Lester Freamon said:

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Lester Freamon said:

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I would like to understand if there is a distinction between hospitalized with COVID and hospitalized for COVID

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And the reason why I ask is this. Even as far back as March/April we were getting reports of people in ER for non COVID who were all of a sudden diagnosed upon Chest x Ray, etc. The example I think of is Marcus Aurelius having a guy in for a broken arm from a car crash who was otherwise perfectly healthy and had interstitial bilateral pneumonia and telltale ground glass opacities that were observed upon x Ray for the broken bone

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Those cases are not that common, at least not yet. I'm sure 1 or 2 of those currently hospitalized have some kind of story like that, but almost every single one of them are primarily hospitalized for COVID.

Dr. Not Yet Dr. Ag said:

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San Antonio area

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When they said flatten the curve, they never said which axis.

corleoneAg99 said:

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Dr. Not Yet Dr. Ag said:

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FriscoKid said:

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I think this is just about over at this point.

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Unfortunately for us in Texas, it is only just starting. The several hospitals I currently work at are now filled with COVID patients in their ERs, which was never the case previously. We are now required to wear N95s at all times while at work, due to how bad conditions have got. Patients are waiting 5-6 hours to have labs drawn in the ER because we have no beds to place patients in. We have run out of high-flow nasal cannulas at one location. We have COVID patients sitting in hallways. COVID patients sitting in waiting rooms. We have quickly gone from just young and healthy COVID patients, to elderly COVID patients mixed in. 2 weeks ago, I was still seeing 1 every other shift. I am now seeing 7-8 every shift, and that number continues to increase.

This is not over by a long shot, and will get much worse if you live in Texas. Death rates lag behind new cases. Expect a significant increase in deaths 1-2 weeks from now.

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How does your projection of increased deaths square with reports of far better treatments that prevent death? Are you saying that you aren't experience that in your hospital(s) or just that pure volume alone will cause deaths to drastically increase regardless of gains made in treatment?

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Dexamethasone is the only therapy that has demonstrated a mortality benefit for COVID, although the study hasn't been published, and even then, the number needed to treat to prevent death per the reported results is 8. You have to treat 8 people to prevent 1 death, if the results are to be believed. An NNT of 8 is actually almost unheard of in medicine. It is very rare that we find a drug with that kind of effect size (which is why many doubt the results), but even if these phenomenal results are real, it still means that a sizable number of people will still die, despite perfect medical therapy.

Its like when people talk about aspirin (for heart attacks) and blood pressure meds (to prevent death) being lifesavers, not realizing that their NNT for mortality is something like 42 and 120 respectively (please don't stop taking your meds).

Dr. Not Yet Dr. Ag said:

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corleoneAg99 said:

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Dr. Not Yet Dr. Ag said:

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FriscoKid said:

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I think this is just about over at this point.

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Unfortunately for us in Texas, it is only just starting. The several hospitals I currently work at are now filled with COVID patients in their ERs, which was never the case previously. We are now required to wear N95s at all times while at work, due to how bad conditions have got. Patients are waiting 5-6 hours to have labs drawn in the ER because we have no beds to place patients in. We have run out of high-flow nasal cannulas at one location. We have COVID patients sitting in hallways. COVID patients sitting in waiting rooms. We have quickly gone from just young and healthy COVID patients, to elderly COVID patients mixed in. 2 weeks ago, I was still seeing 1 every other shift. I am now seeing 7-8 every shift, and that number continues to increase.

This is not over by a long shot, and will get much worse if you live in Texas. Death rates lag behind new cases. Expect a significant increase in deaths 1-2 weeks from now.

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How does your projection of increased deaths square with reports of far better treatments that prevent death? Are you saying that you aren't experience that in your hospital(s) or just that pure volume alone will cause deaths to drastically increase regardless of gains made in treatment?

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Dexamethasone is the only therapy that has demonstrated a mortality benefit for COVID, although the study hasn't been published, and even then, the number needed to treat to prevent death per the reported results is 8. You have to treat 8 people to prevent 1 death, if the results are to be believed. An NNT of 8 is actually almost unheard of in medicine. It is very rare that we find a drug with that kind of effect size (which is why many doubt the results), but even if these phenomenal results are real, it still means that a sizable number of people will still die, despite perfect medical therapy.

Its like when people talk about aspirin (for heart attacks) and blood pressure meds (to prevent death) being lifesavers, not realizing that their NNT for mortality is something like 42 and 120 respectively (please don't stop taking your meds).

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Ok thanks. I was referring mainly to this quote from Marcus on another thread re: therapies:

"Absolutely. Remdesivir at admission. Tocilizumab at cytokine storm. Full anticoagulation. Convalescent plasma. Plus minus steroids. Avoid intubating. People arent dying at my hospital like they were in beginning."

corleoneAg99 said:

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Dr. Not Yet Dr. Ag said:

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corleoneAg99 said:

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Dr. Not Yet Dr. Ag said:

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FriscoKid said:

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I think this is just about over at this point.

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Unfortunately for us in Texas, it is only just starting. The several hospitals I currently work at are now filled with COVID patients in their ERs, which was never the case previously. We are now required to wear N95s at all times while at work, due to how bad conditions have got. Patients are waiting 5-6 hours to have labs drawn in the ER because we have no beds to place patients in. We have run out of high-flow nasal cannulas at one location. We have COVID patients sitting in hallways. COVID patients sitting in waiting rooms. We have quickly gone from just young and healthy COVID patients, to elderly COVID patients mixed in. 2 weeks ago, I was still seeing 1 every other shift. I am now seeing 7-8 every shift, and that number continues to increase.

This is not over by a long shot, and will get much worse if you live in Texas. Death rates lag behind new cases. Expect a significant increase in deaths 1-2 weeks from now.

---

How does your projection of increased deaths square with reports of far better treatments that prevent death? Are you saying that you aren't experience that in your hospital(s) or just that pure volume alone will cause deaths to drastically increase regardless of gains made in treatment?

---

Dexamethasone is the only therapy that has demonstrated a mortality benefit for COVID, although the study hasn't been published, and even then, the number needed to treat to prevent death per the reported results is 8. You have to treat 8 people to prevent 1 death, if the results are to be believed. An NNT of 8 is actually almost unheard of in medicine. It is very rare that we find a drug with that kind of effect size (which is why many doubt the results), but even if these phenomenal results are real, it still means that a sizable number of people will still die, despite perfect medical therapy.

Its like when people talk about aspirin (for heart attacks) and blood pressure meds (to prevent death) being lifesavers, not realizing that their NNT for mortality is something like 42 and 120 respectively (please don't stop taking your meds).

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Ok thanks. I was referring mainly to this quote from Marcus on another thread re: therapies:

"Absolutely. Remdesivir at admission. Tocilizumab at cytokine storm. Full anticoagulation. Convalescent plasma. Plus minus steroids. Avoid intubating. People arent dying at my hospital like they were in beginning."

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Remdesivir potentially reduces length of hospital stay, but does not effect mortality. The rest have no high quality studies to demonstrate efficacy, although most have RCTs that are pending. They are promising, but we just don't know whether they actually save lives.

Dr. Not Yet Dr. Ag said:

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FriscoKid said:

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I think this is just about over at this point.

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Unfortunately for us in Texas, it is only just starting.


This is not over by a long shot, and will get much worse if you live in Texas. Death rates lag behind new cases. Expect a significant increase in deaths 1-2 weeks from now.

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He meant enough people caring to make a difference in how many people die

Dr. Not Yet Dr. Ag said:

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FriscoKid said:

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I think this is just about over at this point.

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Unfortunately for us in Texas, it is only just starting. The several hospitals I currently work at are now filled with COVID patients in their ERs, which was never the case previously. We are now required to wear N95s at all times while at work, due to how bad conditions have got. Patients are waiting 5-6 hours to have labs drawn in the ER because we have no beds to place patients in. We have run out of high-flow nasal cannulas at one location. We have COVID patients sitting in hallways. COVID patients sitting in waiting rooms. We have quickly gone from just young and healthy COVID patients, to elderly COVID patients mixed in. 2 weeks ago, I was still seeing 1 every other shift. I am now seeing 7-8 every shift, and that number continues to increase.

This is not over by a long shot, and will get much worse if you live in Texas. Death rates lag behind new cases. Expect a significant increase in deaths 1-2 weeks from now.

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Would not be surprised to see field hospitals opening up soon.

I don't think this has as much to do with the economy reopening in general as it does with people having parties, going to clubs, and of course, massing together in the streets with thousands of people. What's interesting is a lot of the smaller town hospitals like in Tyler are seeing small increases but not seeing massive spikes. Kind of makes you curious what's been going on in the big cities. Maybe they just haven't hit that point yet.

Moxley said:

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Would not be surprised to see field hospitals opening up soon.

I don't think this has as much to do with the economy reopening in general as it does with people having parties, going to clubs, and of course, massing together in the streets with thousands of people. What's interesting is a lot of the smaller town hospitals like in Tyler are seeing small increases but not seeing massive spikes. Kind of makes you curious what's been going on in the big cities. Maybe they just haven't hit that point yet.

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Protests and bars.

Not a coincidence we are seeing the same kind of spikes in big cities that NO saw after Madri Gras. Mass crowds in streets. Not a good idea.

Moxley said:

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Not a coincidence we are seeing the same kind of spikes in big cities that NO saw after Madri Gras. Mass crowds in streets. Not a good idea.

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Agree.

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