I think a flattening of the death rate will be more telling than a flattening of the case count. Case count is heavily impacted by how many tests are being administered and processed. Deaths are deaths and that count is less likely to be underreported.

The long time to get results is definitely a problem. I have people tested 3 days ago and still do not have results. The backlog on tests is a huge bottleneck. Some of it will improve with the Abbott test but even we it can be done in 5 to 15 minutes it is limited to 4 - 10 per hour. The bottleneck will continue to be a problem. But even though we are testing more per day each day the rate of rise is decreasing. The cases will continue to rise and the next 3-4 weeks will be tough as the fatalities start to rise. Fatalities fall about 2 weeks behind the cases. Let's just pray it gets better soon.

Ogre09 said:

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I think a flattening of the death rate will be more telling than a flattening of the case count. Case count is heavily impacted by how many tests are being administered and processed. Deaths are deaths and that count is less likely to be underreported.

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I agree and we are not going to see that for almost a month or maybe more.

beerad12man said:

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Currently I'm experiencing one of the 6 you mentioned, the shortness of breath. But it's really just allergy induced asthma, so I'm not even sure if it's the same as what is meant by shortness of breath.

I've basically beaten/grown out of asthma. I haven't been on a daily inhaler in 15+ years and now just take a rescue inhaler every so often when allergies hit. But even then it's not necessary to take, just makes it a little more comfortable. How concerned should I be now since allergies have hit a little that my lungs aren't at full capacity?

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Allergies are common right now! Asthma will be getting worse as anxiety also. So both of those are things to consider in the current environment. If that is only symptom not likely to be COVID but you should contact your physician to determine the etiology of the shortness of breath.

rcb said:

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Howdy Doc Rev, any thoughts on the usefulness (for the average layperson/consumer) of the pulse oximeters that go on the tip of the finger to measure pulse and oxygen saturation? Are they more geared for athletes?

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I think now that they are inexpensive every house should own one!

For anyone who has a newish Samsung Galaxy phone, there's a pulse oximeter built into the phone next to your fingerprint login sensor.

Find or download the free Samsung Health App, use the Measure Stress function, and place your fingertip on the sensor to get your readings. Supposedly they are as accurate as the normal ones.

Doug Ross said:

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rcb said:

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Howdy Doc Rev, any thoughts on the usefulness (for the average layperson/consumer) of the pulse oximeters that go on the tip of the finger to measure pulse and oxygen saturation? Are they more geared for athletes?

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you can get a pulse ox, but to be honest it doesn't matter unless you are hypooxic ({under 90%), you may have covid, but until then please don't come to the hospital until you need life support.

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Jesus, doc, calm the **** down. It was an honest question out of general curiosity, as you should have been able to discern, given your obvious genius that allowed you to obtain your medical degree.

Where in my question did you get the idea I even had symptoms or was contemplating a trip to the ER? The funniest part was i was asking to see if it would be a good screening device for folks to KEEP them from over reacting and going to the ER.

Perhaps take note of the difference in your response to me, and others, versus Doc Rev's.

Doug Ross said:

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ok long story short,

people die from covid because they go into this thing called ARDS (acute respiratory distress syndrome.) aka patient's lungs fill with fluid and people die due to hypoxia. there is no treatment, it is all supportive.

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Some of them require supplementary oxygen and don't need a vent. You don't know if you need supplementary o2 unless you can check your oxygen levels. The pulse ox is a method of determining need for going to the ER or staying home.

Doug Ross said:

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beerad12man said:

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Currently I'm experiencing one of the 6 you mentioned, the shortness of breath. But it's really just allergy induced asthma, so I'm not even sure if it's the same as what is meant by shortness of breath.

I've basically beaten/grown out of asthma. I haven't been on a daily inhaler in 15+ years and now just take a rescue inhaler every so often when allergies hit. But even then it's not necessary to take, just makes it a little more comfortable. How concerned should I be now since allergies have hit a little that my lungs aren't at full capacity?

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dude you are likely fine. if you don't have fever or cough. sounds like allergies. take a zyrtec and lemme know if it gets worse. doubt it will. .

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You sound like the caring and sympathetic Dr that I hope is treating me......

Doug Ross said:

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stop going to the hospital/ER. if you are mildly symptomatic, okay cool, stay at home for 14 days. even if I did test you....stay at home for 14 days because the sensitivity of the test is ***** DO NOT GOT TO THE HOSPITAL UNLESS YOU HAVE TO BE ON LIFE SUPPORT.

UNLESS YOU ARE LITERALLY GOING TO DIE, DO NOT GO TO THE HOSPITAL. You are putting myself and nurses at risk. I will not test you for covid unless you are a health care worker, please stop coming to the ER.

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People who require hospitalization are also getting tested. These stringent testing criteria are likely why our Covid-19 numbers in Texas are so low and the death rate has been too high.

It is important that people stay home unless they believe they need supplemental oxygen or even more intensive care related to Covid, and as an ER doc myself, I understand how on edge you are right now and that every person you see is one more person who might give you Covid-19.

I know how it feels to worry you are going to bring this home to your family, to worry one of your co-workers or yourself might get a high inoculum from a patient who coughs at just the wrong time or maybe someone who lied to registration and the triage nurses about their symptoms (has happened to me more than once), and I know that you worry you, your friends and/or your loved ones may die because a "walking well" Covid patient wanted a swab that ultimately won't change the course of their disease at all.

But you have to remember, people out there are scared too, and they don't have your medical education to give them comfort. There is a lot of misinformation out there. People have lots of questions and they come on here to try to find those answers. They should not be ridiculed or derided for trying to learn about this disease.

I understand your pain is real and this thing shakes all of us in healthcare to our very cores, but don't let it seep out on here. Remember to take some time to yourself, do something that burns off some stress. I fish when I can and it helps. Do your thing and don't let Covid be better than you.

Player To Be Named Later said:

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Doug Ross said:

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beerad12man said:

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Currently I'm experiencing one of the 6 you mentioned, the shortness of breath. But it's really just allergy induced asthma, so I'm not even sure if it's the same as what is meant by shortness of breath.

I've basically beaten/grown out of asthma. I haven't been on a daily inhaler in 15+ years and now just take a rescue inhaler every so often when allergies hit. But even then it's not necessary to take, just makes it a little more comfortable. How concerned should I be now since allergies have hit a little that my lungs aren't at full capacity?

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dude you are likely fine. if you don't have fever or cough. sounds like allergies. take a zyrtec and lemme know if it gets worse. doubt it will. .

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You sound like the caring and sympathetic Dr that I hope is treating me......

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Give him a break. Look at his other posts and the time of this one. He is exhausted and on the front lines. I think he needs to take a break, if he can.

Bless all of you folks on the front lines!

We all handle the situation differently and I can't imagine how nerve racking it must be to stand in front of someone infected. Day after Day!

We send care packages to deployed soldiers.

How can we safely do the same for Healthcare Providers?

Bless all of you!

88planoAg said:

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Player To Be Named Later said:

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Doug Ross said:

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beerad12man said:

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Currently I'm experiencing one of the 6 you mentioned, the shortness of breath. But it's really just allergy induced asthma, so I'm not even sure if it's the same as what is meant by shortness of breath.

I've basically beaten/grown out of asthma. I haven't been on a daily inhaler in 15+ years and now just take a rescue inhaler every so often when allergies hit. But even then it's not necessary to take, just makes it a little more comfortable. How concerned should I be now since allergies have hit a little that my lungs aren't at full capacity?

---

dude you are likely fine. if you don't have fever or cough. sounds like allergies. take a zyrtec and lemme know if it gets worse. doubt it will. .

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You sound like the caring and sympathetic Dr that I hope is treating me......

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Give him a break. Look at his other posts and the time of this one. He is exhausted and on the front lines. I think he needs to take a break, if he can.

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I get that, trust me. I've been in law enforcement, on the streets, for 18yrs. You can bet I get tired and frustrated. Doesn't mean I get to talk down to or yell at people. Maybe Docs can, but the public won't tolerate me doing that.

fig96 said:

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People on this thread seem to be getting very easily offended.

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Doctors are overworked, under-protected, stressed to the max, and probably a little scared.

The rest of of are anxious, bored, stir-crazy, and also a little bit scared.

It's not an ideal time for calm discourse in general. Just try to keep in kind that we're all trying to do what we can to get through this, medical professionals especially, and try to keep from going off the handle at each other. And more importantly overlooking/forgiving when others do.

Totally agree, you'd think folks would be giving doctors a bit of the benefit of the doubt right now.

i think my neighbor was trying to murder me with his eyes on Monday when I had an AC repair truck at my house almost all day..

i considered upstairs AC being out as essential... kids can't sleep in their rooms because they're covered in sweat at night and after they found mold, we decided to drop $10k and have a whole system put in rather than attempt to clean the coil and replace a few parts on a 15 year old system for just over $1k... repairmen used drop cloths on our floors, were mostly in the attic and outside, and we wiped everything they could have possibly touched afterwards, but I'm pretty sure my neighbors think I'm a nonbeliever with a death wish or something.

People need to get the f*** over themselves. We can't shut down life for 3 months. We just can't. AC repairs are a must in Texas.

74OA said:

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When do you think we can expect to start hearing official results from the hydrochloroquine treatment observational tests being conducted in New York hospitals?

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Here is a new study posted yesterday (from China so YMMV).

https://www.medrxiv.org/content/10.1101/2020.03.22.20040758v2

"But for TTCR, the body temperature recovery time and the cough remission time were significantly shortened in the HCQ treatment group. Besides, a larger proportion of patients with improved pneumonia in the HCQ treatment group (80.6%, 25 of 32) compared with the control group (54.8%, 17 of 32)."