SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)
- Thread starter Don't Kill Bill
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In the latest episode of the United Hour Podcast, Nik @Rood and Imran @Annihilate Now! start with the good news by celebrating Manchester United Women's emphatic FA Cup win over Spurs at Wembley and the future of manager Marc Skinner.
Then it's the bad news and the ever worsening form of our Men with losses to Arsenal and Palace.
Finally the main debate - ETH Out now or keep him until the end of the season - if not longer. Are you Team Nik or Team Imran?
Do I need to rush out and buy some or is eating my lunch outside every day enough?
The government has issued advice and suggest that the general public should not be buying and eating sardines however they recommend that NHS front line staff do.
I'm not mistaken ethnic minorities are generally known to have lower Vit D levels too? I know in hospitals there was a strong correlation between covid hospital patients and their Vit D levels and this was recognized back in March. Think at the time they were unsure if it's the virus bringing down Vit D levels or its that they caught the virus because they already had low levels in the first place.
In any case Vit D is one of those things many people may be low on without knowing until they get a blood test. I've been on a maintenance dose for a while, does no harm.
In any case Vit D is one of those things many people may be low on without knowing until they get a blood test. I've been on a maintenance dose for a while, does no harm.
Pretty much. From what I've seen all the teacher unions want is to be able to teach in safe conditions and the government haven't been able to provide that confidence.
No I'm merely pointing out that there are alternative points of view to those that are being pedalled as the "the right one". I do not deny that mistakes have been and will continue to be made in this chaotic situation. I do think that politicians are unwise to make promises they might not be able to keep e.g. on the testing targets and the launch of a road map by a certain date.
Your opinions are fuelled by what you read in biased publications and media. The Express article does at least appear to have some balance but I consider everything I read or hear with caution and make my own mind up.
What is this 'virus could be eradicated in London in two weeks' stuff i keep seeing? How misleading is that?
The problem is that the safe conditions that the Unions want are no pandemic.
I hear a local secondary school by me has been readying itself with a device for temperate checks on entry, directional routes in and out revised timetables to accommodate the numbers in order that social distancing can be observed - all this being prepared weeks in advance of the announcement.
Imagine living in a country where common sense can prevail in order to prevent a state of permanent lockdown that extends to the point of economic and social ruin?
You probably don’t need it but they’re cheap to buy and don’t do any harm. Vit D deficiency is quite common in Ireland because of our shite weather. If your complexion is in any way dark you’re more likely to need a top up (I’m kind of swarthy)
No no, I mentioned in my response to Pogue that a lot of them are
Bear in mind I'm referring to seasonal and not pandemic flu. I don't take seasonal flu lightly, first thing I tell my patients in GP surgery is to get their flu jab.
My first job was in respiratory medicine as a junior (albeit in the summer) but I have worked in A&E and resus in the winter and my acute medical rotation was in a second tier NIV-equipped ward which saw complicated flu patients
Certainly we do see pneumonias, myopathies, myocardial involvement, encephalitis, GBS, sepsis, worsening of chronic diseases with flu in addition to delirium in the elderly. But my point is the incidences of those complications and like I said covid is new so we're still awaiting data but the breath of complications are more vast
I don't know how prevalent coagulopathies are for example in the instance of severe flu, nor the degree of acute kidney injuries or ARDS which are features of COVID.
By every metric from what I've seen in my line of work covid patients even the non-ITU ones have been sicker. The white outs on their chest Xrays are more, the lactates, trops and d-dimers are higher, electrolytes more deranged, eGFRs and blood pressures are lower, oxygen sats are lower, pH's more acidotic, the older's one arrest more, the younger ones arrest too or reach peri-arrest very easily and often. And they need to be on tubes for longer, harder to wean off, get intubated more often, inotrope needs are higher, get way more secretions and require more intense chest physio. And I'm using as a comparison the sick, young, few comorbidities complicated flu vs complicated covid for comparison as best as I can from memory and experience.
But of course we have to wait for the formal data.
I think certainly the R0 for covid might be higher but flu has a shorter median incubation period (the time from infection to appearance of symptoms) and a shorter serial interval (the time between successive cases) than COVID which means flu in theory can spread faster. Mortality I think for covid generally is higher and I don't know whether the seasonal flu we see year after year is something that is a less deadly strain and that we are getting more immune to it and as a result most are not as ill
Incidentally my wife works as a dermatologist, covid presents in all weird and wonderful dermatological manifestations but she has just biopsied a potential toxic epidermal necrolysis (TEN) patient secondary to covid. TEN is a rare but very serious condition and one of the few true derm emergencies. I don't think I've seen case reports of TEN secondary to covid in literature yet but yet another one to add to how shitty covid is.
So I just think prognostic implications on a population wide basis if our strategy is gradual herd immunity (or if that just seen as an inevitable clincal end point) that we take into consideration prevalence and extent of complications beyond case fatality rate.
If all the infected die then it's eradicated.
I take vitamin D too, mostly also because of this thing, but I'm frontline covid-patient-seeing doctor who's of pakistani origin and is fat from stress-eating
I thought you were an invulnerable Canadian with wild hair.
That too
Read the top headline hits on each search. They're very clear.
My issue with @Wolverine 's post quoted below is his/her assertion in the last sentence and your similar assertion with the three complications you singled out.
I would rather you both do your own research before posting these generalisations or put them in to context. As I have said, the main danger with COVID-19 compared to flu is the absence of a vaccine and proven effective treatments. Pretty much all of the other complications; and also the consequences of ventilation listed below can occur with flu. It may well be (and probably highly likely) that their incidence is greater in COVID-19, especially currently, but that is not what is being claimed....
"Any herd immunity like strategy would have to take into account that we would be exposing a significant proportion of the population to risks of pulmonary emobolism, strokes, myocarditis, cardiomyopathies, kidney complications, limb venous thrombosis (with potential amputation risks in extreme), possibly irreversible lung damage, intubation complications, tracheostomy complications, increased heart attack risks, vasculitis-like rashes in adults and children , neurological complication, psychological complications, memory and cognitive deficits if they recover from delirium. That is simply not the case when thinking of the flu."
Imagine a country where members of parliament are working from home and don't think it's safe yet to return to their offices but are more than happy to tell others to do it.
When MPs are sitting shoulder to shoulder in the HoC again - that's when it'll be safe to reopen the schools to their previous levels of overcrowding.
Why are you ignoring what people tell you?
@Arruda already told you that the prothrombotic and vasculitic complications aren’t seen with flu. He’s a doctor. So understands this shit better than you. So is @Wolverine. So am I. A lot of the potential long term complications are common to all ITU patients and/or seen with other severe viral infections. But not all of them.
Wading into this thread picking arguments with - and repeatedly ignoring explanations provided by - people better qualified than you is not a good look.
Well said.
I have done research. I do it everyday. There is a paucity of meta-analysis level of data given how relatively novel COVID is to be making accurate comparisons so I was partly going by what I've read, seen, experienced since end of March/early april from dealing with covid patients, speaking to ITU consultants, infectious disease doctors who I'm friends with, virologists who I've attended lectures of in person (initially) but now mainly on webinars
Certainly I was wrong if I implied that aforementioned complications didn't exist in flu, but what I meant to say as I posted above it its about rates of complications, range of complications, severity of complications. All of which of course will be elucidated later on with more sound data. But absence of evidence isn't evidence of absence as they say.
But I mean with flu in young kids the hyperinflammatory Kawasaki-esque post-COVID syndrome just wasn't part of the picture. Things like that. Like I can't remember renal wards telling us their dialysis machines are clotted up or oxygen supplies run out during any of the previous flu seasons.
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I think teachers have a right to see that any preparations made by schools are led by guidance backed by scientific opinion. Unions have an even bigger role in ensuring those protections. The testimony to committee from the DFE has not provided that confidence and has been worryingly poor.
But Tory bot ManUArfa thinks everyone should just use common sense, a position he definitely arrived at independently.
It doesn't take a great deal of empathy to understand why teachers would be concerned for their own health and/or that of their loved ones.
With the sheer number of doctors in here I think we've reached nerd immunity.
I know that doesn't make sense but just punning.
The downward trend seems to continue in Belgium.
I have a happy picture of you in my head.
With the amount of boring 'facts' and 'statistics' you losers post, I'd imagine you've definitely got 'bird immunity'.
(As in women won't go near you, because they hate facts and well thought out logic and instead love alpha males like @ManUArfa who just goes with his feelings and alternative facts)
works for me.There are loads alright. Long gone the days when it was only me and @Dwazza Gunnar Solskjær (not actually a doc but did a damn good impression of one for years)
That's terrible and I know a thing or two about bad puns.
Not at all, some people are quite happy to have open marriages. You need to open your eyes and be more accepting of people's choices.
Thank you. This is the context I felt that was required as the statement on its own was potentially misleading and many people choose to view misleading statements, and comments out of context, as truth. The dangers posed by COVID-19 are extremely worrying at this stage of the knowledge and treatment base.
PS. I don't we should view natural here's immunity as a policy, more so an inevitably. The worldwide aim at the moment, in the absence of a vaccine, is to slow that down as much as possible to protect health systems and save lives.
100 seems quite low. I take 7000 iU every day during the Winter months. I read quite a lot of articles about it when I started taking vitamin D supplements a few years back and the consensus seemed to be that even much higher amounts were safe.
There was some discussion yesterday about how Vietnam has managed to have no deaths at all, and only about 300 cases. This article on the BBC explains how they achieved it, but I don't think people would comply to the same extent in a lot of countries.
https://www.bbc.com/news/world-asia-52628283
https://www.bbc.com/news/world-asia-52628283
Erm, his style indicates he could be the future president of the USA. Or even prime minister of the UK. I would be careful.
I've got friends living in HCM - they said there was a lockdown but people didn't really pay much attention and there still didn't seem to be many cases. Interesting for sure!
That isn't what the unions want and it is totally disingenuous to suggest so.
I think you, like everyone on this thread, have something to contribute. We are all learning, we are all hopefully polite individuals. But as far as I can tell, so far in this thread, you've accused others of making it political, while showing a clear political bias yourself and have approached conversations with people who on paper probably know more than you on this topic with unnecessary aggression imo.
It isn't really useful or conducive to a good debate or learning environment, for anyone involved.
Only 300-ish cases, but they haven't done much testing (they don't need to, really). It's quite amazing how they haven't been affected.
I totally agree. As good a job as the carers often do (and it is a job where you don't get much thanks or appreciation), it will never be like family.
The cultural differences are certainly interesting too. My Dutch in laws see it as perfectly normal to go to a care home if you're older and no longer coping/ your family are bit further away etc. My Egyptian in laws baulk at the idea.
That's great news about your neighbour, hope you guys are staying safe.
Yeah its a pretty terrible illness. Pretty embarrassing for me, once upon a time, I was one of the docs who went out there to help in some of the initial outbreak control
. Guess I've lost touch with it recently.Great news though.
The flip side of Ebola management in the past though is it shows how effective public health measures can be in controlling outbreaks even if you don't have a good vaccine or treatment.
Typo! I meant 1000iU. I think you get into diminishing returns above that dose.
I have a colleague who knows one of the leads in the Oxford trial. He says she's very confident so we'll see. I hope they're right and as @Pogue Mahone said, seems vaccine development has come on leaps and bounds over the past few years.
I'd also be very surprised if infection doesn't give you at least some short-mid term immunity but we'll see as time goes on I guess!