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The Coronavirus Pandemic thread III
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Excalibur Offline
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RE: The Coronavirus Pandemic thread III
https://blogs.scientificamerican.com/obs...o-oranges/

Whether you think Covid-19 is scary or not is all relative. For a 40 year old man it is way less dangerous than spending 1 month riding the motorcycle to work. But stop comparing it to flu.

You can talk to any random 100 hospital internal medicine doctor or nurse, and they will tell you in their 10-20-30 year career they can hardly recall any patient died of flu or having to urgently intubate a patient with flu. And I have have never heard of any doctor or nurse worry about going into a flu patient's room with out proper protection, N95 mask. I've never heard of a doctor or nurse died from contracting flu from a patient.

Whether you want to stay at home or open up the economy, just have a little respect for your health care workers. They are grinding through something that is unprecedented. Yes the urgent care and outpatient clinic are pretty quiet now, and hospital admission are slowing down. All good news. But many of these health care worker are still masking and gowning up 10-20 times a day, risking their health.

All the flu death number are retrospectively extrapolated, not actual diagnosed cases. 2 years later when they retroactively count the COVID death, it will be 50-100% more than the currently diagnosed.
05-03-2020 09:57 AM
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RE: The Coronavirus Pandemic thread III
ER doctor at Harvard explaining why you can't compare flu deaths to coronavirus deaths

(05-03-2020 09:57 AM)Excalibur Wrote:  https://blogs.scientificamerican.com/obs...o-oranges/

Whether you think Covid-19 is scary or not is all relative. For a 40 year old man it is way less dangerous than spending 1 month riding the motorcycle to work. But stop comparing it to flu.

You can talk to any random 100 hospital internal medicine doctor or nurse, and they will tell you in their 10-20-30 year career they can hardly recall any patient died of flu or having to urgently intubate a patient with flu. And I have have never heard of any doctor or nurse worry about going into a flu patient's room with out proper protection, N95 mask. I've never heard of a doctor or nurse died from contracting flu from a patient.

Whether you want to stay at home or open up the economy, just have a little respect for your health care workers. They are grinding through something that is unprecedented. Yes the urgent care and outpatient clinic are pretty quiet now, and hospital admission are slowing down. All good news. But many of these health care worker are still masking and gowning up 10-20 times a day, risking their health.

All the flu death number are retrospectively extrapolated, not actual diagnosed cases. 2 years later when they retroactively count the COVID death, it will be 50-100% more than the currently diagnosed.
05-03-2020 10:00 AM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 08:34 AM)SamuelBRoberts Wrote:  
(05-03-2020 08:03 AM)Handsome Creepy Eel Wrote:  With the tiny difference being that flu has an incubation period of 2 days, not 10. It's certainly not typical to get infected with the flu and then spread it around for two weeks without knowing.

Average incubation period of COVID is between 3-5 days...

The page that you linked actually says something quite different:

Quote:Coronavirus Incubation Period:
Last updated: March 12, 15:00 GMT
2 - 14 days
Possible outliers: 0 - 27 days

2-14 days represents the current official estimated range for the novel coronavirus COVID-19.

2-14 is quite far from both "2" and "3-5".

But wait, it gets better:

Quote:    

If you're trying to evaluate or stop the spread of a disease, it's little consolation to say "well, 51% of patients will develop symptoms within 5 days", if for others takes as long as 7, 10 or 14 days. The victim who picked up from someone who was in their 12th day doesn't magically get cured or stop spreading it just because "it should have been 5 days". Wishful thinking < Reality.

SamuelBRoberts Wrote:Add "Coronavirus's incubation period isn't that much different than other viruses" to the things that should've been obvious at the start but somehow got mysteriously lost in the panic and fear.

Your own sources clearly say that no other virus that you mentioned has either an incubation time or incubation range as long as COVID-19, so no, it should not have been obvious.

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05-03-2020 10:06 AM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 09:57 AM)Excalibur Wrote:  https://blogs.scientificamerican.com/obs...o-oranges/

Whether you think Covid-19 is scary or not is all relative. For a 40 year old man it is way less dangerous than spending 1 month riding the motorcycle to work. But stop comparing it to flu.

You can talk to any random 100 hospital internal medicine doctor or nurse, and they will tell you in their 10-20-30 year career they can hardly recall any patient died of flu or having to urgently intubate a patient with flu. And I have have never heard of any doctor or nurse worry about going into a flu patient's room with out proper protection, N95 mask. I've never heard of a doctor or nurse died from contracting flu from a patient.

Whether you want to stay at home or open up the economy, just have a little respect for your health care workers. They are grinding through something that is unprecedented. Yes the urgent care and outpatient clinic are pretty quiet now, and hospital admission are slowing down. All good news. But many of these health care worker are still masking and gowning up 10-20 times a day, risking their health.

All the flu death number are retrospectively extrapolated, not actual diagnosed cases. 2 years later when they retroactively count the COVID death, it will be 50-100% more than the currently diagnosed.

^This is exactly the Plandemic's efficacy in action. High volume of fear inducing mis-information propagates as low information conditioning and acceptance.

I'd marvel at the genius of it if it wasn't so sad

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05-03-2020 10:08 AM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 10:00 AM)Excalibur Wrote:  Whether you think Covid-19 is scary or not is all relative. For a 40 year old man it is way less dangerous than spending 1 month riding the motorcycle to work. But stop comparing it to flu.

You can talk to any random 100 hospital internal medicine doctor or nurse, and they will tell you in their 10-20-30 year career they can hardly recall any patient died of flu or having to urgently intubate a patient with flu. And I have have never heard of any doctor or nurse worry about going into a flu patient's room with out proper protection, N95 mask. I've never heard of a doctor or nurse died from contracting flu from a patient.

Whether you want to stay at home or open up the economy, just have a little respect for your health care workers. They are grinding through something that is unprecedented. Yes the urgent care and outpatient clinic are pretty quiet now, and hospital admission are slowing down. All good news. But many of these health care worker are still masking and gowning up 10-20 times a day, risking their health.

"It's worse than the flu because they intubate people and they wear lots of protective equipment."

Well, we know now that one of the reasons so many people died in NY is that they freaked out and started intubating people who didn't need it. Which drove the death rate higher, which made them more scared of it, which meant they intubated more people. So it's scary because they intubate, and because it's scary they intubate. It's a catch-22 of stupidty.
05-03-2020 10:11 AM
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RE: The Coronavirus Pandemic thread III
You keep peddling the tired old lie of people being kidnapped, strapped into ICUs and murdered by ventilators, but it's simply not true:

(04-18-2020 05:20 PM)Handsome Creepy Eel Wrote:  The whole "Wuhan protocol" theory is just a fantasy that Simeon cooked up after his ridiculous theories that no extra deaths were happening were thoroughly demolished by the data. Patients that enter the ARDS stage already have a 40% base mortality rate, meaning that if they were miraculously cured of whatever caused ARDS right that second, they would still have a 40% chance of dying (usually from multiple organ failure caused by disrupted breathing). Add the virus which continues to cause damage along with the ARDS it already caused, and it climbs to 100%.

The survival rate of patients on ventilators is poor - ranging from 15% to 50% depending on the study - but it's certainly much better than the baseline 0%.

Quote:“If you’re sick enough to be on a ventilator, you’re automatically in a critical situation,” said Albert Rizzo, chief medical officer for the American Lung Association. “The chances of you surviving that event are limited. But they’re not necessarily as limited as people are talking about.”

As Doubting Thomas put it earlier, the survival rate of patients on ventilators is poor, but if you get to that stage and there's no ventilator to help you, you're doomed anyway.

(04-19-2020 02:25 AM)Handsome Creepy Eel Wrote:  
(04-18-2020 07:08 PM)SamuelBRoberts Wrote:  
(04-18-2020 05:20 PM)Handsome Creepy Eel Wrote:  The whole "Wuhan protocol" theory is just a fantasy that Simeon cooked up after his ridiculous theories that no extra deaths were happening were thoroughly demolished by the data.

"Wuhan Protocol" may be Simeon's phrasing, but the general idea is accurate: Early treatment protocols for Corona, which came out of China, involved extremely aggressive use of ventilators to target the disease, on the theory that it was so scary a ventilator was the only way to survive. But as we're learning the disease is less lethal than thought, doctors are moving away from them, and in the process, saving lives.

Here's a good story from the AP talking about this.

"We should try some less invasive methods before resorting to ventilators" is not exactly a Nobel prize-winning therapy - preferring less over more invasive whenever possible is already a keystone of medical science. And there's no indication that it's not exactly how it was done before. Doctors don't exactly yearn to saddle themselves with extra workload by rushing to apply the most complicated and time-consuming therapy.

Again, you don't put a patient on a ventilator unless they're already experiencing acute respiratory distress syndrome (ARDS), from which they are very likely to die even if the condition that caused it was suddenly cured, let alone if the condition continues. The idea that healthy patients with mild cough ended up on ventilators is absolutely ridiculous.

Secondly, the high mortality of patients who end up on ventilators is linked to how late they received it after ARDS began.

But back to the topic - how do I know that putting patients on ventilators was an absolute last resort and not a first-line treatment as you claim? Because Italy, where you just claimed that mass deaths occurred because of ventilators, actually had a severe shortage of ventilators, and as a consequence of triage and rationing, ventilators were not available to any patient older than 60.

Therefore, if "being put on a ventilator" was the cause of death, you'd expect the young patients in Italy to die, and the elderly to survive. In fact, the exact opposite is what happened. The average age of deaths in Italy is 85 years. You yourself like to quote that fact as if your life depended on it.

So no, there's no "Wuhan protocol" that kills scores of healthy patients, and "ventilators are killing people instead of coronavirus" is a fantasy.

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(This post was last modified: 05-03-2020 10:20 AM by Handsome Creepy Eel.)
05-03-2020 10:18 AM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 10:11 AM)SamuelBRoberts Wrote:  "It's worse than the flu because they intubate people and they wear lots of protective equipment."

Well, we know now that one of the reasons so many people died in NY is that they freaked out and started intubating people who didn't need it. Which drove the death rate higher, which made them more scared of it, which meant they intubated more people. So it's scary because they intubate, and because it's scary they intubate. It's a catch-22 of stupidty.

I've said this before, but this point is completely untrue. At least at my hospital, we were way more conservative about intubating patients than we are normally because we could not handle so many intubated patients. Again, you can't just intubate someone and call it a day. A ventilator is more complicated than an on button, you need to monitor blood tests and update settings constantly. That's why patients on ventilators need to go to the ICU if they are intubated. Also, I'd like to ask what you propose should be done with a patient who is tachypneic with a respiratory rate in the 50s and oxygen saturations in 70s already on a 100% oxygen mask.

And by the way, what happens when you intubate someone unnecessarily? Nothing happens, you take the tube out and then people can breath in their own fine. People are intubated for elective surgeries all the time, and it's not a big deal if they don't have underlying lung issues.

Also, for what it's worth, lots of people have advanced directives, such as do no resuscitate/do not intubate orders, which we respect. So we have a pretty big decent sample size of seeing what happens when very sick patients are not intubated. Suffice to say, they don't do well (although admittedly it is mostly patients who are already older and sicker who tend to opt for DNR/DNI).
05-03-2020 10:36 AM
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Post: #3308
RE: The Coronavirus Pandemic thread III
Brian Rose & David Icke live now : https://www.youtube.com/watch?v=lSZ4QyC17F8

That's not how we do things in Russia, comrade.

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05-03-2020 11:25 AM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 10:36 AM)Doubting Thomas Wrote:  
(05-03-2020 10:11 AM)SamuelBRoberts Wrote:  "It's worse than the flu because they intubate people and they wear lots of protective equipment."

Well, we know now that one of the reasons so many people died in NY is that they freaked out and started intubating people who didn't need it. Which drove the death rate higher, which made them more scared of it, which meant they intubated more people. So it's scary because they intubate, and because it's scary they intubate. It's a catch-22 of stupidty.

I've said this before, but this point is completely untrue. At least at my hospital, we were way more conservative about intubating patients than we are normally because we could not handle so many intubated patients. Again, you can't just intubate someone and call it a day. A ventilator is more complicated than an on button, you need to monitor blood tests and update settings constantly. That's why patients on ventilators need to go to the ICU if they are intubated. Also, I'd like to ask what you propose should be done with a patient who is tachypneic with a respiratory rate in the 50s and oxygen saturations in 70s already on a 100% oxygen mask.

And by the way, what happens when you intubate someone unnecessarily? Nothing happens, you take the tube out and then people can breath in their own fine. People are intubated for elective surgeries all the time, and it's not a big deal if they don't have underlying lung issues.

Also, for what it's worth, lots of people have advanced directives, such as do no resuscitate/do not intubate orders, which we respect. So we have a pretty big decent sample size of seeing what happens when very sick patients are not intubated. Suffice to say, they don't do well (although admittedly it is mostly patients who are already older and sicker who tend to opt for DNR/DNI).

As a physician, are you really trying to tell people there is zero side effects or downside to intubating someone without reason? Especially elderly or already compromised patients (or the 99% of COVID patients).

We follow an entire protocol to intubate people for surgery. That is a planned procedure with a full pre-surgical work up. Now consider a rapid-sequence on an older or compromised patient with little to zero history and without a glideascope. Nothing happens? Really?

We also try to extubate them as quickly as possible to avoid lung or trachea damage as soon as the surgery is over. Many times, ``just pulling the tube out'' doesnt work like magic. They crash again, need bagged or re-intubated. I have seen this happen to those are younger and far healthier than your average COVID patient. There is a reason you have a CRNA and a doctor standing there when you extubate someone in the OR. While rare, people can become vent dependent in only a few hours. I would think as a doctor you would know all this, and not make such a general statement.

I think both a pulmonologist and an anesthesiologist would disagree whole heartily about your statement that tubing someone isnt a big deal and nothing bad happens.
05-03-2020 01:31 PM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 01:31 PM)AlphaRN Wrote:  
(05-03-2020 10:36 AM)Doubting Thomas Wrote:  
(05-03-2020 10:11 AM)SamuelBRoberts Wrote:  "It's worse than the flu because they intubate people and they wear lots of protective equipment."

Well, we know now that one of the reasons so many people died in NY is that they freaked out and started intubating people who didn't need it. Which drove the death rate higher, which made them more scared of it, which meant they intubated more people. So it's scary because they intubate, and because it's scary they intubate. It's a catch-22 of stupidty.

I've said this before, but this point is completely untrue. At least at my hospital, we were way more conservative about intubating patients than we are normally because we could not handle so many intubated patients. Again, you can't just intubate someone and call it a day. A ventilator is more complicated than an on button, you need to monitor blood tests and update settings constantly. That's why patients on ventilators need to go to the ICU if they are intubated. Also, I'd like to ask what you propose should be done with a patient who is tachypneic with a respiratory rate in the 50s and oxygen saturations in 70s already on a 100% oxygen mask.

And by the way, what happens when you intubate someone unnecessarily? Nothing happens, you take the tube out and then people can breath in their own fine. People are intubated for elective surgeries all the time, and it's not a big deal if they don't have underlying lung issues.

Also, for what it's worth, lots of people have advanced directives, such as do no resuscitate/do not intubate orders, which we respect. So we have a pretty big decent sample size of seeing what happens when very sick patients are not intubated. Suffice to say, they don't do well (although admittedly it is mostly patients who are already older and sicker who tend to opt for DNR/DNI).

As a physician, are you really trying to tell people there is zero side effects or downside to intubating someone without reason? Especially elderly or already compromised patients (or the 99% of COVID patients).

We follow an entire protocol to intubate people for surgery. That is a planned procedure with a full pre-surgical work up. Now consider a rapid-sequence on an older or compromised patient with little to zero history and without a glideascope. Nothing happens? Really?

We also try to extubate them as quickly as possible to avoid lung or trachea damage as soon as the surgery is over. Many times, ``just pulling the tube out'' doesnt work like magic. They crash again, need bagged or re-intubated. I have seen this happen to those are younger and far healthier than your average COVID patient. There is a reason you have a CRNA and a doctor standing there when you extubate someone in the OR. While rare, people can become vent dependent in only a few hours. I would think as a doctor you would know all this, and not make such a general statement.

I think both a pulmonologist and an anesthesiologist would disagree whole heartily about your statement that tubing someone isnt a big deal and nothing bad happens.


The problem here is you guys are ignoring each other's valid points.

You're ignoring Thomas's valid comments ask you what you would do with a patient experiencing respiratory failure - tachypnea, sats in the 70s - while already on 100% O2 face mask. For the most part, doctors and the team do not haphazardly intubate patients although I have heard that initial treatments were to intubate if a pt required greater than 6L of O2 because they thought it would lead to better outcomes. The medical team also tries to wean and extubate ASAP as each day on the ventilator is associated with worse outcomes...

AlphaRN also makes a good point: there are risks to intubation and of course the risks are higher in the sick, frail and elderly. The paralytics and amnesics given during rapid sequence intubation will make it so that the patient won't be able to breath on his own for a least a while. These drugs added to the patient's deteriorating condition likely wouldn't make it so that "nothing would happen" and that people can immediately breath on their own. But that said, you're caught between a rock and a hard place because the patient is already deteriorating so you take the risks of intubation.

At least it seems like you two know what you're talking about although you're both not completely correct. Some other guys have no clue what they're talking about and it is frustrating seeing a lot of flat out wrong opinions being spewed as fact on the forums and the general public.
05-03-2020 02:25 PM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 10:18 AM)Handsome Creepy Eel Wrote:  You keep peddling the tired old lie of people being kidnapped, strapped into ICUs and murdered by ventilators, but it's simply not true:

(04-18-2020 05:20 PM)Handsome Creepy Eel Wrote:  The whole "Wuhan protocol" theory is just a fantasy that Simeon cooked up after his ridiculous theories that no extra deaths were happening were thoroughly demolished by the data. Patients that enter the ARDS stage already have a 40% base mortality rate, meaning that if they were miraculously cured of whatever caused ARDS right that second, they would still have a 40% chance of dying (usually from multiple organ failure caused by disrupted breathing). Add the virus which continues to cause damage along with the ARDS it already caused, and it climbs to 100%.

The survival rate of patients on ventilators is poor - ranging from 15% to 50% depending on the study - but it's certainly much better than the baseline 0%.

Quote:“If you’re sick enough to be on a ventilator, you’re automatically in a critical situation,” said Albert Rizzo, chief medical officer for the American Lung Association. “The chances of you surviving that event are limited. But they’re not necessarily as limited as people are talking about.”

As Doubting Thomas put it earlier, the survival rate of patients on ventilators is poor, but if you get to that stage and there's no ventilator to help you, you're doomed anyway.

(04-19-2020 02:25 AM)Handsome Creepy Eel Wrote:  
(04-18-2020 07:08 PM)SamuelBRoberts Wrote:  
(04-18-2020 05:20 PM)Handsome Creepy Eel Wrote:  The whole "Wuhan protocol" theory is just a fantasy that Simeon cooked up after his ridiculous theories that no extra deaths were happening were thoroughly demolished by the data.

"Wuhan Protocol" may be Simeon's phrasing, but the general idea is accurate: Early treatment protocols for Corona, which came out of China, involved extremely aggressive use of ventilators to target the disease, on the theory that it was so scary a ventilator was the only way to survive. But as we're learning the disease is less lethal than thought, doctors are moving away from them, and in the process, saving lives.

Here's a good story from the AP talking about this.

"We should try some less invasive methods before resorting to ventilators" is not exactly a Nobel prize-winning therapy - preferring less over more invasive whenever possible is already a keystone of medical science. And there's no indication that it's not exactly how it was done before. Doctors don't exactly yearn to saddle themselves with extra workload by rushing to apply the most complicated and time-consuming therapy.

Again, you don't put a patient on a ventilator unless they're already experiencing acute respiratory distress syndrome (ARDS), from which they are very likely to die even if the condition that caused it was suddenly cured, let alone if the condition continues. The idea that healthy patients with mild cough ended up on ventilators is absolutely ridiculous.

Secondly, the high mortality of patients who end up on ventilators is linked to how late they received it after ARDS began.

But back to the topic - how do I know that putting patients on ventilators was an absolute last resort and not a first-line treatment as you claim? Because Italy, where you just claimed that mass deaths occurred because of ventilators, actually had a severe shortage of ventilators, and as a consequence of triage and rationing, ventilators were not available to any patient older than 60.

Therefore, if "being put on a ventilator" was the cause of death, you'd expect the young patients in Italy to die, and the elderly to survive. In fact, the exact opposite is what happened. The average age of deaths in Italy is 85 years. You yourself like to quote that fact as if your life depended on it.

So no, there's no "Wuhan protocol" that kills scores of healthy patients, and "ventilators are killing people instead of coronavirus" is a fantasy.

This 100%. It's absurd to think that there is some evil boogyman elite team calling the shots in the background telling doctors to unnecessarily intubate patients to kill them off.

Perhaps intubation isn't the best strategy and they were intubating too early but you're stuck between severe respiratory failure with low saturations and the risks of intubation. It's unrealistic to assume that every medical team, in every hospital dealing with COVID has been taking orders from "above" to sabotage patients. Unfortunately, some people actually think this. This level of mass coordination is not possible.

This would also go against the fact that patients are always being trialed to wean and extubate daily.

People who have no understanding of medicine are voicing incorrect opinions. Like Handsome eel posted, your mortality rate is already super high when you're in ARDS and have more than 1 organ failing. People are making the spurious correlation of a vent CAUSING death when it's actually a last resort to help prevent a course that is likely leading to death. People don't understand what hypoxemia and a serious systemic infection does to the organs of the body and that once an organ isn't getting enough oxygen, it dies which leads to the person dying.

Does this mean everyone getting COVID will have this happen? No. We have seen that in the vast majority of causes people are ok. But we also have seen that COVID is more likely to cause these deadly outcomes compared to the regular flu.
05-03-2020 02:35 PM
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RE: The Coronavirus Pandemic thread III
(05-03-2020 01:31 PM)AlphaRN Wrote:  As a physician, are you really trying to tell people there is zero side effects or downside to intubating someone without reason? Especially elderly or already compromised patients (or the 99% of COVID patients).

The point was perhaps a bit oversimplified on my end, but in general someone with no underlying lung issues should not be difficult to extubate. Medicine is all about weighing risks vs benefits, and there isn't a medication or procedure that exists (including doing nothing) that has zero risk, so perhaps "nothing happens" is a bit strongly worded on my end. I've seen people arrest peri-intubation, but to think that "so many people died in NY [because] they freaked out and started intubating people who didn't need it" is flatly untrue. And of course, I don't mean to imply that people should be getting intubated for no reason, but the broader point is two-fold.

1) Patients are not getting intubated who aren't at risk of imminent respiratory failure

2) There are risks of every procedure, but in general intubating someone who "doesn't need it" carries less risk of morbidity and mortality than not intubating someone who DOES need it
(This post was last modified: 05-03-2020 02:39 PM by Doubting Thomas.)
05-03-2020 02:38 PM
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Post: #3313
RE: The Coronavirus Pandemic thread III
Related question for all medical professionals here: how quickly does muscle atrophy set in from being in a paralyzed state due to being intubated (or any other paralyzed state such as an ordinary coma)? I'm hearing many horror reports of fit, healthy, middle-aged people having to undergo grueling physical therapy to even move their fingers after spending two to three weeks on life support.

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(This post was last modified: 05-03-2020 02:41 PM by Handsome Creepy Eel.)
05-03-2020 02:38 PM
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BetaNoMore Offline
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Post: #3314
RE: The Coronavirus Pandemic thread III
(05-03-2020 02:38 PM)Doubting Thomas Wrote:  The point was perhaps a bit oversimplified on my end, but in general someone with no underlying lung issues should not be difficult to extubate. Medicine is all about weighing risks vs benefits, and there isn't a medication or procedure that exists (including doing nothing) that has zero risk, so perhaps "nothing happens" is a bit strongly worded on my end. I've seen people arrest peri-intubation, but to think that "so many people died in NY [because] they freaked out and started intubating people who didn't need it" is flatly untrue. And of course, I don't mean to imply that people should be getting intubated for no reason, but the broader point is two-fold.

1) Patients are not getting intubated who aren't at risk of imminent respiratory failure

2) There are risks of every procedure, but in general intubating someone who "doesn't need it" carries less risk of morbidity and mortality than not intubating someone who DOES need it

Of course. Which is why it's frustrating to see the uninformed make sweeping statements on things they have no experience with.

If COVID pt with a bad disease progression is intubated and desaturates to 50% WITH intubation (which happens all the time), imagine what would happen if the patient wasn't getting support of the ventilator?

Again, they try to wean and extubate ASAP. People just don't know what they're talking about.
05-03-2020 02:43 PM
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Post: #3315
RE: The Coronavirus Pandemic thread III
(05-03-2020 02:38 PM)Handsome Creepy Eel Wrote:  Related question for all medical professionals here: how quickly does muscle atrophy set in from being in a paralyzed state due to being intubated (or any other paralyzed state such as an ordinary coma)? I'm hearing many horror reports of fit, healthy, middle-aged people having to undergo grueling physical therapy to even move their fingers after spending two to three weeks on life support.

It happens very fast. I can't remember the exact numbers but your nutritional state is poor and you're not using the muscles. After a week, significant muscle mass is lost especially in the already frail and weak.

It doesn't have to be in a paralytic state either. Not everyone who is intubated in paralyzed for the whole duration of intubation. Most aren't. It's the most severe cases who can't ventilate on their own that are paralyzed and put on ARDS protocols to protect against barotrauma. Even if you're not paralyzed, merely laying in the bed in a state of medication induced sedation causes quick atrophy of the muscles.
(This post was last modified: 05-03-2020 02:46 PM by BetaNoMore.)
05-03-2020 02:44 PM
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Post: #3316
RE: The Coronavirus Pandemic thread III
The interesting thing about all this is seeing how many ignorant people there are having strong convictions about what's happening. They're using their misinformation and small level of knowledge without context to make sweeping conspiracy theories about what's happening.

This has lead me to re-evaluate my own gaps in knowledge on topics I have only small levels of knowledge and the "conspiracy" theories I believe in. If people are wrong about the medical system and the theories they come to, then perhaps I am incorrect about many topics which I think I know about but really don't know enough to really know what's going on.


Edit:

I know our forum isn't about pick up anymore but an analogy of the situation would be that an inexperienced male sees an "alpha male" tease a woman during flirting and the woman is attracted to this. He sees this in isolation without any other background knowledge, nuance or context. The inexperienced male then makes a huge generalization thinking that all women love to be verbally and physically abused at all times. He then makes grandiose theories on the nature of women and then generalizes this to societal implications. This is how I see a lot of people when they are making comments on COVID and the medical system. And this could very well be me in many other topics.
(This post was last modified: 05-03-2020 03:04 PM by BetaNoMore.)
05-03-2020 02:53 PM
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Vladimir Poontang Offline
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Post: #3317
RE: The Coronavirus Pandemic thread III
Here's the whole interview with Brian Rose & David Icke : https://londonreal.tv/1000000-fighting-for-freedom/

That's not how we do things in Russia, comrade.

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05-03-2020 03:28 PM
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Post: #3318
RE: The Coronavirus Pandemic thread III
(05-03-2020 02:38 PM)Handsome Creepy Eel Wrote:  Related question for all medical professionals here: how quickly does muscle atrophy set in from being in a paralyzed state due to being intubated (or any other paralyzed state such as an ordinary coma)? I'm hearing many horror reports of fit, healthy, middle-aged people having to undergo grueling physical therapy to even move their fingers after spending two to three weeks on life support.

Paralytics and steroids will make the muscle atrophy more severe. You'll probably see some level of atrophy after about 72 hours, but for the sort of story you mentioned of people barely able to move their fingers it would probably take weeks. Imagine you need to stay in bed for 2 weeks and are not allowed to leave, not for the bathroom or anything. And in that case, at least you'd be able to roll over yourself and move around.

Although now that I'm thinking about it, I do remember a patient, about a year ago before all the COVID stuff, who also had ARDS and a prolonged ICU course including paralytics and proning, who actually got better enough to be able to walk out of the hospital under his own power. So I guess as with most things there is significant variation with different patients, but I'm sure he was weaker when he left the hospital then when he came in.

(05-03-2020 02:53 PM)BetaNoMore Wrote:  The interesting thing about all this is seeing how many ignorant people there are having strong convictions about what's happening. They're using their misinformation and small level of knowledge without context to make sweeping conspiracy theories about what's happening.

When I see people flat out denying things which I've seen with my own eyes, it does make me reconsider what other conspiracies I believe in. I'm admittedly a pretty new member, so not sure how it was back in the day, but it would seem at least in recent times that one doesn't join a forum like this if they aren't somewhat conspiracy-minded.
05-03-2020 06:28 PM
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Post: #3319
RE: The Coronavirus Pandemic thread III
(05-03-2020 09:57 AM)Excalibur Wrote:  https://blogs.scientificamerican.com/obs...o-oranges/

You can talk to any random 100 hospital internal medicine doctor or nurse, and they will tell you in their 10-20-30 year career they can hardly recall any patient died of flu or having to urgently intubate a patient with flu.

This is just not true. I recall that about 5 years ago a internal medicine doctor told me that during a flu season the elderly and sick are "dying like flies", but largely unnoticed by the general public.
05-04-2020 04:29 AM
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Post: #3320
RE: The Coronavirus Pandemic thread III
Brazil shall be renamed to Batsoupville.
05-04-2020 09:36 AM
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