Covid-19 Update Aggie Physician

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maroonbeansnrice
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AG
BiochemAg97 said:

Whitetail said:

Good read about why CHQ+ZPAK+ZINC works:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Also why ventilators aren't fixing the main problem which is in your blood.
I feel like we talked about the heme issues weeks ago, especially as a reason why diabetics (high A1C) are at high risk.

Also that article seems to have a lot wrong. I can't wrap my head around what they are trying to say about HCQ and DNA and heme.

Also, malaria isn't a bacteria, it is a single cellular eukaryote.

And with that, random person who doesn't seem to understand the basic science posting an article on medium lost all credibility.
For you laypeople out there like me (I just happen to be reading a book on the Mosquito) malaria is caused by a parasite. The parasite, unlike mutli-celled worms etc., happens to be a single celled eukaryotye. Correct me if I'm wrong on that doc(s).
“It ain’t like it used to be.”
-Jimbo Fisher
nos7610
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Woke up Saturday morning with a mild fever, cough, tickle in my throat and tightness in my chest. Video called a Doctor and he said that while my symptoms are mild he'd still like to have me tested given the spread rate in this county. I got tested that afternoon and I'm still waiting on the results as of this morning. I feel okay, I Just don't feel like myself. I know longer have fever but the cough. tightness in my chest and slight shortness of breath are still around. How much of that is anxiety, I'm not sure but I can tell you the waiting alone has been the worst part thus far.
BiochemAg97
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AG
LongLurking Ag said:

Thinking forward, let's say we get this phase under control and cases go down. Unless there are vaccines available it probably will be back again (fall or winter). Would people who were exposed this year have an immunity for the next cycle or would the virus have mutated to make them susceptible again?
Most likely anyone exposed this round would have immunity for a next round. The virus doesn't appear to be mutating fast enough that we fear loss of immunity in a years time. Only changes in some very specific portions of the virus genome would lead to a change in the parts of the virus recognized by the immune system.


In my opinion, I do not think we should expect this virus to behave like the flu virus and go away in the summer to come back in the fall. This isn't influenza, and if you look at the history of SARS, it doesn't appear to me that the warming of the summer made it go away, but rather it took a lot of effort to isolate infected individuals to prevent the spread. That may be a good thing. If we can manage the rate of infection and keep vigilant in quickly identifying and isolating infected individuals, we can slowly build immunity in the population without overwhelming the healthcare system. Hopefully we also add to that some effective treatment protocols that can significantly reduce the severity and duration of the disease and we don't get a repeat performance of the economic shutdown in the fall.
BiochemAg97
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AG
maroonbeansnrice said:

BiochemAg97 said:

Whitetail said:

Good read about why CHQ+ZPAK+ZINC works:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Also why ventilators aren't fixing the main problem which is in your blood.
I feel like we talked about the heme issues weeks ago, especially as a reason why diabetics (high A1C) are at high risk.

Also that article seems to have a lot wrong. I can't wrap my head around what they are trying to say about HCQ and DNA and heme.

Also, malaria isn't a bacteria, it is a single cellular eukaryote.

And with that, random person who doesn't seem to understand the basic science posting an article on medium lost all credibility.
For you laypeople out there like me (I just happen to be reading a book on the Mosquito) malaria is caused by a parasite. The parasite, unlike mutli-celled worms etc., happens to be a single celled eukaryotye. Correct me if I'm wrong on that doc(s).
Yes. A parasite small enough to live and reproduces inside a red blood cell. And when it makes enough additional parasites, the red blood cell bursts allowing all the new parasites to invade other red blood cells. And then there is the whole complicated life cycle where it gets sucked up by a mosquito, reproduces in the mosquito, and then waits to be spit into the next host.

And for those that may have forgotten their biology, bacteria are prokaryotes that are basically a sack filled with stuff with everything happening in the same space. Eukaryotes include animals, plants, etc that have little sacks inside a big sack so they can isolate specialized functions like DNA replication in a nucleus and energy production in mitochondria.
SoulSlaveAG2005
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EKUAg
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Question for the docs.

I've seen hydroxychloroquine but also just chloroquine being used as one of the drugs to treat COVID-19. I have also seen them lumped together as the same drug, but my understanding is that they are actually different drugs. Is my understanding correct?
Maroon and White always! EKU/TAMU
good_ag
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Dr. Coates, first off, thank you so much for doing these daily updates. I read them every morning, I realize that social distancing is the best practice to not contract the virus.Flattening the curve as people in the medical field like to say, but what are your thoughts on, once the virus is contained and everyone starts going back to work do you think we will see a resurgence of the virus? I.E. Will flattening of the curve cause this Virus to stick around longer then if everyone were to get exposed to it right now? I realize that this would overwhelm the health care systems. But in your expert opinion what is a reasonable time line for things to return to normal? Thanks again!
good_ag
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AG
Also, is the only real solution to this virus herd immunity? With a vaccine probably being at least a year off to protect people from getting infected.
Ogre09
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It seems very difficult to identify and isolate infected individuals when people can be asymptomatic carriers.
Ogre09
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AG
Hopefully a vaccine comes before herd immunity, even if the vaccine is 1-2 years away. Herd immunity in that time frame means lots of outbreaks and deaths.
Tom Cardy
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If there are asymptomatic carriers, wouldn't herd immunity be closer to reality than we think?
DadHammer
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AG
Kick-R said:

If there are asymptomatic carriers, wouldn't herd immunity be closer to reality than we think?
I agree
buffalo chip
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S
BiochemAg97 said:

maroonbeansnrice said:

BiochemAg97 said:

Whitetail said:

Good read about why CHQ+ZPAK+ZINC works:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Also why ventilators aren't fixing the main problem which is in your blood.
I feel like we talked about the heme issues weeks ago, especially as a reason why diabetics (high A1C) are at high risk.

Also that article seems to have a lot wrong. I can't wrap my head around what they are trying to say about HCQ and DNA and heme.

Also, malaria isn't a bacteria, it is a single cellular eukaryote.

And with that, random person who doesn't seem to understand the basic science posting an article on medium lost all credibility.
For you laypeople out there like me (I just happen to be reading a book on the Mosquito) malaria is caused by a parasite. The parasite, unlike mutli-celled worms etc., happens to be a single celled eukaryotye. Correct me if I'm wrong on that doc(s).
Yes. A parasite small enough to live and reproduces inside a red blood cell. And when it makes enough additional parasites, the red blood cell bursts allowing all the new parasites to invade other red blood cells. And then there is the whole complicated life cycle where it gets sucked up by a mosquito, reproduces in the mosquito, and then waits to be spit into the next host.

And for those that may have forgotten their biology, bacteria are prokaryotes that are basically a sack filled with stuff with everything happening in the same space. Eukaryotes include animals, plants, etc that have little sacks inside a big sack so they can isolate specialized functions like DNA replication in a nucleus and energy production in mitochondria.
I know that the author lost credibility regarding his/her description of malaria (bacteria vs. eukaryote), One mistake does not necessarily impugn the whole. I was wondering about the described virus attack on hemoglobin causing the oxygen deficiencies and its explanation for why the virus seems more potent against those who are diabetic?
Cepe
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AG
Hi Doc, thoughts on nitric oxide?

https://www.bostonherald.com/2020/04/06/massachusetts-general-hospital-among-first-to-test-nitric-oxide-on-pandemic-patients/
Reveille
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AG
good_ag said:

Dr. Coates, first off, thank you so much for doing these daily updates. I read them every morning, I realize that social distancing is the best practice to not contract the virus.Flattening the curve as people in the medical field like to say, but what are your thoughts on, once the virus is contained and everyone starts going back to work do you think we will see a resurgence of the virus? I.E. Will flattening of the curve cause this Virus to stick around longer then if everyone were to get exposed to it right now? I realize that this would overwhelm the health care systems. But in your expert opinion what is a reasonable time line for things to return to normal? Thanks again!
Yes we will see flattening of the curve then we will slowly start opening up things but with precautions. We will gradually be developing immunity in the communities with all of the asymptomatic people now recovered. There will be some resurgence but not to the extent we saw the first time as some people will be immune and everyone will still be more cautious. I don't think we will have large gatherings for awhile though. Need to get a high percent of the population immune before we do that. If people are slowly getting infected it should not be a huge problem as the hospitals should be able to handle them.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
nos7610
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nos7610 said:

Woke up Saturday morning with a mild fever, cough, tickle in my throat and tightness in my chest. Video called a Doctor and he said that while my symptoms are mild he'd still like to have me tested given the spread rate in this county. I got tested that afternoon and I'm still waiting on the results as of this morning. I feel okay, I Just don't feel like myself. I know longer have fever but the cough. tightness in my chest and slight shortness of breath are still around. How much of that is anxiety, I'm not sure but I can tell you the waiting alone has been the worst part thus far.


Just got the call, test results came back NEGATIVE!! Such a relief! Praise God!
JeepWaveEarl
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AG
When all this blows over I'd like to help you adapting your site over to different look and feel, if you're so inclined. It's the least I can do for all your help and information. I'll be in touch at that time and see if you're interested.
Reveille
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buffalo chip said:

BiochemAg97 said:

maroonbeansnrice said:

BiochemAg97 said:

Whitetail said:

Good read about why CHQ+ZPAK+ZINC works:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Also why ventilators aren't fixing the main problem which is in your blood.
I feel like we talked about the heme issues weeks ago, especially as a reason why diabetics (high A1C) are at high risk.

Also that article seems to have a lot wrong. I can't wrap my head around what they are trying to say about HCQ and DNA and heme.

Also, malaria isn't a bacteria, it is a single cellular eukaryote.

And with that, random person who doesn't seem to understand the basic science posting an article on medium lost all credibility.
For you laypeople out there like me (I just happen to be reading a book on the Mosquito) malaria is caused by a parasite. The parasite, unlike mutli-celled worms etc., happens to be a single celled eukaryotye. Correct me if I'm wrong on that doc(s).
Yes. A parasite small enough to live and reproduces inside a red blood cell. And when it makes enough additional parasites, the red blood cell bursts allowing all the new parasites to invade other red blood cells. And then there is the whole complicated life cycle where it gets sucked up by a mosquito, reproduces in the mosquito, and then waits to be spit into the next host.

And for those that may have forgotten their biology, bacteria are prokaryotes that are basically a sack filled with stuff with everything happening in the same space. Eukaryotes include animals, plants, etc that have little sacks inside a big sack so they can isolate specialized functions like DNA replication in a nucleus and energy production in mitochondria.
I know that the author lost credibility regarding his/her description of malaria (bacteria vs. eukaryote), One mistake does not necessarily impugn the whole. I was wondering about the described virus attack on hemoglobin causing the oxygen deficiencies and its explanation for why the virus seems more potent against those who are diabetic?
I read it an while there are some errors mentioned above, overall I think for non-medical people he does a good job of explaining things particularly with his truck analogy.
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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AG
AGGODDESS said:

When all this blows over I'd like to help you adapting your site over to different look and feel, if you're so inclined. It's the least I can do for all your help and information. I'll be in touch at that time and see if you're interested.
Thanks I would appreciate that! I have't had time to spend on the website at all. Just updated it for the first time a couple of weeks ago since 2013.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
FrioAg 00
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AG
Kick-R said:

If there are asymptomatic carriers, wouldn't herd immunity be closer to reality than we think?


Talked to an epidemiologist about this - given the raw RO of between 1.5 to 3, to effectively achieve Herd Immunity we need 40-70% of the population to be immune.

Without an effective vaccine we can only get to immunity through having the virus and recovering. What's not clear yet is how long someone is immune to this disease after they've recovered.

Corona viruses like the ones that cause the common cold generally have a very short period of immunity, however there is reason for optimism here in that it attacks deeper in the respiratory system (lungs) and that almost always translates to a more durable presence of those antibodies.


Good article explaining relationship between RO and Herd Immunity coverage linked below

https://www.google.com/amp/s/theconversation.com/amp/what-is-herd-immunity-and-how-many-people-need-to-be-vaccinated-to-protect-a-community-116355
good_ag
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AG
Thank you!
atag
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Would severe vomiting/diarrhea be an indicator of this at all or more likely a stomach bug/food poisoning? My mom got sick last night and the rational side of me would assume some kind of food poisoning but she is in her late 60s so obviously there should be a different level of concern given what is going on. Should she go get tested or would she be safer riding it out and not getting exposed?
proudest member of the fightin texas aggie class of 2005.
BiochemAg97
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Ogre09 said:

It seems very difficult to identify and isolate infected individuals when people can be asymptomatic carriers.
Depends on how testing is implemented and what asymptomatic carrier means.

assuming 50% are asymptomatic carriers and 50% show symptoms, carrier should make someone sick and if you contact trace (forward and backward) and test, you can probably do a good job of picking up a number of asymptomatic carriers. And you don't have to be perfect to prevent overwhelming the system, just keep the effective R0 < 2, preferably <1.


Also, China seems to be identifying carriers. Does that mean a short term (12-24 hrs) spike in temp with no other symptoms. If we monitor temps frequently (as in China) you might be able to catch the carriers.
BiochemAg97
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buffalo chip said:

BiochemAg97 said:

maroonbeansnrice said:

BiochemAg97 said:

Whitetail said:

Good read about why CHQ+ZPAK+ZINC works:

http://web.archive.org/web/20200405061401/https://medium.com/@agaiziunas/covid-19-had-us-all-fooled-but-now-we-might-have-finally-found-its-secret-91182386efcb

Also why ventilators aren't fixing the main problem which is in your blood.
I feel like we talked about the heme issues weeks ago, especially as a reason why diabetics (high A1C) are at high risk.

Also that article seems to have a lot wrong. I can't wrap my head around what they are trying to say about HCQ and DNA and heme.

Also, malaria isn't a bacteria, it is a single cellular eukaryote.

And with that, random person who doesn't seem to understand the basic science posting an article on medium lost all credibility.
For you laypeople out there like me (I just happen to be reading a book on the Mosquito) malaria is caused by a parasite. The parasite, unlike mutli-celled worms etc., happens to be a single celled eukaryotye. Correct me if I'm wrong on that doc(s).
Yes. A parasite small enough to live and reproduces inside a red blood cell. And when it makes enough additional parasites, the red blood cell bursts allowing all the new parasites to invade other red blood cells. And then there is the whole complicated life cycle where it gets sucked up by a mosquito, reproduces in the mosquito, and then waits to be spit into the next host.

And for those that may have forgotten their biology, bacteria are prokaryotes that are basically a sack filled with stuff with everything happening in the same space. Eukaryotes include animals, plants, etc that have little sacks inside a big sack so they can isolate specialized functions like DNA replication in a nucleus and energy production in mitochondria.
I know that the author lost credibility regarding his/her description of malaria (bacteria vs. eukaryote), One mistake does not necessarily impugn the whole. I was wondering about the described virus attack on hemoglobin causing the oxygen deficiencies and its explanation for why the virus seems more potent against those who are diabetic?
The first part of the article about the virus binding RBCs/heme seemed like info gather from somewhere else, so mostly valid. I think Doc Rev talked about elevated A1C (sugar modified heme) being the risk mechanism there (more impaired heme) a while back.

The rest of the article about malaria and the virus eating heme and theorizing how HCQ would work to stop that is where the author stops making any sense. I think it makes more sense that HCQ acts to increase intracellular zinc, which we know inhibits replication of this family of viruses.



Matilda
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AG
I've noticed an increase in neighbors wearing masks during afternoon walks. We live inside the loop in Houston, however, maintaining six feet of social distance is still feasible. I completely understand the value of wearing masks in indoor environments (where social distance cannot be reliably maintained), however, do you advise wearing masks in this situation? Is it a "it can't hurt" or "you need to do it" (especially given the limitations on availability)?
Squadron7
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AG
Matilda said:

I've noticed an increase in neighbors wearing masks during afternoon walks. We live inside the loop in Houston, however, maintaining six feet of social distance is still feasible. I completely understand the value of wearing masks in indoor environments (where social distance cannot be reliably maintained), however, do you advise wearing masks in this situation? Is it a "it can't hurt" or "you need to do it" (especially given the limitations on availability)?

Good question. Wife and I walk every day through our neighborhood and never within 6 yards of other people let alone 6 feet. Is a mask necessary?
aggiemike02
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AG
CDC Cloth Face Covering Guidance
buffalo chip
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S
Thanks again!
MAROON
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AG
Squadron7 said:

Matilda said:

I've noticed an increase in neighbors wearing masks during afternoon walks. We live inside the loop in Houston, however, maintaining six feet of social distance is still feasible. I completely understand the value of wearing masks in indoor environments (where social distance cannot be reliably maintained), however, do you advise wearing masks in this situation? Is it a "it can't hurt" or "you need to do it" (especially given the limitations on availability)?

Good question. Wife and I walk every day through our neighborhood and never within 6 yards of other people let alone 6 feet. Is a mask necessary?



No
What do you boys want for breakfast BBQ ?.....OK Chili.
1982Ag
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Dr. Coates, really appreciate all your hard work here. A couple of folks we know ran low grades fevers for about 24 hours, and no symptoms since. Any conclusions or advice regarding how long an asymptomatic carrier might in fact be a carrier? Thanks again doc.
Reveille
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1982Ag said:

Dr. Coates, really appreciate all your hard work here. A couple of folks we know ran low grades fevers for about 24 hours, and no symptoms since. Any conclusions or advice regarding how long an asymptomatic carrier might in fact be a carrier? Thanks again doc.


That's a good question and we don't have definitive answer yet but the data in have seen believes up to 14 days.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
Mark Fairchild
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AG
Dr Coates, my wife is extremely allergic to sulfa. If the need arises, will she be able to take hydroxychoroquine? Thanks in advance.
Gig'em, Ole Army Class of '70
LongLurking Ag
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I think after all this is over, TexAGS admin needs to come up with a new level of poster and Dr. Coats becomes the "GOAT" which goes beyond legend and hall of famer posters. We all thank you for all the work you are doing but more importantly for the spread of CREDIBLE information We also thank all other doctors helping us understand this virus. This is invaluable and I would bet there will be lives saved based on the information we get on a daily basis.
AggieJ2002
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AG
Mark Fairchild said:

Dr Coates, my wife is extremely allergic to sulfa. If the need arises, will she be able to take hydroxychoroquine? Thanks in advance.


I'm allergic to Erythromyvin and Sulfa drugs so I know Z-Pack is out ... when I looked online it looked like Hydroxychloroquine was not a Sulfa drug, but would love to get confirmation on that as well.
Reveille
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AG
Mark Fairchild said:

Dr Coates, my wife is extremely allergic to sulfa. If the need arises, will she be able to take hydroxychoroquine? Thanks in advance.
LOL this one took me a second to wonder why you were asking. But I finally figured it out and yes the sulfate used after a drug name is just the last name of the chemical, its the sulfate salt. It has nothing to do with sulfonamides which is what a sulfa allergy is.
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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