

Dr. Not Yet Dr. Ag
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Oops wrong thread
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aggierogue
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Thanks for the response.
74OA
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Stupe said:

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.
Agree, it would also help if the doc was temporarily given staff designation so we could use the "staff only" button and quickly go thru his responses.
deddog
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Doc Reveille
How much sleep are you getting?

Thanks for all that you are doing.
deddog
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Also,
Doc I have a teen with VTach that is currently being treated well with medication. Otherwise he is extremely fit.
Is he at higher risk? Never understood whether Vtach that's controlled by medication is heart disease or not.
PuryearFratDaddy
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Mantis, thank you for your response.

And that goes for all other MD's, (beyond Reveille) nurses and others that have posted on this and other threads!! It truly helps!
Reveille
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deddog said:

Also,
Doc I have a teen with VTach that is currently being treated well with medication. Otherwise he is extremely fit.
Is he at higher risk? Never understood whether Vtach that's controlled by medication is heart disease or not.
No if he is otherwise healthy and the V-Tach is controlled with medications than I would not expect him to be at too much of a higher risk then the general population.
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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deddog said:

Doc Reveille
How much sleep are you getting?

Thanks for all that you are doing.
I squeeze some in here and there.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
atag
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Do you think this is affecting the elderly moreso because they tend to have more underlying health issues or because of age alone. My mom is in her late 60s but she is super healthy (she competes regularly in the senior games for track). She thinks because of her fitness that she isn't as much at risk.
proudest member of the fightin texas aggie class of 2005.
Patentmike
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Reveille said:

deddog said:

Also,
Doc I have a teen with VTach that is currently being treated well with medication. Otherwise he is extremely fit.
Is he at higher risk? Never understood whether Vtach that's controlled by medication is heart disease or not.
No if he is otherwise healthy and the V-Tach is controlled with medications than I would not expect him to be at too much of a higher risk then the general population.
Sending you a PM.
PatentMike, J.D.
BS Biochem
MS Molecular Virology


Rachel 98
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My mom (70 years old) had heart valve repair two years ago. She was born with a septal defect that was repaired when she was 15, but was gradually starting to have more and more exercise intolerance, shortness of breath, etc. She has done great since the surgery and I think is now mostly asymptomatic on just furosemide. Would this bump her up in risk (above just her age risk)? She also has pretty bad food, inhalant, and chemical allergies and has always had low WBC counts (lifelong). I'm just trying to decide how strict to advise her to be as far as keeping her distance from other folks. She is quite fit and active but I want her to be careful. I don't want to overreact though and tell her to lock herself in solitary confinement though if that would be overkill!
Reveille
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atag said:

Do you think this is affecting the elderly moreso because they tend to have more underlying health issues or because of age alone. My mom is in her late 60s but she is super healthy (she competes regularly in the senior games for track). She thinks because of her fitness that she isn't as much at risk.
Underlying medical conditions I believe is way more of a risk factor than just age alone. Not all 70 year old's are the same. I have some with very few or no medical issues and other's with multiple medical conditions that I consider very unhealthy. The later patient I would consider to be much higher risk than other patient even though they are the same age.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
oh no
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Is someone who was in the UK last week more scary and dangerous in your community right now than someone who flew in from SFO or SeaTac?

Case numbers and community spread seem worse in CA and WA than the UK, but some organizations' ban and self isolation rules seem pretty arbitrary when they make rules against only those who have been outside the continental US.

For example, my daughter's gym won't let her come to training for 14 days since we went to London for spring break, but they are letting someone train who went to CA for spring break. Also, my company's operations in CA, WA, Ny, etc. are operating as normal, and my company is flying a bunch of people from CA to Houston with no restrictions, yet they act like I have the plague because I went to London last week- again- fewer cases and far fewer deaths than the US in CA and WA. I'm ok with my family staying in for a while and I understand everyone is afraid of me and my family right now, but why not the same rules for people coming from CA and WA?
Law361
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Reveille,

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
12thmandy
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What are the recommendations for those of us with infants? I can't stay at home because I have a job that will likely not be able to close. If I'm exposed I'm afraid I'll easily pass it to my infant. Is there anything I should be doing other than the obvious washing my hands etc. to help keep her safe? Also, my mom (in her late 60s) usually watches her while I'm at work. Should I be thinking of another plan for that?
Reveille
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Rachel 98 said:

My mom (70 years old) had heart valve repair two years ago. She was born with a septal defect that was repaired when she was 15, but was gradually starting to have more and more exercise intolerance, shortness of breath, etc. She has done great since the surgery and I think is now mostly asymptomatic on just furosemide. Would this bump her up in risk (above just her age risk)? She also has pretty bad food, inhalant, and chemical allergies and has always had low WBC counts (lifelong). I'm just trying to decide how strict to advise her to be as far as keeping her distance from other folks. She is quite fit and active but I want her to be careful. I don't want to overreact though and tell her to lock herself in solitary confinement though if that would be overkill!


First she should be congratulated on overcoming what she has to date. However,because of the risk of cardiomyopathy she should almost certainly be considered high risk. It would not take much for to decompensate and go into congestive heart failure.

She doesn't have to stay completely inside. Jogging or waking would not increase her risk as she is not around others. And this will help keep her heart in shape.
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dutch15
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Reveille,

I posted previously, but not sure you saw it. How did China keep there numbers so low (relatively speaking)? Also, they are allowing people to go back to work because cases are on the decline, so how do they keep from having a relapse?

eidetic78
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aggierogue said:

What is the likelihood of contracting the virus twice? If someone gets the virus and recovers, are they in the clear for this cycle/season?
Each person's immune response will be slightly different, so whether being infected will confer protective immunity won't be an always yes or always no. Additionally, in the event that a person does generate protective antibodies, how long they last in any given person will be different. So, for some people, they may be in the clear for some period of time with respect to reinfection with the same strain, and for others they may be immediately at risk again. For this new strain, those answers aren't yet known.

Edit: I meant to say my assumptions in protective antibody generation are based on the original SARS strain and MERS. I'm assuming this current strain is likely to be similar, though that's just a guess.
eidetic78
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Law361 said:

Reveille,

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
With respect to the duration a virus remains infectious on playground surfaces, it really depends on the local weather conditions. It also varies widely from virus to virus, but obviously we're talking about coronavirus here.

Based on previous SARS and MERS strains, this virus is stable for a relatively short period of time outside of the body. Weather conditions that lead to quick desiccation (warm / dry / sunny) and surfaces exposed to UV will render any virus present non-infections quickly. Within just a few minutes. Some of these reports about coronavirus being stable for many days on inanimate objects are under ideal conditions without any exposure to UV/water/heat/etc... They also are reporting ANY remaining detectable infectious virus. My point being once the virus is out of its host, the particles begin to degrade quickly. So even though there may be a few infectious particles after an extended time, the vast majority of the initial number are inert.

For public playground equipment, as you said those surfaces don't get "disinfected" regularly (or ever), but, depending on where you live, the normal weather can keep them fairly sterile. Specifically in the case of coronavirus, the more exposed surfaces will be safer. Overall, unless the equipment is currently or recently occupied with many kids, in my opinion it's a very low risk activity.
eidetic78
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dutch15 said:

Reveille,

I posted previously, but not sure you saw it. How did China keep there numbers so low (relatively speaking)? Also, they are allowing people to go back to work because cases are on the decline, so how do they keep from having a relapse?


In the city of Wuhan specifically, they were able to keep their numbers as low as they did because they initiated the lock down of that area when there were only a total of ~440 confirmed cases. They appreciated the threat, and reacted quickly.

As far as "relapse", there will almost certainly continue to be new infections. However, the population is now better educated (or scared.. just as helpful I suppose), and is likely to use more sensible approaches to gatherings, personal space/isolation, etc... and help prevent the exponential growth they experienced in Jan/Feb.
TAMUallen
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Are there tips or easy to cite stats/projections to use for my very stubborn grandfather who is 80+ and has had multiple bypasses?

He is stubborn as a damn mule and my grandmother has Parkinson's so she stays home. Made progress with him not going to church this morning but he ****ing went to Costco this morn for FREAKING 3 things that weren't even needed.
BreNayPop
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Hey roomie

Is that lab up and running yet?
eidetic78
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TAMUallen said:

Are there tips or easy to cite stats/projections to use for my very stubborn grandfather who is 80+ and has had multiple bypasses?

He is stubborn as a damn mule and my grandmother has Parkinson's so she stays home. Made progress with him not going to church this morning but he ****ing went to Costco this morn for FREAKING 3 things that weren't even needed.
data is a month old, but this site has some death rate stats. There are a whole lot of caveats that go with those calculations, but the trends are unlikely to be affected (just the overall actual percentages), and they show a very clear and stark increase in risk of death with increased age. Likely because the prevalence of underlying negative health conditions increases with age.

https://www.businessinsider.com/coronavirus-death-rate-by-age-countries-2020-3#still-older-patients-in-south-korea-also-had-a-much-higher-death-rate-than-younger-ones-patients-older-than-80-had-a-72-death-rate-as-of-wednesday-6

eidetic78
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BreNayPop said:

Hey roomie

Is that lab up and running yet?
not funny!

Doing my part to curb the TP run, but I fear I may be too late.

We're expecting the testing supplies to be delivered Tuesday, but we're clearly not the only lab ordering testing kits. Availability dates keep moving.
Cepe
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TAMUallen said:

Are there tips or easy to cite stats/projections to use for my very stubborn grandfather who is 80+ and has had multiple bypasses?

He is stubborn as a damn mule and my grandmother has Parkinson's so she stays home. Made progress with him not going to church this morning but he ****ing went to Costco this morn for FREAKING 3 things that weren't even needed.


Interesting that when I read your post I had a completely different reaction to it. What I read is a man who is comfortable in his life and chooses to live it without fear. I aspire to get to that point someday when I know I'll be called home but I'm not there yet.

Of course I have never met any of you but that came to mind that he's prepared. Just a thought
Reveille
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oh no said:

Is someone who was in the UK last week more scary and dangerous in your community right now than someone who flew in from SFO or SeaTac?

Case numbers and community spread seem worse in CA and WA than the UK, but some organizations' ban and self isolation rules seem pretty arbitrary when they make rules against only those who have been outside the continental US.

For example, my daughter's gym won't let her come to training for 14 days since we went to London for spring break, but they are letting someone train who went to CA for spring break. Also, my company's operations in CA, WA, Ny, etc. are operating as normal, and my company is flying a bunch of people from CA to Houston with no restrictions, yet they act like I have the plague because I went to London last week- again- fewer cases and far fewer deaths than the US in CA and WA. I'm ok with my family staying in for a while and I understand everyone is afraid of me and my family right now, but why not the same rules for people coming from CA and WA?


Not sure how to answer this one, but personally in would consider anyone traveling from an infected area to be treated about the same. They should be isolated for at minimum a week but preferably 14 days to watch for signs of symptoms
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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Law361 said:

Reveille,

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


Walks and parks are likely ok if you are not with a group of people. The virus can live up to 3 days and steel and plastics in laboratory experiments. But outdoor activities as a whole should be relatively ok because you are not in close contact with anyone and the wind blows the virus around.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
anaggieshusband
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Are we going to start hearing more people talking about plasma next week?
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