I just found this article which addresses exactly what we are discussing ...

https://time.com/5818547/ventilators-coronavirus/

It seems like there is something unique about COVID-19 that causes patients on ventilators to fair worse than patients that are intubated because of other respiratory illnesses.

Good info, thanks for sharing. I agree about ventilators...I believe I read a statistic that something around 80% of those that go on ventilators dont make it.

They’re well worth any sacrifices you make for them. I’m on the other end now, my son is 22 and my daughter is 20

Went to the local flea market, about 10% of the vendors...

Fun signs...

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Pretty sure the number is more like 40% don't make it, but that's still bad...

I remember at one time they were saying if you went on a ventilator that you only had a 20% Chance of survival.

So a couple thoughts.

First you are possibly correct. It may not be possible to come up with a vaccine that really works. Coronaviruses have been difficult to develop vaccines for in the past, this one may be the same.

Second, I disagree that flattening the curve doesn't reduce deaths. It absolutely does. Yes, there is a certain percentage of people that are going to die regardless of what we do. However, there is a significant proportion of people that would survive with appropriate care. If the hospital system is overwhelmed those people don't have access to care and die.

Third, I certainly don't think the lockdown will remain for 18 months. I think you will start to see a phased re-opening in the next 30-45 days in various states. How rapidly those states can get back to some semblance of normal really depends on what their curves do after the various phases of opening. If you start to see a spike you may have to tap the brakes a little. It's going to be state to state.

Lastly, I think everyone in the country understands that shutting down the economy was a drastic measure and there are certainly going to be repercussions. I really wish there was a way to have people travel to an alternate reality where we didn't shut down so they could see what would have happened. Can we be 100% certain that it would have been a public health disaster? No, but I'd say the chances are north of 98% that you would have seen hundreds of thousands of dead Americans in a 2-3 month period without any mitigation measures. As there's no way to take Rick and Morty's interdimensional portal to see that alternate reality, we have to just trust in the numbers and the behavior of similar pandemics in the past.

I never saw anyone say it was that low on the news I read or saw. 60% survival (40% mortality) is the lowest I saw, but even that is pretty damned bad. I'm glad doctors are banging out alternative treatment therapies with better survival rates.

Very Well Said

Even if there will never be a vaccine, if you contract this later in the curve, you may benefit from better treatment options.

So many studies happening right now on various drugs, vaccines, and treatments, the longer you go without infection, the more likely you will have the best available treatment if you do get sick.

I keep hearing that it's "more likely than not that there will be a "wave" of sickness worst than the first with this virus"... since this virus is obviously unique to other viruses since we've been tracking them in the early 1900s, what scientific evidence is out there that backs up this claim? Not refuting it necessarily but I just haven't been privy to the science behind the claim.

A local mainstay event just cancelled for the first time since it’s debut. It’s in September. I think it’s safe to say everything is cancelled this year.

I think that’s up to us. The theory is that we’ll get bored or complacent and go back to our old ways of doing things, and new infections will go way up. But yeah nah, that would never happen.

This is what I needed today, thank you.

The people of Wal-Mart.....

Since you’re talking Disney. This popped up on a Google news feed. Thoughts?

https://www.fool.com/amp/investing/2020/04/26/3-reasons-disney-world-will-open-this-summer.aspx

This covers a lot of the factors that lead many scientists to that conclusion about another wave of COVID-19 outbreaks in the fall/winter:

https://www.marketwatch.com/story/we-will-not-have-a-vaccine-by-next-winter-what-happens-when-coronavirus-returns-2020-04-22

Some interesting points in that article.

This doesn't sound good:

Coronavirus immunity differs from other diseases. Immunizations against smallpox, measles or Hepatitis B should last a lifetime, Poland said. Coronaviruses, first discovered in the 1960s, interact with our immune system in unique and different ways, he added.

How do other coronaviruses compare to SARS-CoV-2? People infected by SARS-CoV, an outbreak that centered in southern China and Hong Kong from 2002 to 2004, had immunity for roughly two years; studies suggest the antibodies disappear six years after the infection.

For MERS-CoV, a coronavirus that has caused hundreds of cases in the Middle East, people retain immunity for approximately 18 months — although the long-term response to being exposed to the virus again may depend on the severity of the original infection.

Herd immunity:

“There’s no chance that immunity is going to be high enough to reach herd immunity,” Poland said. “With influenza, you need herd immunity of 60% to 70%. With measles, you need about 95%. With COVID-19, it’s somewhere in the middle.”

In the absence of a vaccine, Poland said several conditions are necessary for herd immunity to work: a very high level of population immunity, for that immunity to be durable, and for the virus to not mutate. “None of those seem to be operational at present,” he said.

In addition to the level of herd immunity (or lack thereof) to protect those who are most vulnerable, people will have to be cognizant of the disease spreading through asymptomatic carriers — that is, people who are infected but show no signs that they’re ill.

Second wave:

And the second wave of SARS-CoV-2? “It will likely hit harder in areas not severely impacted the first time in the interior of the U.S., where there’s a lot more susceptible people,” Kullar said. “COVID-19’s sweet spot could be October to May, with it peaking, likely, in October and November.”

Great picture . It's funny I live in Melbourne and watch Nine News , yet it takes someone in the US to post it on a Pinball website for me to see it . What a world .

The run of good movies on free-to-air has ended so I'm going to check out Chris Hemsworth's new film on Netflix

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They are trying Famotidine, active ingredient in Pepcid as a potential. Very interesting...

https://www.cnn.com/2020/04/27/health/famotidine-coronavirus-northwell-trial/index.html

Thanks for the lengthy and informative response. A couple of thoughts...

I can agree that not over running hospitals was a good thing, and have saved lives by having available facilities available. But, devils advocate, two points. Hospitals, with the exception of NYC, have been far from over run. In fact many have furloughed nurses and doctors for lack of patients. So if that's the goal, why haven't those areas been reopened. Secondly have hospitals really been successful in treating patients with Covid. The recent study from NY that showed that 88% of those that were put on ventilators never came off. Other than a few spotty stories of various antiviral drugs having some limited success, I'm not sure that we are being successful with hospitalizations. I know the alternative of staying at home may not be viable either, but unfortunately there seems to have been no successful treatments. So have we really done anything by keeping the hospitals empty? I dont know, but asking your opinion as you seem to be well versed in the medical arena.

As for the hundreds of thousands dead Americans, perhaps. But I fear we are going to have that anyway. We are already approaching 60k, which the models had us out to August. We will be at 100k by August unless the curve takes a drastic change soon. And with the prediction that the fall will be worse, we will be at several hundred thousand potentially.

I realize noone has the answers, and it is all speculation and what ifs. I just feel like the current wait and see policy at the expense of inducing a Depression, is not the ideal solution.

The U.S. health care challenge

All of these bailouts to aviation, the stimulus checks we are getting, etc. pass the test that makes me think it is all Socialism. But I don't hear of any laid off capitalists bitching about getting a $1200.00 gimme check in the mail. I am amazed at how fast "keep your hands off my jack" has turned into" all for one and one for all. "

But the U.S. healthcare system ain't feeling the love.

https://www.cnn.com/2020/04/27/perspectives/medicaid-health-care-coronavirus/index.html

"It's also essential that Medicaid explicitly covers treatment and vaccines for COVID-19 with no cost-sharing for patients. I fought for this common sense policy as part of the Coronavirus Aid, Relief, and Economic Security (CARES) Act that cleared Congress last month, but it was not included. A vaccine coverage guarantee was included for Medicare beneficiaries in that act, and there is no reason why those who count on Medicaid should be excluded from such explicit protections.

" People who have Medicaid shouldn't have to fight endless paperwork battles to keep their coverage. Frontline health care providers shouldn't be threatened with massive cuts while workers are asked to risk their lives every day. These efforts need to end immediately.

This trope is so tired...

1) The hospitals adapted a ton of capacity to be stay ahead of the demand. The 'demand didn't materialize because the hospitals aren't overflowing' spin ignores the fact CHANGES WERE MADE to stay ahead of demand.. and in the hard hit areas it still was only barely enough.
2) The 'only NYC' point is outright false. The 'slice of truth' is yes, not all spots are hit as hard as the areas like NYC.. and the vast majority (by numbers) are not overwhelmed because the vast majority of the country doesn't have the same scale of outbreak. But where they do.. like Detroit and others... they too were overwhelmed
3) The oft cited "then why are they laying people off" is simple misuse of information. Medical Systems do a wide range of things. Simply because one category is busy, does not mean all categories are busy. The resources used for one type of patient treatment are not universally interchangable with other needs. Your physical therapist isn't going to be a lot of help treating COVID patients. Now apply that idea to EVERYTHING Medical Networks handle... and you can see why shutting down non-essential activities means that yes.. even Hospitals are impacted and need to reduce staffing/services.

Some will say this was $11 MILLION wasted... but concerning human life, is there such a thing?

https://www.click2houston.com/news/local/2020/04/27/ask-2-how-many-patients-have-used-the-11-million-pop-up-hospital-built-at-nrgs-parking-lot/

Did you forget the part where hospitals were barred from doing elective surgeries in order to be ready for Covid-19. Elective surgeries are hospital bread and butter. The hospital profit machine. So, the hospitals have been shut down like all the other businesses. No revenue.

Explain Tokyo then please

https://www.wsj.com/articles/japans-coronavirus-cases-fall-sharply-without-compulsory-measures-11587993871

This thread gets so repetitive because it seems new arrivals to this thread are too lazy or unwilling to read back a bit.

If you want intelligent conversation. Do yourself and us a favor and familiarize yourself with the earlier posts and the posters here before you post.

Pinball_Gizzard is an MD

You are not.

Now I am going to break all of the rules and go pickup a new machine

thanks

I'll debate here that it's still too soon to make a conclusion about this. While I don't disagree with you that this is bound to be a different equation for each and every human body, I still believe we just don't know enough about this situation to draw conclusions yet.

Keep in mind early on folks were using vents like this was any other illness that required early intervention. That wasn't leading to very good outcomes due to the severe O2 exchange deficiency in the ARDS condition that COVID-19 causes. Now it appears that high-O2 feeds were found to do a better job early on, at least until life-saving measures are required due to the patient coding.

More data is needed all around. More time. Unfortunately, time is not our ally at this point. Especially with folks clamoring to get out after being told to stay home for several weeks now. They're getting antsy. I can already see it in my community, especially since the weather is getting nicer up here.

I'm in a pretty rural community in Western Wisconsin, and we still only have 4 documented cases so far, with no new cases reported in more than 2 weeks. I work in the county south of where I live, and the cases there are still at 13 total cases, but we are 40 minutes away from Minneapolis / St Paul, where it's pretty dense. Lots of commuters live here, and work there.

I'm just hoping that contact tracing and diligent testing will hold things at bay here to keep things slow. We'll see infections here, no doubt. I just want them to go slowly.

My thinking exactly. We are trying to buy time to find some effective treatment options and effective vaccine in the longer term.

No, I just didn't list it explicitly. Simply lumping all that together under the stuff 'that isn't COVID 19 treatment'. The PT example is used to make it obvious... because if you use something like surgeries people get wound up arguing that those doctors should be treating COVID patients. Not really grasping the whole concept of specialties. It's much easier to use an example they can't munge

It's not even worth getting into the financial discussion with them... they think hospitals just shit money. Not being bothered to understand how some areas are very costly, and are offset by other areas that are more profitable. And this whole elective-shutdown has nuked the more profitable portion while the 'very costly' portion runs wild.

But they'd rather just focus on 'see, I saw there was a layoff... so they can't be busy...'

#detailsMatter

I take famotidine twice a day now for acid reflux since ranitidine (Zantac) got pulled. This article doesn't do a very good job of explaining why theoretically famotidine could be helpful, though.

H2 blockers like famotidine block the histamine 2 receptors which can help with acid reflux. Histamine activation is part of a bodies immune response and H1 blockers like fexofenadine are used for allergies as well.

Is the theory that histamine overreaction to the virus contributes to the inflammation in the lungs and cytokine storm currently theorized may be occurring in some Covid patients being hospitalized with severe lung and breathing problems?

Theoretically, if there turns out to be some benefit to drugs like these, the other 2-3 available otc would likely have some benefit as well. Sounds like a run on H2 blockers and meat is the next thing...

Frankly, I'm a little tired of hearing about potential cures. Let me know when there's a study saying something has actually been proven effective.

I appreciate the information. Not sure why you had to lead with an insult, but nonetheless, thanks. But to your point, if hospitals geared up, and are now generally not seeing patients, Covid or otherwise, why not open back up to elective surgeries?

I'm aware that Grizzard is an MD....but your Appeal to Authority fallacy doesnt fly. And I'm sorry I dont monitor this thread 24/7, but are you really complaining as a member of a forum that routinely asks the same which machine is better?

I imagine they have to start somewhere and build from there.....
I know it's shooting blanks for now and I'm confident that something will be produced.

In Chicago, they turned our convention center into a 3,000 bed care center for COVID-19 patients. To my knowledge, none have been used yet. Some may see that as a huge waste of resources, but I see it as the overwhelming success of the stay at home order. That's the thing about social distancing. People look at the number of infected people after the fact and jump to the false conclusion that the lock down was an overreaction. The reality is that the numbers would have been exponentially worse if the extreme social distancing measures weren't implemented.

My wife has MS

Her Rx caused us to isolate 6 weeks ago

Now docs are using several MS meds to treat COVID-19 since both trigger cytokine storms. So the risk in some cases is the reward. Fine line inbetween I'm sure.

What a rollercoaster it's been. I will be returning to work on the 1st & taking every precaution I can.

I forget what it's like to talk to people, wear shoes, work, etc. Wish me luck!

My mother was admitted yesterday for pneumonia. So that's super shitty. Wish her luck too.

Well for starters, look at the picture in the article. Everyone without exception is wearing a mask. Also, the Japanese actually revere their elderly, so I’d imagine social disapproval is enough to keep people social-distancing. Lastly, one counter-example doesn’t prove that social distancing doesn’t work (even if that were the case).

It is easy to be a Monday morning quarterback but when dealing with unknowns the best anyone can do is to be prepared for the worst and hope for the best. I think a lot of mistakes have been made but if some of these decisions were not made who knows how much worse it could have been or still could be.

When looking at death tolls the people saying "it is only 60,000 people who have died so far it isn't all that bad" most likely have not lost a parent, spouse, child or good friend yet. On the flip side is what was done to our economy or the world economy "worth it" to save a few people - who knows? I guess the answer to these questions basically comes down to what impact this had had on you.

Bottom line is this who thing "sucks" and it likely isn't going to end anytime soon. So I think all any of us can do is make the best of a very bad situation and do what we can to help the people hit the hardest by this. History shows us at some point it will be over - for now all we can do is the best we can do.

Not sure how you got 'not seeing patients, Covid or otherwise' from that. You need to stop thinking of hospitals and medical systems as some singular thing. One side can be very busy, another side is empty. That was the point. Being busy treating Covid is not enough to support the entire business model the medical provider is built upon. That's why you see layoffs and changes.

Just like a restaurant doing carry-out isn't enough to support their previous business model... so people like waitstaff and bussers were being laid off.

For the same reasons they stopped elective procedures in the first place.

High risk population, high contact places, non-essential services, and it was competing with things needed for essential care like PPE supplies.

I'm just going by what others in the healthcare industry are saying. I readily admit, I'm not a hospital administrator, nor pretend to be. I can understand your point about hospitals having vast specialties, but is that really the case with more rural hospitals?

https://www.newsweek.com/most-us-hospitals-are-empty-soon-they-might-closed-good-opinion-1500028

This is all very new info so take it with a grain of salt. The famotidine question was raised based on an observation that patients in Asia who were on famotidine for reflux seemed to have a little better outcome. The theory is that perhaps famotidine interferes with the viral replication machinery in some way. The doses used are very high and it is given IV.

Very experimental and lots more data needs to be seen.

To robertmee, I suspect hospitals and clinics will start opening up more to elective procedures and visits in the coming weeks. The main thing that may keep hospitals from being able to open to elective procedures is PPE burn. With the increased use of PPE for all patients, elective patients included, you have to make sure the elective procedures don’t burn through your available PPE and put staff at risk if they have to treat COVID patients.

People need to understand that specific policy decisions were made to increase the capacity for COVID patients early on. In many areas the mitigation measures were effective and so the created capacity was not all needed. That’s a good thing. It is NOT proof that the mitigation measures weren’t needed or that the whole thing is a hoax. Let’s just stop that nonsense now.

The system was prepared for a disaster that could easily have occurred and almost certainly would have occurred without mitigation. At the time there was no way to know how compliant Americans would be with mitigation and whether we even had enough time to make a dent in transmission before a critical mass of patients was produced. New York is an example of an area where the infection rate was too high for mitigation measures to keep a mass of patients from needing hospital care. We likely would have been looking at the same scenario in every major US city without mitigation.

Now then, hospitals usually operate on a very tight budget and thin margins. A major source of income for hospitals are elective surgeries and procedures. When those procedures go away, the hospital loses money. So, you are now seeing some people being laid off due to budget constraints related to income loss at the hospital. The money provided by the government doesn’t even come close to covering the shortfall.

Once hospitals begin to see the elective patients again you will see their revenues rise and those people laid off will find jobs.

Everyone had to make sacrifices here, medical personnel and hospitals included.