Coronavirus

[Evermind]

That account certainly sounds awful, but that's not a normal case, that's a bad case. A bad case of the flu feels like death too (and can lead to death for otherwise healthy people). Not necessarily saying this is no worse than the flu. It certainly likely is. Just pointing out that only a small minority have a case as bad as that.

She also says she's asthmatic, so that might've made it worse.

[Lonk]

A DT fan came to a preshow I was hosting in Baltimore a couple of years ago.  He ended up helping me big time, we became friends, and together hosted the recent preshows in DC in April (over 80 attendees) and Baltimore in October (over 50 attendees).  If anyone here attended, he was the bearded guy with the skulls.

Last night, him and his wife took their two year old daughter to the E.R., because she had a 104.7 temperature.  From his Fbook

Coronavirus screening was in being done at Carroll County Hospital, before we even walked in the door. We were asked questions about travel and symptoms. Also, w visitation/escort procedures had been altered- my wife had to go back with her alone while I waited in the car.  My daughter's fever was brought down with Motrin and Tylenol, and she is currently OK.

She tested negative for the Flu and RSV.

Since fever is a symptom of COVID-19, it is a possibility. But my daughter could not be tested for it because the doctor said they are only testing critical patients, because there aren't enough test kits yet. He recommended we self quarantine for 14 days, and we will.

Downright scary, as most people who get COVID-19 will not be critical. We should be doing more testing. The quarantine is just a recommendation. I am sure some people won't follow if they have the same experience.

Quoting my own post from a few days back.  Well, my friend's daughter became worse yesterday, they took her back to the hospital, they finally tested her, but won't know the results for days.  And yet again, the friend and his wife didn't get tested, because there are not enough kits.

https://baltimore.cbslocal.com/2020/03/24/coronavirus-test-shortage-latest/

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

[millahh]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

[bosk1]

^Very helpful.

[Dublagent66]

In more simpler terms.  The virus affects different people in many different ways causing many different reactions.  Some may have it and not be sick at all.  That's the really scary part.

Fortunately those terms are out there to help all people so maybe we can suck it up and be annoyed by words for a few more weeks while people are dying cause they can't breathe.

Sure they're meant to help. But when they're said a million times they lose meaning. "Stay six feet away from others" is much more meaningful than "practice social distancing".

So, we repeat phrases to instill them into people's heads and make people pay attention. But apparently repeating phrases makes them lose their meaning. Honestly, I think people are just looking for things to complain about. I've heard "Stay six feet away from others" about as often as I've heard "practice social distancing." I don't get the logic in criticizing repeating good advice when the worst of the storm hasn't even washed over us yet.

I know the people who can't breathe because they have no respirators sure don't think it's annoying, or the people who have lost family members.

Exactly.  People can actually call it what ever they want.  I call it "not being around all the other whiny motherfuckers".  Or, "stay 6 feet away from me and out of kicking distance." 

[lonestar]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Is there any data on how people with auto-immune disorders react? Like psoriasis?

[bosk1]

In more simpler terms.  The virus affects different people in many different ways causing many different reactions.  Some may have it and not be sick at all.  That's the really scary part.

Well, I wouldn't really call it "scary" though, and I think it is a problem when we react that way.  What that means is that, as health officials have been saying is the likely scenario fairly consistently right from the beginning, our reaction to this particular cold virus in this respect is fairly similar to other cold viruses.  Yes, there are some key differences.  But in terms of reaction, once symptoms manifest, our bodies' reactions to them tend to follow a similar pattern in many respects. 

[The Walrus]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Well, don't forget, this virus has been mutating and is different in different locations compared to the strain in China, from everything I've read. So I wouldn't be surprised if some of the symptoms are actually worse depending on the location, as well as all of the above.

Biology (and virology) is wild.

[millahh]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Is there any data on how people with auto-immune disorders react? Like psoriasis?

From what I can find, there doesn't seem to be an inherent elevated risk for these patients (it's not like they are immunocompromised); I don't think they are any more likely to have cytokine storms than anyone else, as in autoimmune diseases, it's about the body inappropriately attacking one very specific kind of cell.  The one wrinkle here is that the meds for psoraisis are themselves immunosuppressants.  What I'm seeing preliminary is that it is recommended that people stay on their biologics, and follow all of the recommendations about distancing, sanitation, etc.  It could be a bit different of other autoimmune disorders, which may require heavier duty drugs (e.g. methotrexate, which is basically chemo), or where the person is in crummy overall health in the first place.

[cramx3]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Well, don't forget, this virus has been mutating and is different in different locations compared to the strain in China, from everything I've read. So I wouldn't be surprised if some of the symptoms are actually worse depending on the location, as well as all of the above.

Biology (and virology) is wild.

I read one study yesterday saying it's not mutating fast enough for a mutation to be a concern in the near future.  This stuff changes every day and who knows the truth though. 

[lonestar]

Prince Charles tested positive.

From what I can find, there doesn't seem to be an inherent elevated risk for these patients (it's not like they are immunocompromised); I don't think they are any more likely to have cytokine storms than anyone else, as in autoimmune diseases, it's about the body inappropriately attacking one very specific kind of cell.  The one wrinkle here is that the meds for psoraisis are themselves immunosuppressants.  What I'm seeing preliminary is that it is recommended that people stay on their biologics, and follow all of the recommendations about distancing, sanitation, etc.  It could be a bit different of other autoimmune disorders, which may require heavier duty drugs (e.g. methotrexate, which is basically chemo), or where the person is in crummy overall health in the first place.

I actually went off my biologics (Otezla) last year, my insurance shifted with my job, and my copay for it went from 20/mo to 250/mo (but on the other side, the new insurance supplied me with an at home UVb unit, which makes up for it).

[Nick]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Well, don't forget, this virus has been mutating and is different in different locations compared to the strain in China, from everything I've read. So I wouldn't be surprised if some of the symptoms are actually worse depending on the location, as well as all of the above.

Biology (and virology) is wild.

I read one study yesterday saying it's not mutating fast enough for a mutation to be a concern in the near future.  This stuff changes every day and who knows the truth though. 

I was thinking about this the other day as another reason to keep infections as low as possible, even among those less likely to be affected directly. I don't know if the science behind this theory is sound or not, but it would stand to reason that the more people infected, the more attempts the virus is making at replicating, and the higher likelihood of a deadlier mutation occurring.

[millahh]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Well, don't forget, this virus has been mutating and is different in different locations compared to the strain in China, from everything I've read. So I wouldn't be surprised if some of the symptoms are actually worse depending on the location, as well as all of the above.

Biology (and virology) is wild.

I read one study yesterday saying it's not mutating fast enough for a mutation to be a concern in the near future.  This stuff changes every day and who knows the truth though.

There's no selection pressure to drive mutation, because there is no treatment...it can rip through the population like wildfire as-is. A little bit of drift is to be expected (as in anything over the course of generations), but nothing terribly radical.

EDIT: To Nick's point, there could be mutations making it more severe...though there could also be ones that make it less so.  It's already infectious as hell...anything that makes it kill much more/faster would actually be disadvantageous for the virus, as it would be less likely to propagate.  Not that it helps us, though...

[jingle.boy]

I think I snatched his from Lowdz' FB feed.  There's lots of vids like this out there, but I found this to be a really informative breakdown of how the virus works.  8.5 mins long

https://www.youtube.com/watch?v=BtN-goy9VOY

[Volante99]

Hope his daughter is not in critical condition. We are seeing more and more cases of young adults/teenager being hospitalized over COVID. Some had no previous condition.

The previous condition/comorbidity thing can make things much, much worse, but it's not the only reason some people get hit really hard. In some cases, peoples' immune systems basically lose their shit and go HAM (these are the technical terms  ).  Capillaries in the area of the infection already open up a little bit to allow white cells through to fight the virus.  Inflammation lowers the lung volume a bit on its own, and dead cells from the infection (both lung cells and white cells, and mucus) start to fill the lung with fluid, further reducing capacity.  When things go off the rails, the immune system really opens up the capillaries and intensifies its attack, and also starts attacking any target in the area, not just the virus (this is called a cytokine storm).  So now you have a much greater amount of inflammation, a much great rate of fluid accumulation, and the body is attacking healthy tissue.  And add a high fever on top of this. And as far as I'm aware, there's no way to predict who may react in this way (it's not age dependent).

It sounds like splitting hairs, but it's not so much that the disease is really bad in some people, it's that some people's immune systems react REALLY badly to this infection.

Is there any data on how people with auto-immune disorders react? Like psoriasis?

From what I can find, there doesn't seem to be an inherent elevated risk for these patients (it's not like they are immunocompromised); I don't think they are any more likely to have cytokine storms than anyone else, as in autoimmune diseases, it's about the body inappropriately attacking one very specific kind of cell.  The one wrinkle here is that the meds for psoraisis are themselves immunosuppressants.  What I'm seeing preliminary is that it is recommended that people stay on their biologics, and follow all of the recommendations about distancing, sanitation, etc.  It could be a bit different of other autoimmune disorders, which may require heavier duty drugs (e.g. methotrexate, which is basically chemo), or where the person is in crummy overall health in the first place.

I’m on a biologic (Remicade) for Crohn’s disease and fairly concerned. However, It seems like the verdict is really out on whether or not this puts you at a huge disadvantage with Coronavirus. On one hand you’re probably more likely to acquire it and suffer symptoms but also because you’re on a biologic, you’re immune response may prevent things like a cytokine storm, inflammation and just general immune overreaction which is what apparently killed most people in the 1918 flu epidemic. They are recommending people stay on their medication with the exception of prednisone which seems to REALLY weaken the bodies ability to fight off viruses.

[Dublagent66]

In more simpler terms.  The virus affects different people in many different ways causing many different reactions.  Some may have it and not be sick at all.  That's the really scary part.

Well, I wouldn't really call it "scary" though, and I think it is a problem when we react that way.  What that means is that, as health officials have been saying is the likely scenario fairly consistently right from the beginning, our reaction to this particular cold virus in this respect is fairly similar to other cold viruses.  Yes, there are some key differences.  But in terms of reaction, once symptoms manifest, our bodies' reactions to them tend to follow a similar pattern in many respects.

To clarify the scary part, I'm just referring to people who may have the virus but manifest no symptoms and inadvertently pass it on to others.

[Indiscipline]

Infections slightly trending down for the fourth consecutive day in Italy.

[bosk1]

Hopefully, that's a good sign.  But I hate to read too much into it, kinda like watching one's stock portfolio values minute-by-minute and trying to draw conclusions from that.

[Indiscipline]

I wholeheartedly agree. At least here, drawing fast and instinctive conclusions from convenient data has hindered the reaction machine royally. Still, we can use even a small size trend as encouragement towards enduring strict rules.

[cramx3]

Yea, at this point you got to be happy about any positive news, but it still should be taken lightly and not as "the end is near".  Just too early to tell, but regardless, that is good news to see the flattening of the curve starting.

[MirrorMask]

Yeah, this is not the D-Day, but with everybody finally brought inside their homee, we can call it a Dunkirk.

[DragonAttack]

Japanese Americans wish they would have had to suffer like this during WW II.  Forced to stay in one's own home with cable, internet, take out food, booze at the ready......

[cramx3]

https://www.yahoo.com/news/york-city-st-augustine-fever-024401833.html

Data from health technology company Kinsa, which did the analysis using its digital thermometers, show the number of people with flulike illness — atypical fever and symptoms — began dropping almost immediately after mandatory social distancing measures were implemented in some areas.

The company downloads fever readings from more than 1 million thermometers in use around the U.S.

Kind of cool that there's already data collected that shows social distancing is working. 

[Harmony]

New York yesterday 

In several hours on Tuesday, Dr. Ashley Bray performed chest compressions at Elmhurst Hospital Center on a woman in her 80s, a man in his 60s and a 38-year-old who reminded the doctor of her fiancé. All had tested positive for the coronavirus and had gone into cardiac arrest. All eventually died.

Elmhurst, a 545-bed public hospital in Queens, has begun transferring patients not suffering from coronavirus to other facilities as it moves toward becoming one dedicated entirely to the outbreak. Doctors and nurses have struggled to make do with a few dozen ventilators. Calls over a loudspeaker of “Team 700,” the code for when a patient is on the verge of death, come several times a shift. Some have died inside the emergency room while waiting for a bed.

A refrigerated truck has been stationed outside to hold the bodies of the dead. Over the past 24 hours, New York City’s public hospital system said in a statement, 13 people at Elmhurst had died.

“It’s apocalyptic,” said Dr. Bray, 27, a general medicine resident at the hospital.

https://www.nytimes.com/2020/03/25/nyregion/nyc-coronavirus-hospitals.html

[cramx3]

My doctor friend shared me a screenshot with his sister, also a doctor in NYC, who said her friend pronounced 11 people dead at a hospital at or near Columbia university (he wasn't clear where his sister's friend was working) and they converted 20 operating rooms to ICU with 4 vents per room.

[The Walrus]

I cannot even fathom what it's like to be working in a hospital in NYC right now. Whatever they're getting paid is not nearly enough.

[cramx3]

I can't either, whenever I think of how shitty my situation is (which isn't that shitty really) I think about those who have it much worse, whether being on the front lines in the hospital or being infected and in the hospital.  Crazy how this is all happening and while it feels like it's been a slow build, it really has been very quick on a global scale.

https://www.cnn.com/2020/03/25/health/coronavirus-death-peak-three-weeks-epidemiologist/index.html

[Cool Chris]

Today is the first time I've been out and noticed significantly fewer cars out on the road. The past week or so it's felt like a holiday (no school, government buildings closed, etc...) but today there was an even greater discernible decrease in traffic.

[TAC]

Today was definitely the lightest so far.


My kids are now out of school until at least May 4th.

[The Walrus]

Today is the first time I've been out and noticed significantly fewer cars out on the road. The past week or so it's felt like a holiday (no school, government buildings closed, etc...) but today there was an even greater discernible decrease in traffic.

Man. Not here. Last few days it was pretty light outside but today was fantastic weather and when I got off work at 5 I saw a bunch of people out for walks, walking their dogs, lots of traffic... it was like people think the shelter in place til April 7th thing only applied really for the weekend.

[Stadler]

Today is the first time I've been out and noticed significantly fewer cars out on the road. The past week or so it's felt like a holiday (no school, government buildings closed, etc...) but today there was an even greater discernible decrease in traffic.

Man. Not here. Last few days it was pretty light outside but today was fantastic weather and when I got off work at 5 I saw a bunch of people out for walks, walking their dogs, lots of traffic... it was like people think the shelter in place til April 7th thing only applied really for the weekend.

I apologize if I wrote this here, but over the weekend - warm - people had to step off the sidewalks to let others pass.   My ex and her husband went hiking and said she ran into like four people she knew.  HIKING.  In the WOODS.   

People are staying home from work and school, but not much else if you're asking me.   

[Lethean]

Why the emphasis on the woods?  I would think that if your stay at home order allows for you to go outside for exercise, and some do, that the woods would be better than the sidewalk. 

(Now personally, if I went to the woods and it was clear I wasn't going to be able to follow the guidelines and stay 6feet away, or maybe 20 for good measure, I'd leave)

[Lonk]

I think the emphasis on “THE WOODS” is because you don’t expect to see many people in the woods, much less 4 people you know, specially in times when you are being told to stay at home.

[The Walrus]

I keep seeing articles on news sites about going hiking and for walks etc. too. Like... it's baffling 

[KevShmev]

I had planned on getting in the car tonight to just go for a drive and crank some tunes, but I was under the weather for much of the day, so that went by the wayside.  Maybe tomorrow.