I Hate Dialysis Message Board

Dialysis Discussion => Dialysis: News Articles => Topic started by: enginist on February 24, 2020, 04:48:14 PM

Title: COVID-19
Post by: enginist on February 24, 2020, 04:48:14 PM
For those of us with compromised immune systems, which is almost all of us, an infection by the coronavirus could cause serious problems.  And according to an article in The Atlantic, it is likely that we'll all be infected.  The virus may replicate faster than our immune systems can respond, and inflammation of the lungs can spread to other organs.  It won't be much of a threat to the young and healthy, but it could raise the mortality rate for anyone with a chronic illness.  The most insidious thing about it is that an infected person may be asymptomatic and still be highly infectious.
Title: Re: COVID-19
Post by: iolaire on February 24, 2020, 05:04:48 PM
I’m worried about it.  I take the bus and metro to work so worry that that it will hit before I know to work from home.
Title: Re: COVID-19
Post by: enginist on February 24, 2020, 06:02:41 PM
I too am germophobic.  I think that we soon will see an upsurge in people wearing masks, especially in contamination zones, like buses and train cars.  On Amazon, the prices for an N95 mask are soaring.
Title: Re: COVID-19
Post by: iolaire on February 25, 2020, 06:03:18 AM
I did order a pair of paper 3M 8511 Respirator, N95, Cool Flow Valve on Sunday night from Amazon.  All the CDC instructions say to only wear a mask if infected which seems odd to me.  Smart coworkers say any of the N95 masks will work, even if its for drywall, welding ect...
Title: Re: COVID-19
Post by: enginist on February 25, 2020, 07:02:08 AM
Those are good masks, but two is not enough.  They must be disposed of after five days, or if you touch the front part with your fingers, or if someone on the bus coughs or sneezes in your direction.  You know how rude and thoughtless people can be.  Worse, they don't protect the eyes, a major transmission site.  I bought a pair of protective goggles to supplement my mask, which has replaceable filters.  Not cheap, but I'm expecting the worst.  The CDC has some good advice on mask reusability.  It also recommends washing hands over wearing masks.  I think that this is dubious advice.  I can see saving masks for the front-line health care workers, but you know that this won't happen.  Hoarding has already wiped out the supply, which was too low to begin with.  Every source I've read online says that droplets from a cough or sneeze can travel a maximum of six feet, which I don't agree with.  Particulates from a sneeze are expelled at a much greater velocity than those from a cough, so simple physics says they will travel farther.  Tiny virus particles, which are in the submicron range, travel farther than droplets.  I'd recommend a radius of 12 or 13 feet.  I know it isn't possible to keep your distance from everyone, but it is clearly the safest course of action.  Either that, or wear some sort of mask.

Anyway, here's a link to the CDC:

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
Title: Re: COVID-19
Post by: Paul on February 27, 2020, 10:20:32 AM

For those of us with compromised immune systems............an infection by the coronavirus could cause serious problems.

Not just those with a compromised immune system. In Britain we have had several cases of infection, but only one death. I was listening to the radio news on the day that was announced, and the news reader went to great pains to tell the listeners not to panic. He pointed out that the reason the patient died of coronavirus was because he had other serious, existing conditions. These were diabetes and the fact that he was on dialysis. "OK" I thought "That's me dead then!"

Was talking to a patient at the dialysis clinic, he had found out that the hospital the clinic is in, is the area's coronavirus test centre, so anyone suspected of having the disease will be walking the same corridors as us. His intention for today was to search the Internet to find a supplier of the plastic masks.

Title: Re: COVID-19
Post by: enginist on March 01, 2020, 08:31:14 PM
The claim that masks aren't helpful if you haven't been infected is a lot of nonsense.  According to a piece in The Guardian, wearing a mask if you're sick or not gives you five times more protection than no mask at all.  Even a loosely fitting surgical mask is better than nothing.  This is common sense.  If a mask is too expensive or otherwise unavailable, a scarf over the nose and mouth and a pair of sunglasses will give you at least a margin of safety.

Here's an article that gives the truth on masks.

https://www.nytimes.com/2020/03/17/opinion/coronavirus-face-masks.html?action=click&module=Opinion&pgtype=Homepage

And here's a short piece on homemade masks.

https://www.researchgate.net/publication/258525804_Testing_the_Efficacy_of_Homemade_Masks_Would_They_Protect_in_an_Influenza_Pandemic
Title: Re: COVID-19
Post by: Simon Dog on March 04, 2020, 03:11:07 PM
...
the news reader went to great pains to tell the listeners not to panic. He pointed out that the reason the patient died of coronavirus was because he had other serious, existing conditions. These were diabetes and the fact that he was on dialysis. "
He was telling YOU to panic.
Title: Re: COVID-19
Post by: Michael Murphy on March 05, 2020, 10:00:25 AM
 The good news is that covid-19 has a calculated R value of around 2.8.
Measles has a R value of 13.  This is the expected number of people who will in infected by a individual patient. While this virus is spreadable it is not highly contagious. 
Title: Re: COVID-19
Post by: enginist on March 05, 2020, 11:34:48 PM
It's inaccurate to compare this to the measles, which is highly contagious but largely contained.  Most people have been vaccinated for measles. You're right that the R number is the reproduction rate, but your interpretation is way off.  Think of the R number as the ratio between each number in a series of numbers.  For example, if the R number were 2, the series would look like this: 1, 2, 4, 8, 16, 32... In other words, it increases at an exponential rate.  But nobody knows the R number for the coronavirus.  The World Health Organization estimates that it is between 1.4 and 2.5.  Which is not good news.  Anything over 1 means that the virus will spread rapidly, uncontained. 

Plus, the mortality rate is far higher than the flu's.  About 1 in 50 who get the virus will die, while approximately 1 in 1,000 people who get the flu will succumb to it.  We've had about 40,000 flu deaths in the U.S. this year.  Multiplying 40,000 by a factor of 20 gives us, in the U.S. alone, 800,000 probable deaths from the coronavirus.  Make it an even million.
Title: Re: COVID-19
Post by: fifal9 on March 09, 2020, 03:16:29 PM
Plus, the mortality rate is far higher than the flu's.  About 1 in 50 who get the virus will die, while approximately 1 in 1,000 people who get the flu will succumb to it.  We've had about 40,000 flu deaths in the U.S. this year.  Multiplying 40,000 by a factor of 20 gives us, in the U.S. alone, 800,000 probable deaths from the coronavirus.  Make it an even million.

For what it's worth, I saw online https://wattsupwiththat.com/2020/02/15/amazing-but-hidden-news-about-coronavirus/ (https://wattsupwiththat.com/2020/02/15/amazing-but-hidden-news-about-coronavirus/) (not a particularly reputable source or anything) and guess it could be extrapolated (loosely) that if the USA is approx. 5 times the population as the US (66M vs 330M) and gets infected at the assumed 60% infection figure as being assumed for the UK, then maybe around 2 million deaths in the US.... not that I am worried or believe this will happen.

Quote
From the Telegraph:

Prof Neil Ferguson, professor of mathematical biology at Imperial College, has warned that the world is “in the early phases of a global pandemic”.

He said Britain is probably only picking up around one in three cases, focusing on those coming in to the country, when cases may have arrived – and gone undetected – before restrictions set in.

“Surveillance has started in hospitals across the UK of pneumonia cases, that will give us a proper picture,” he said.

“Our best estimate is that transmission in the UK will get going in the next few weeks; unless we are very lucky probably peaking 2 to 3 months after that,” he said. “If it truly establishes itself in terms of true person-to-person transmission it will behave like a flu pandemic, maybe up to 60 percent of the population being affected but most of those people having very mild symptoms.”

He suggested that 400,000 people in the UK could die from it in the next 12 months, based on estimates of a 1 per cent mortality rate and an infection rate of 60 percent of the population.
Title: Re: COVID-19
Post by: PrimeTimer on March 09, 2020, 09:17:52 PM
 :twocents; Here's my 2 cents....fresh air and ventilation. No matter how cold/hot it is outdoors people might ought to consider stepping outdoors a few times a day and when indoors, leave a window cracked open about 1 inch. Of course, this may depend on the neighborhood you live in.
Title: Re: COVID-19
Post by: Hereware on March 10, 2020, 01:41:03 AM
OMG!!! where is the cure????
Title: Re: COVID-19
Post by: MooseMom on March 10, 2020, 12:15:01 PM
I received this from the Renal Support Network.  It doesn't really have any new info, but since it is targeted to renal patients, it is of interest.

https://www.rsnhope.org/rsn-blog/tips-to-avoid-catching-covid-19-coronavirus/

This is why and how COVID-19 is so lethal in certain populations, including ours:

https://www.nationalgeographic.com/science/2020/02/here-is-what-coronavirus-does-to-the-body/

Title: Re: COVID-19
Post by: enginist on March 10, 2020, 06:53:33 PM
The second link, MooseMom, describes in vivid detail just how horrible a death this could be.  If confined to the lungs, it would be like coughing to death or drowning in your own fluids.  In other cases, inflammation could spread throughout your body, causing your organs to fail one by one.  When you ultimately die of kidney failure, death would be a welcome relief. 

Meanwhile, here's an update on the latest strategy, called "Flattening the Curve," which comes to us from the CDC.  Despite its recent bungling and the spineless leadership of its director Robert Redfield, the CDC is still capable of doing good work.  In any case, we are asked as individuals to spread this approach to the virus far and wide.  It essentially means slowing down the rate of infection so that the health care system isn't overwhelmed.  It makes perfect sense to me, and there's a lot of good information in the link, the single best resource I have found so far.

https://www.vox.com/2020/3/10/21171481/coronavirus-us-cases-quarantine-cancellation?utm_source=digg
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 11, 2020, 03:47:25 AM
Well, it's finally hit home.  ::)

My husband just received a warning that he was at a conference where a person has tested positive. Keep in mind, it ended over 10 days ago, so it shows how long it can take to show symptoms. There were thousands of people there so I highly doubt he came in contact/got infected but even if had been he's been home all this time. So, yay!

He has been advised to watch for fever and monitor how he feels. No need to self-quarantine yet. He's strong and healthy so naturally we aren't concerned about him...  :lol; but me!
Title: Re: COVID-19
Post by: iolaire on March 11, 2020, 04:49:29 AM
He has been advised to watch for fever and monitor how he feels. No need to self-quarantine yet. He's strong and healthy so naturally we aren't concerned about him...  :lol; but me!
Can you use that story to start sliding in warnings about your needs into discussions at your workplace? 

My work came out with a formal FAQ that in part stated if you feel you need to stay home because of health concerns you need a doctors note, I think my managers are ok with me at home, but I might need to get that at some point.
Title: Re: COVID-19
Post by: MooseMom on March 11, 2020, 09:22:39 AM
UT, are you doing anything special to protect yourself?  Are you avoiding crowds, etc?  Do you feel it is necessary just yet?

Iolaire, I have found that all you need to do is say "transplant patient", and people aren't going to question you!  LOL!  You were dealt the kidney card, so play it when you need to.  I don't think you'll have any problem getting a doctor's note!

I don't want to bother my tx coordinator will questions of this nature, so I'll ask you all to tell me what you would do...

1.  I have labs tomorrow, and the waiting room is the same as for patients waiting to see other PCPs who have their offices in the came suite.  If it were you, would you still go?  I think I will; labs are important, but I have seen lots of Purell around in the past, so I'll make good use of it.

2.  I have my annual eye exam in 2 weeks.  I have no eye health problems, so it's just my regular check up.  Should I go, or should I postpone it indefinitely?  What would you all do?

I live a generally quiet life here at home at the end of the cul-de-sac, so I figured that self-isolation would not be a big problem.  But then I started thinking of all of the one-off things I need to attend to outside of my moose-bubble!
Title: Re: COVID-19
Post by: enginist on March 11, 2020, 11:23:18 AM
I'd get my labs done, but the waiting room is a petri dish, so I'd wear a mask in there, even if I had to improvise.  I'd also wear gloves--Latex or winter gloves--at all times.  When I go to the store or go out running I wear thin leather gloves that I spray with alcohol when I get home.  Handwashing, of course, is never omitted.  I'd cancel the eye test as unnecessary.  An eye test is too up close and personal, and you don't know who was examined before you.

On second thought, I'd cancel the blood test too, unless your numbers are unstable.  A waiting room full of vulnerable people is like a large public area but in concentrated form.  To ensure your maximum safety, assume that a random number of patients--even if it's only one--will be sick and not know it yet.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 11, 2020, 11:31:51 AM
Iolaire, yes, I have contacted my boss and let him know of the situation. As well, I've made note that since this "could potentially" be a case of community transmission, I'd prefer to work from home. I noted that in the case that I am living with someone who has "potentially been exposed" to the virus I would not want to "get my colleagues ill" it is only right for me avoid them. Used both sides of the card.

Do you have to use special software (or whatever) to be able to work from home or do you have a laptop specifically for work? I know that's a discussion going on.

MooseMom, at the moment, I am kind of confused on what to do. My husband suggested I stay at a hotel and he at home (keep in mind, he hasn't been told to social distance yet). But, in the case that he is asymptomatic, it would mean I've been exposed and would share the virus with other people, though I am not sick at all. I DO have a cough that scares people but that's from a breathing tube incident.

I just don't freaking understand why a convention/conference would have went ahead especially with attendees from '132 countries' as they say on the website during a global public health crisis. Top politicians attended too, so probably, it was more a case of investments trump sanity.

In general, I am just hand sanitizing the heck out of everything, like I do anyway, especially on shopping trolleys or doors. But most definitely, I second guess going around anything crowded. Staying out of the airport is definitely on my list.

As for your questions:
1. Yes, transplant labs are important, so I would go. If the people waiting for their PCPs are following instructions, if they are infected, they'll know to call directly, rather than sit in a waiting room. As usual, sanitize and common sense.
2. Kinda conflicted on the eye exam appointment and I am in the same shoes. I go on Friday but I have eye issues. To be honest, I have caught the flu once visiting the eye doctor as well as the dentist. A side of me says to go because you don't know the next time you'll be able to get in if many people cancel and the risk is generally low. On the other hand, it isn't a really necessary outing, especially with a close proximity to people.

Title: Re: COVID-19
Post by: iolaire on March 11, 2020, 01:13:54 PM
Do you have to use special software (or whatever) to be able to work from home or do you have a laptop specifically for work? I know that's a discussion going on.
I'm at a not small company (3k-5k employees) so for the past many years the setup has been a VPN client that authenticates via my phone, that's on my home computer, then I remote desktop (RDP) in to my windows work computer with that connection going over the VPN and use my desktop computer directly via RDP.

Today in my office they told everyone to pickup Chromebooks, which I did, the instructions are the same, but it feels like they might require the Chromebook over desktop computers.  Its probably much safer enterprise security wise to move everyone to the Chromebook.  The Chromebook was not customized or locked down, just a raw in the box little laptop.  People with company laptops just work directly on their laptop and access the entire local work network from the laptop and VPN, my VPN connection doesn't allow that only RDP.
Title: Re: COVID-19
Post by: enginist on March 13, 2020, 09:24:59 AM
Requiring a note from a doctor sounds like grammar school.  Isolation is needed for everyone--everyone, everywhere--not only those with underlying conditions. 

For any of you who like to geek out on numbers and graphs, this article, which is long and detailed but highly illuminating, could keep you  entertained for a couple of hours. 

https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca

The takeaway is that the virus is here.  It's hidden and it's growing exponentially.  A total lockdown is required.  All nonessential exposure to humanity must cease.  Not tomorrow but today.  Time to go into hermit mode, into self-imposed exile. 
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 13, 2020, 02:13:57 PM
I'm at a not small company (3k-5k employees) so for the past many years the setup has been a VPN client that authenticates via my phone, that's on my home computer, then I remote desktop (RDP) in to my windows work computer with that connection going over the VPN and use my desktop computer directly via RDP.

Today in my office they told everyone to pickup Chromebooks, which I did, the instructions are the same, but it feels like they might require the Chromebook over desktop computers.  Its probably much safer enterprise security wise to move everyone to the Chromebook.  The Chromebook was not customized or locked down, just a raw in the box little laptop.  People with company laptops just work directly on their laptop and access the entire local work network from the laptop and VPN, my VPN connection doesn't allow that only RDP.

Ah, okay, at a "larger" company I would fully expect for them to have more advanced systems or a sort of contingency plan. I work for a much smaller operation so the person in HR is working with the ownership to come up with something. We rely on a lot of evidence, data and reports so it can easily be done at home and we already have virtual conferencing software. Once thing is definitely for sure is that I will not be personally meeting with clients.

As for my husband, it was later revealed that the man at the convention that tested positive "was not contagious" at the time. Still, all attendees have to still monitor for symptoms. No fever or anything out of the ordinary for him. Besides, well, some sadness that ice hockey is cancelled...

I went to my eye appointment and it was pretty much the most perfect scenario. First appointment of the day, no one else in the office and I could smell the antiseptic scent on the machines. They did call ahead of time to say if I had any cold/flu symptoms to cancel. As well, I will keep my dental appointment because I specifically see one dentist (very knowledgeable about medications/pre-existing conditions and teeth) and he cancelled on me twice. They wear masks, visors and gloves around me anyway.

Besides all that, my primary care provider told me that as of yesterday, I really need to self-isolate. It's bad enough to be a tx patient and immune-compromised, but she assumed I'd have to be shipped off to tx hospital because few want to even deal with a pancreatic transplant in such a precarious scenario. I'm going to go crazy.
Title: Re: COVID-19
Post by: iolaire on March 13, 2020, 04:30:44 PM
Requiring a note from a doctor sounds like grammar school.  Isolation is needed for everyone--everyone, everywhere--not only those with underlying conditions.
Last night they sent an email say people like me could work from home. Which was good because they reached out to my manager something this week saying I need a note.  Any what received two week approval for at home work and by then end of that everyone will be home. Our schools are closed on Monday and within three weeks out CEO expects everyone should be working from home.  My wife is depressed that her source of dvds, our library, is closed as of tomorrow.

UT sorry your company is slow to accommodate you. Do your best to keeps some distance from coworkers. 
Title: Re: COVID-19
Post by: iolaire on March 14, 2020, 06:47:45 AM
In the DC, Maryland, and Virginia area schools are closed for the rest of the month and things are becoming real for more people.

This article is a good read on the various interpretations of social distancing that we need to do. It’s also interesting the different viewpoints from the three experts.
https://www.theatlantic.com/family/archive/2020/03/coronavirus-what-does-social-distancing-mean/607927/?utm_source=feed
Title: Re: COVID-19
Post by: fifal9 on March 14, 2020, 08:26:05 AM
Things aren't as bad in my state as some of the coast-line states.
There's fewer than 100 'confirmed cases' and only 1 death so far.
I put 'confirmed' in quotes because they are only testing about 100 people a day, so who really knows.

All the schools, libraries, etc are closed until the end of the month. I'm not sure how much good it will do considering what i read from the CDC about school closures here:
Quote
Modeling data for other respiratory infections where children have higher disease impacts, suggests that early short-term closures are not impactful in terms of overall transmission.
Social mixing may still occur outside of school with less ability to monitor, especially among older students.
Will increase risk to older adults or those with co-morbidities, as almost 40% of US grandparents provide childcare for grandchildren. School closures will likely increase this percentage.
https://www.cdc.gov/coronavirus/2019-ncov/downloads/considerations-for-school-closure.pdf

My company sent out notice yesterday that all employees world-wide should work from home until the end of the month as well. I was already home because I have a cough and I'm on anti-biotics. I'm pretty sure it's not corona, but just a lingering of the pneumonia I had in January. As a mild agoraphobe I'm actually a little excited - not about corona of course, but being isolated for 2 weeks is like a dream come true even if I have to sit at my desk for 8 hours a day. It's WAY better than a 2 hour commute (1 hour each way) on trains and by car and occasional bus to downtown area to work in a sky-scraper full of people in business suits.

I've ordered groceries and can't get delivery for 2 days. The main thing I hear people complaining about is a lack of toilet paper and sanitizer at the stores. People are saying they will buy bidets if they can't find TP soon. But you still have to dry it off right? Do people really shoot cold water at their nethers and then just leave them wet?

It's crazy times. Be safe guys.
Title: Re: COVID-19
Post by: enginist on March 14, 2020, 08:51:50 AM
If you get it, these are the rough odds.


Age       Chance of Dying     With Underlying Condition
30s              1 %                              2 %
40s              2                                  3
50s              3                                  5
60s              5                                 10
70s              10                               20
80s              20                               40

Heart disease patients have it the worst, followed by those with lung conditions.  Transplants and dialysis patients aren't that far behind.
Title: Re: COVID-19
Post by: Cupcake on March 14, 2020, 12:19:32 PM
fifal9- those new fancy Japanese toilets (Toto is one brand) that are like bidets also have a blow dryer. Maybe that's what they mean.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 14, 2020, 02:28:53 PM
Here's one of the articles that mention bidet use as an alternative: https://www.theglobeandmail.com/opinion/article-forget-toilet-paper-hoarding-in-the-time-of-coronavirus-lets-seize/ (https://www.theglobeandmail.com/opinion/article-forget-toilet-paper-hoarding-in-the-time-of-coronavirus-lets-seize/)

I’ve used a few bidets in my day (as well as Toto toilets at hotels) so I can give a little insight.

There is a lot of attention on the Tushy right now as it is an example of a simple attachment to an already in place toilet. It sprays water and yes, you still require toilet paper and have to pat yourself dry. (The toilet paper obviously gets tossed into the toilet). It said "Pat dry" as a final step for use when I looked at it awhile ago.



So, if looking for a simple attachment or an actual bidet make sure that it has a drying feature, not just the water spray. Not all come with it.



In some cases, and this just makes me squirm, but there is a cotton towel (terry cloth or whatever) beside the bidet on a towel ring as a way to dry off after the stream of water. Witnessed it more than I'd like to admit. Thank goodness for tissue packs for purses.
Title: Re: COVID-19
Post by: MooseMom on March 14, 2020, 02:46:29 PM
What about voting?

My state is one of those whose primary elections are this Tuesday 17 March.  My usual polling place is in a quiet residential area; I usually vote in the middle of the day, so I've never had to wait in line to cast my ballot and don't anticipate having to do that this year, either.  But still, I hope the polling station has hand sanitizer available, and I hope they regularly wipe down the machines.

And I hope not too many people stay home and don't vote at all.
Title: Re: COVID-19
Post by: Paul on March 15, 2020, 09:53:28 AM

What about voting?
My state is one of those whose primary elections are this Tuesday 17 March.
 

London had a mayoral election scheduled for a few weeks time, that has been put off for a year. This simply means that the current mayor lasts an extra year. So if you can take an extra year of Trump.....
Title: Re: COVID-19
Post by: MooseMom on March 15, 2020, 11:01:02 AM
Quote
London had a mayoral election scheduled for a few weeks time, that has been put off for a year. This simply means that the current mayor lasts an extra year. So if you can take an extra year of Trump.....

Well, this is a primary election.  This is to decide who will run for office(s) in the general election in November.

Many states have already had their primary, but my state has not.  I am not sure what would happen if it was decided that, essentially, only two thirds of the country gets to vote.  The supporters of the candidate who are currently behind in the race would not be best pleased as they need to pick up more delegates before the conventions in the summer.

We are all in the process of voting not just on who will be opposing President Trump in November, but we are also voting for candidates in Congress, but Federal and at the State level.  There are also loads of local elections at stake.

It gets complicated.

I'm just waiting for the President to declare that the November general election must be cancelled.
Title: Re: COVID-19
Post by: enginist on March 15, 2020, 01:12:56 PM
Under the Emergency Powers Act, he could cancel the election and declare himself President-for-Life.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 15, 2020, 01:45:17 PM
This article came out a couple days ago and places tx patients right in the middle. Obviously nothing that we don't know but at least highlight the risk we don't know much about this virus yet. I'm really concerned for my friend with a lung transplant. :(

https://ottawacitizen.com/news/local-news/everything-can-kill-me-for-transplant-patients-shortage-of-hand-sanitizer-a-matter-of-life-and-death (https://ottawacitizen.com/news/local-news/everything-can-kill-me-for-transplant-patients-shortage-of-hand-sanitizer-a-matter-of-life-and-death)
Title: Re: COVID-19
Post by: Paul on March 15, 2020, 04:57:35 PM

Well, this is a primary election.  This is to decide who will run for office(s) in the general election in November.

Yeah, I know. My point was that if you postpone the presidential election you could postpone the primaries. But the downside is another year of Trump.
Title: Re: COVID-19
Post by: Paul on March 15, 2020, 04:58:40 PM

Under the Emergency Powers Act, he could cancel the election and declare himself President-for-Life.[/size]

Shut up you fool, he will hear you!. :)
Title: Re: COVID-19
Post by: enginist on March 15, 2020, 06:58:47 PM
Fortunately, Paul, I was joking.  The 22nd Amendment, limiting presidents to two four-year terms, was passed by Congress in 1947.  The virus will end up being Trump's and Boris Johnson's worst nightmare.
Title: Re: COVID-19
Post by: Paul on March 17, 2020, 04:23:24 AM

Fortunately, Paul, I was joking.

Yeah but when someone suggested that Trump should be president, they were only joking too, and look what happened there! :)

(Ditto Johnson for Prime Minister.)
Title: Re: COVID-19
Post by: enginist on March 17, 2020, 07:43:51 AM
Right, the unthinkable happened.  Twice.
Title: Re: COVID-19
Post by: Paul on March 17, 2020, 12:47:57 PM

Right, the unthinkable happened.  Twice.

Then, as a punishment for voting those two idiots in, we all get to die! :(
Title: Re: COVID-19
Post by: enginist on March 17, 2020, 08:46:03 PM
If the average IQ is 100, then our collective intelligence isn't very high.  So we get Beavis and Butthead, the leaders we deserve.
Title: Re: COVID-19
Post by: MooseMom on March 19, 2020, 08:59:03 PM
I keep looking for stories about tx patients who have fallen ill with covid-19 and have survived.  This article is about 2 heart tx patients, but the issues are generally the same, I would assume, immunosuppressively speaking...

https://www.globenewswire.com/news-release/2020/03/18/2002847/0/en/JHLT-releases-first-reports-of-heart-transplant-recipients-infected-with-COVID-19.html
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 20, 2020, 04:59:12 AM
Hmm, interesting. Thanks for sourcing that!
Title: Re: COVID-19
Post by: iolaire on March 20, 2020, 05:58:33 AM
Both patients survived the event.   :bandance;
Title: Re: COVID-19
Post by: enginist on March 20, 2020, 07:54:41 AM
There's much that we don't know about this virus, but a lot depends on whether you have access to a hospital bed.  In Italy it seems to be either a bed or a coffin.
Title: Re: COVID-19
Post by: enginist on March 20, 2020, 10:21:30 PM
Here is a very sensible take from a doctor who advocates testing and protecting only the most vulnerable among us--the elderly and those with underlying conditions.  He argues that a blanket stay-at-home order is too broad and economically destructive, a hammer where a needle is required.  The same applies to social distancing, flattening the curve, and all the other emergency measures that seemed at first to make a lot of sense.  Right now, he says, in fear of doing too little, too late, we are doing just the opposite, which is too much, too soon.  His conclusion: our limited resources should be reserved for populations at the greatest risk. 

https://www.nytimes.com/2020/03/20/opinion/coronavirus-pandemic-social-distancing.html?action=click&module=Opinion&pgtype=Homepage



Title: Re: COVID-19
Post by: enginist on March 21, 2020, 03:41:54 PM
But then you read a report like this, concerning patients in their 40s who are otherwise healthy, and you realize that we're in for a world of hurt.

https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients?utm_source=pardot&utm_medium=email&utm_campaign=majorinvestigations
Title: Re: COVID-19
Post by: MooseMom on March 22, 2020, 12:53:26 PM
Well, I'm officially nervous.

We stayed up late drinking wine and watching "Emma", and I woke up in the middle of the night with a headache.  I haven't really felt right since I fell over a month ago, and again last night, I woke up several times with my leg and shoulder hurting.

I feel generally unwell but not with symptoms of the virus, but I admit to starting to feel quite anxious overall.

Then, about an hour ago, my husband was told by his boss that one of the secretaries has been exposed and is under self-quarantine, so the legal dept. in which my husband works is now shut for at least this upcoming week.

And that's what makes me officially nervous.
Title: Re: COVID-19
Post by: iolaire on March 22, 2020, 01:12:58 PM
Let’s hope the headache is from the wine. Best wishes.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 22, 2020, 01:32:51 PM
As iolaire said, let's hope the headache is from the wine.

You can scroll up in this thread (or the other thread) and see that I mentioned my husband was at a convention with a guy that tested positive for the virus. He was told to monitor his symptoms for 14 days. Your anxiety is totally expected! I felt it too! The good news is that he didn't become symptomatic and therefore I never got sick. So, there is that to consider, but at the same time, make sure to monitor how you feel.
Title: Re: COVID-19
Post by: MooseMom on March 22, 2020, 02:13:32 PM
UT, I do remember the circumstances under which your husband found himself after the convention.

I do not think I have the virus.  I don't have any real "symptoms" other than feeling a little "coldy".  My husband has decided he really likes scented candles, so he has been burning one or two all weekend long, and I think they might be irritating my nasal passages.  LOL!  That, plus a wine/sleep deprivation induced headache has made me quite the wet weekend.

Actually, the secretary I mentioned has a boyfriend that she lives with who works with someone who tested positive.  So, I myself am pretty far down the contagion line. 

What unnerved me a bit was the fact that the legal department shut down.  That struck a bit too close to home, is all.

Also, I have been reading a great book called "Seveneves".  It's basically about how humankind is readying itself for total destruction in just two years' time after something struck the Moon and broke it into pieces large enough that it can still maintain a circle of gravity, allowing it to stay somewhat in its original state.  However, these pieces start to collide into each other, and it has been determined by all the smart bods back on Earth that the resulting debris from all of these collisions will eventually begin raining down on Earth and will collectively induce such a firestorm as they enter the atmosphere that Earth will be well and truly baked.  It's probably not the jolliest reading material for these times, but it's a good story, nonetheless.
.
Title: Re: COVID-19
Post by: enginist on March 22, 2020, 04:26:09 PM
Moving from fiction to fact, the Earth would be unstable without the Moon.  It would wobble on its axis, causing the Poles to overheat and the equator to freeze.  On the positive side, the moonless sky would be flooded with starlight, making it much brighter and more romantic.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 22, 2020, 07:20:50 PM
causing the Poles to overheat
Yeah, they have some tempers.  :lol; (Bad joke, but I couldn't pass it up.)

MM, I might have to find that book! It sounds like something I'd like.

So, I just came here to say how thankful I am for this board and the people, especially during this big event. It seems like this is one of the few places where there is an understanding between us about the high risk group we are in. It may be the case that we hear "those with underlying medical conditions" (alongside the elderly and pregnant women) mentioned often, but that message is often lost on peers.

I just got off a conference call. It was work related, but they treated self-quarantine as like an Instagrammable moment or something to talk about. They never really acknowledged my organ transplants before but it was so obvious now. Such as yeah, for real, I might be working from home until June and such things. They don't understand the gravity. So, thanks guys.
Title: Re: COVID-19
Post by: Simon Dog on March 22, 2020, 09:57:01 PM
causing the Poles to overheat
The Poles have also been wrong on occasion - like calling the 2016 election for Clinton.
Title: Re: COVID-19
Post by: enginist on March 22, 2020, 10:28:11 PM
I wouldn't touch either of those jokes with a ten-foot pole.
Title: Re: COVID-19
Post by: MooseMom on March 23, 2020, 08:33:50 AM
I'm seeing photos of people flooding to the beaches here in the US and the UK, and I'm just poleaxed by their stupidity and selfishness.  I'm listening to a London radio talk show right now, and people are calling in with stories about how folks are just out and about in droves.  Soon, they'll be poleaxed by this virus.

Hardy har har har.

Enginist, this book is 900 pages long.  I'm only on page 156, so I suppose there is still time for the poles to go all wobbly.  Most of the story takes place on the ISS as they try to convert it into the "Cloud Ark", and one of the crew is a marine biologist who is indeed concerned about the tides.

UT, yes, for most people, "high risk categories like organ transplant" is a phrase that goes into one ear and right out the other.  That's why being a part of IHD is really an emotional resource that's pretty valuable.  The police chief phoned my husband here at home last night; she did not know that the legal department had been shut down.  My husband explained that I had a kidney transplant; she didn't know that, either, but she was very sympathetic.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 23, 2020, 09:29:20 AM
In regard to the UK, I'd be interested to see how this pans out: https://www.gov.uk/government/news/major-new-measures-to-protect-people-at-highest-risk-from-coronavirus (https://www.gov.uk/government/news/major-new-measures-to-protect-people-at-highest-risk-from-coronavirus)

MM, as much as I hate to say this, but I think empathy for those with illness comes through life experience. Most of the time, that is linked to age. If someone has not experienced major health conditions, they just can't seem to cross that bridge to think 1. that person might be scared/hurting right now, I should reach out 2. my actions can influence their lives (in regard to the virus) so I should give pause to what I do. My bosses are older but they're slavedrivers.  :lol; My co-workers and acquaintances are younger so they have selective empathy. Who knows? They probably want me to kick the bucket for a promotion. Probably way off here in my assessment...

So, in that regard, while there was a large age difference, I miss my dialysis crew in the morning. All except one has since passed away, but we got each other and understood the boat we were in. It was comfortable. Now that I don't go to the clinic anymore and most have passed, there is IHD.

All of that said, I am glad to hear the police chief was sympathetic.  :) That goes a long way.
Title: Re: COVID-19
Post by: enginist on March 23, 2020, 10:57:25 AM
MM, you need a lot of stamina to get through a 900-page novel.  Do you remember James Michener, who wrote thousand-page behemoths?  Someone once said that reading James Michener is like spending a month alone in Sears.

UT, those guidelines say to never go out for anything, not for groceries, medication, or fresh air.  For a year and a half?  I don't think I could do it.

Does anyone know what happened to Katrina?  She's been MIA for months.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 23, 2020, 11:37:24 AM
UT, those guidelines say to never go out for anything, not for groceries, medication, or fresh air.  For a year and a half?  I don't think I could do it.

Does anyone know what happened to Katrina?  She's been MIA for months.

Perhaps I missed something, but a year and a half? I thought it said 12 weeks. Holy cow, a year and a half would mean I'd be stranger than a cult!

As for kristina (if that is who you mean), she has decided to respectfully retire from IHD. I'll respect her privacy and leave it at that. At that time, she was doing well.
Title: Re: COVID-19
Post by: Cupcake on March 23, 2020, 12:12:42 PM
Enginist I think you mean Kristina-I, too, was wondering where she is.
Title: Re: COVID-19
Post by: enginist on March 23, 2020, 12:23:42 PM
UT, maybe 18 months to develop a vaccine, unless an existing drug proves useful.  And there could always be a breakthrough.  We have all done it before, many times throughout history.  All countries have produced brilliant inventors in the laboratory.  All it takes is hard work and a moment of inspiration.   

Yes, I meant Kristina.  Sure, she deserves her privacy, but I still have to wonder why.  Kristina was a sensitive soul and always nice to everyone, but maybe not everyone was always as nice to her.  I did notice once or twice that she was spoken harshly to.  I'll miss her habitual use of "quotation marks."
Title: Re: COVID-19
Post by: MooseMom on March 23, 2020, 12:51:53 PM
Enginist, of course I remember James Michener!  I've read most of his books, and yes, they are real doorstoppers.  My favorite was The Source, which I read in high school.

I think you are right, UT, in thinking kristina has "retired" from IHD.  I don't know if she may still "lurk", but if she does, maybe she will stop by and reassure us that she is OK. 

My main concern on this particular day is the way our Senate seems to be imploding.  I can certainly understand the anxiety and the always present difference of opinion on how to deal with a certain issue.  But what I've read today about the shouting matches taking place on the floor of the Senate don't fill me with confidence.  I don't care which side of the aisle you sit on, there is no excuse for the accusatory behavior I've seen.  I never thought I'd ever say anything positive about any governor of Illinois, but our current guy is pretty impressive. 
Title: Re: COVID-19
Post by: enginist on March 23, 2020, 01:26:47 PM
Yes, Prittzker is acting more presidential than our president.  Plus, he has more money, which Trump would resent.

I'm reading--or I should say, listening to--"The British Are Coming!" by Rick Atkinson.  The title seems unimaginative, but the book is very good.  He describes a lot of battles--the war went on for seven years--and concludes that the plucky Americans, with help from our foreign friends, gave the haughty British a good beating.  We need another great general now, another national hero.

I read the "The Bridges of Toko-Ri," Michener's first and some say best, but I had no interest in the others.  Nonetheless, if you're a reader, you are well positioned to weather out this firestorm.  If you're a reader and a runner, better yet.
Title: Re: COVID-19
Post by: UkrainianTracksuit on March 23, 2020, 01:45:33 PM
Enginist:

In regard to a vaccine, I remain hopeful for the most part but am aware that these things take time. As it currently stands, there are numerous teams out there trying to find one, as you know.

This guinea pig guy has been on the news like 2 or 3 times. (Don’t bash me for the source!)  https://m.youtube.com/watch?v=B4RRsV8nqrc (https://m.youtube.com/watch?v=B4RRsV8nqrc) The one thing that gives me pause is that he mentioned it was a live vaccine. Here is hoping that the final products so to speak are dead and tolerable for tx patients.

As for kristina, your post had the answer in regard to her retirement. You figured it out yourself. Like MM says, I hope she is lurking and says hi.
Title: Re: COVID-19
Post by: MooseMom on March 23, 2020, 02:48:06 PM
The one thing that gives me pause is that he mentioned it was a live vaccine. Here is hoping that the final products so to speak are dead and tolerable for tx patients.

This has been on my mind for several days now.  How awful would it be if they came up with a vaccine that an entire cohort of us high-risk people couldn't take!!

Title: Re: COVID-19
Post by: enginist on March 23, 2020, 05:53:25 PM
So many unknowns.  You have to be somewhat fatalistic about it.
Title: Re: COVID-19
Post by: enginist on March 25, 2020, 01:59:44 PM
We are the most unprepared of all developed nations to deal with this rampaging virus.  What will you do if it doesn't abate but instead intensifies?  If hospitals are overrun, grocery stores are out of stock, and the governor calls out the national guard?

Might as well party like it's 1999.

https://digg.com/2020/trump-impression-coronavirus
Title: Re: COVID-19
Post by: iolaire on March 28, 2020, 07:26:31 AM
https://digg.com/2020/trump-impression-coronavirus
That is a funny but sad video.

Apple released a pre-screening app and website: https://www.apple.com/covid19/ it says i should talk to my doctor because "Your answers suggest you should talk to a medical professional about getting tested for COVID-19" because "You are experiencing symptoms",  and "You have relevant conditions."  I said I have a sore throat and a suppressed immune system, and I live in an area with widespread cases.  Anyway I'm fine, but both my wife an I are feeling allergies as spring is full blown in the DC area and we are not in the clean air systems of the office each day.  Its iterating running through the questions.  Virginia is only doing 1,200 tests/day so even if someone wants a test and has orders its unlikely they will get it.
Title: Re: COVID-19
Post by: MooseMom on March 28, 2020, 09:32:49 PM
Eeeeeek!

https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/

I just don't know what to think.
Title: Re: COVID-19
Post by: enginist on March 29, 2020, 11:07:27 AM
If your condition were that dire, I doubt you'd want your life extended for much longer anyway.  And that's assuming you will be assigned to a hospital bed, which is not a large assumption now but will be in a month or so.  If current projections continue to hold, it is almost a certainty that you will have to fight the virus on your own.  What isn't certain, what's unknown, is how your body will respond to it.  No one has ever decreed that all transplant patients will die, only that a percentage will.  The odds depend on your age, your health, and your overall resilience.  The last one is the x factor here, which may be unquantifiable.  Age is not a fixed number either.  Your biological age may be 10 or 20 years lower than what it says on the calendar.  If so, your odds of dying will go down accordingly.  The opposite is also true.  And then in a certain number of cases, such as when the immune system responds too aggressively, spreading inflammation throughout the body, having a suppressed immunity may actually be an advantage.
Title: Re: COVID-19
Post by: enginist on March 29, 2020, 01:43:19 PM
For anyone worried or in a panic about this contagion from hell, the following video should allay almost all of your concerns.  It is the most enlightening and reassuring information I have yet to come across.  Disseminate it far and wide, for it is meant for everyone.

https://vimeo.com/399733860
Title: Re: COVID-19
Post by: MooseMom on March 29, 2020, 03:28:30 PM
That was very interesting and helpful. enginist.  Thanks so much for posting that!  I actually DO feel quite a bit better!  I will share it.
Title: Re: COVID-19
Post by: SooMK on March 30, 2020, 10:48:36 AM
I had a friend send me that link and it is so reassuring and clear. You can see that doctor is exhausted but he took the time to do this video. Bravo!
Title: Re: COVID-19
Post by: Alexysis on March 31, 2020, 07:50:17 AM
causing the Poles to overheat
The Poles have also been wrong on occasion - like calling the 2016 election for Clinton.

They were also wrong in 1939 when they thought Hitler was their ally.....
Title: Re: COVID-19
Post by: iolaire on April 01, 2020, 05:32:58 AM
I ordered disposable medical masks from China for my family, ~$126 for 200 shipped via DHL.  Ordered on the 20th received on the 31st in DC area.  Another order made on the 26th for delivery in rural Washington state will arrive by Monday (it left Seattle after the China flight yesterday). Folks its time to get serous with masks - import them for yourselves and your loved ones.  I ordered mine on the 20th from China and received them on the 30th via DHL, ~$126 for 200 including shipping.  A coworker who is fluent in Chinese said the manufacturing is a reputable company.

I used https://www.miniinthebox.com/en/p/disposable-face-mask-safety-mask-dust-for-medical-dental-salon-and-personal-health-soft-comfortable-filter-safety-mask-1pc_p7926171.html
Title: Re: COVID-19
Post by: iolaire on April 01, 2020, 10:37:58 AM
Here is a letter that I just received from my transplant center, you will need to look at the image, free online OCR solutions didn't result in readable text.  and sorry you will need to download it and rotate it to read... or try this link: https://photos.app.goo.gl/x8cz8NqN96gcX7Ae6
Title: Re: COVID-19
Post by: MooseMom on April 01, 2020, 12:59:36 PM
Thanks for that, iolaire.

I just got this from my transplant clinic:  https://coronavirus.uwhealth.org/covid-19-precautions-for-transplant-patients/
Title: Re: COVID-19
Post by: Cupcake on April 01, 2020, 03:47:48 PM
Thanks, those are very helpful. Haven't gotten anything from Barnes in St. Louis but I did have my 6 mo visit today via telemedicine; I actually got to talk to one of the drs - usually its a nurse practitioner- she says that recent data out of Italy seemed to see benefit from holding the mycophenolic acid if a transplant patient came down with COVID. She looked up to find the closest transplant center to where I am snowbirding--I hope that doesn't mean she thinks I'm gonna need one anytime soon! Like I hadn't already done that before I ever made the trip. Meanwhile I stay inside my hiding place; my family is gonna mail me some of those surgical masks I have left over at home from my old PD days. Best wishes to everyone to stay healthy.
Title: Re: COVID-19
Post by: justagirl2325 on April 02, 2020, 10:02:36 AM
For anyone worried or in a panic about this contagion from hell, the following video should allay almost all of your concerns.  It is the most enlightening and reassuring information I have yet to come across.  Disseminate it far and wide, for it is meant for everyone.

https://vimeo.com/399733860

What a fantastic video, thank you
Title: Re: COVID-19
Post by: enginist on April 03, 2020, 10:40:12 PM
This is a disturbing video from Japan.  It shows that micro-droplets of the virus can hang suspended in a cloud for at least 20 minutes, a cloud that people can unknowingly enter.  The video recommends opening windows to disperse any lingering mist.  For the same reason, it's better to meet a friend or a date outside on a windy day.  If you live or work in a high-rise building, elevators could pose a serious risk.

https://www.youtube.com/watch?v=vBvFkQizTT4
Title: Re: COVID-19
Post by: enginist on April 05, 2020, 02:56:10 PM
A meta-study on PubMed concluded that supplementation with vitamin D reduces the risk of respiratory infection.

https://www.ncbi.nlm.nih.gov/pubmed/28202713

Supplementation is most effective in those with lower amounts of naturally acquired vitamin D; i.e., those who avoid the sun or live in northern latitudes. 
Title: Re: COVID-19
Post by: Simon Dog on April 06, 2020, 07:02:55 AM
I'm convinced the info we are being given is partially filtered for social engineering, especially the part about "masks don't help stop the spread unless you are a medical professional".  It's a matter of getting people to forgo behavior that is the best thing for them, but not the best for society at large.
Title: Re: COVID-19
Post by: MooseMom on April 06, 2020, 09:15:03 AM
I'm convinced the info we are being given is partially filtered for social engineering, especially the part about "masks don't help stop the spread unless you are a medical professional".  It's a matter of getting people to forgo behavior that is the best thing for them, but not the best for society at large.

That's a pretty incendiary statement, so could you elaborate?  I don't want to misunderstand.

It is my understanding that the CDC is now recommending that people use masks when they go out for essentials like groceries, etc.  Is this correct?
Title: Re: COVID-19
Post by: Simon Dog on April 06, 2020, 09:40:19 AM
You are correct on the CDC recommendation (as far as I know).

I suspect, but cannot prove, that the "do not wear a mask in public" order came out of a desire to preserve the masks for medical professionals, rather that actually being the best thing for the individual.   

For example, some leaked guidelines call for denying ventilators to dialysis patients with COVID-19 who need them and relegating them to comfort care.  This is beneficial in the aggregate (more life-years saved) but in direct conflict to the interest of the D patient who comes in and is told "you have to die since you are low on the priority list and not important enough for us to make an exception".

If you want a vent if needed, familiarize yourself with the guidelines and decide if you want to mention that solid tumor you had removed (kind of hard to hide dialysis).  For example, know if mentioning that "one thing" will cost you a point on the Charlson Cormobidity Index - it could cost you your life.


Then there is the matter of Trump's initial belittling of the problem in a futile attempt to keep the stock market from reacting.

Title: Re: COVID-19
Post by: enginist on April 07, 2020, 05:04:20 PM
I think they were overconfident and intentionally deceptive.   
Title: Re: COVID-19
Post by: enginist on April 14, 2020, 02:18:55 PM
The NYT has a dramatic visualization of the droplet spread by coughing, sneezing, and talking.   It demonstrates that six feet is nothing.   Besides wearing a mask, avoid other people like the plague.

https://www.nytimes.com/interactive/2020/04/14/science/coronavirus-transmission-cough-6-feet-ar-ul.html?utm_source=digg
Title: Re: COVID-19
Post by: iolaire on April 14, 2020, 04:19:36 PM
I’m less stressed about it these days as we are home one person goes shopping less than weekly.  Usually my wife goes but on Saturday I went to Safeway at 6:15 am to grab TP, because I could not tell if Amazon was sending it with my subscription. On Monday my two cases arrived so we have some to share in neighborhood. I’m wearing surgical mask in walks all the time. My wife will take if off for the few minutes we are not close to people.  I now have excess surgical masks and KN95 (Chinese) masks that are both a single step down from the good medical levels.  At this moment area medical facilities are not begging for masks so maybe it’s getting better now that I have some to donate.

Unfortunately I forecast this will be a fairly long term problem that we will worry about for years.  I expect I’ll be working from home for most or all of this year.
Title: Re: COVID-19
Post by: MooseMom on April 15, 2020, 08:05:01 AM
It sounds like you're quite well prepared.  Well done!  My husband runs any and all errands that require leaving the home.  We have some surgical masks from several years ago when I first got my tx.  We are not having much difficulty finding the things we need.  My husband will be working from home until at least 30 April.  The Geek Squad had installed a new printer for us several months ago, but we've just discovered that the fax function does not work.  Our printer is a brand new model, and I am thinking that it was not installed properly/completely.  Best Buy is not sending any techs out to anyone's home, so we are just hoping neither of us will need to fax anything any time soon!

I have been wondering about vaccines for covid that are being created and tested, and I've wondered if they will be made with the dead virus like Shingrex is for shingles.  I managed to find this article, and although it is a bit outdated by now, it at least addresses the question.

https://www.livescience.com/us-coronavirus-vaccine-trial-recruiting.html

I don't have time at the moment to do more research, but if someone else is inclined to do so, please do!
Title: Re: COVID-19
Post by: enginist on April 18, 2020, 12:00:20 PM
Kidneys are failing and dialysis is lacking.

https://www.nytimes.com/2020/04/18/health/kidney-dialysis-coronavirus.html?action=click&module=RelatedLinks&pgtype=Article
Title: Re: COVID-19
Post by: fifal9 on April 22, 2020, 10:37:29 AM

Exactly - similar story but in video format:


PBS NewsHour - Why doctors are worried about severe kidney damage in some COVID-19 patients
Yale University's Dr. Alan Kliger talks about Covid-19 and Kidney failure
https://www.youtube.com/watch?v=nJtfesZlvcw
Title: Re: COVID-19
Post by: enginist on May 24, 2020, 08:26:55 PM
Nouriel Roubini, an economist at NYU who predicted the collapse of the housing bubble, is now predicting that food riots are only a step away. 

https://nymag.com/intelligencer/2020/05/why-the-economy-is-headed-for-a-post-coronavirus-depression-nouriel-roubini.html
Title: Re: COVID-19
Post by: UkrainianTracksuit on October 18, 2020, 05:50:50 PM
Québec has particularly suffered with the pandemic and now this is on the rotating loop on the news: 5 patients on the renal transplant floor have contracted the virus.

https://www.cbc.ca/news/canada/montreal/hotel-dieu-quebec-city-kidney-transplants-suspended-1.5766664 (https://www.cbc.ca/news/canada/montreal/hotel-dieu-quebec-city-kidney-transplants-suspended-1.5766664)
Title: Re: COVID-19
Post by: MooseMom on October 19, 2020, 08:26:02 AM
It sounds logical that transplant patients, being immunosuppressed, are particularly vulnerable to developing severe symptoms should they catch covid.  But I still wonder just how immunosuppressed we actually are.  Like most of you, no doubt, I have regular labs done which include a full wbc panel, and all of my results come back as "within normal range".  So, exactly how "vulnerable" am I?

So, I have to wonder how the 5 patients on the renal transplant floor will present with severe symptoms.  It doesn't surprise me that they got it, but is it because they are immunosuppressed, or is it because there are probably loads of people coming in and out of the ward?
Title: Re: COVID-19
Post by: iolaire on October 19, 2020, 08:45:12 AM
So, I have to wonder how the 5 patients on the renal transplant floor will present with severe symptoms.  It doesn't surprise me that they got it, but is it because they are immunosuppressed, or is it because there are probably loads of people coming in and out of the ward?

When I read I article I thought the same thing.  The post transplant parts of the ward should have better than normal infection controls due to the infection risks post transplant so it worried me that this virus was able to spread so widely.
Title: Re: COVID-19
Post by: UkrainianTracksuit on October 19, 2020, 10:59:24 AM
I've never been to a Québec hospital so I can't speak about any actual on the ground, however I know from following Transplant Québec that they have already made amendments to the transplant process in the appropriate hospitals, like not allowing family visits, etc, rather they are done by telephone. Hospitals are a lot "deader" now they they typically are (really bad pun) so I assume that that it wouldn't be "loads" of people in/out.

Québec City is in a "Red Zone" so a lot of stuff is closed down so I'm having so many questions.
(https://www.iheartradio.ca/image/policy:1.13596232:1601259042/image-3.jpg?f=default&$p$f=587521d)


With the screening and temperature checks at the door, it's making me wonder if it's asymptomatic spread in staff. It's often been expressed that tx patients typically present with diarrhea as their first symptom, but that it's difficult to pinpoint because that one thing could mean so much. Visitors can obviously play a part but they have tightened up on that, such as having to book in advance and one person per day. So, the hospital outbreaks are mainstay on the news. Can't escape it! https://toronto.ctvnews.ca/three-toronto-hospitals-confirm-new-covid-19-outbreaks-1.5150014 (https://toronto.ctvnews.ca/three-toronto-hospitals-confirm-new-covid-19-outbreaks-1.5150014)

Even when paramedics come to your home, they screen ahead of time at the door, social distance (before any physical touch) and all that stuff. Witnessed it with my own eyes.
Title: Re: COVID-19
Post by: MooseMom on October 19, 2020, 02:53:06 PM
As I've mentioned earlier, I was in hospital in Michigan back in August for a few nights.  There were indeed "loads" of people coming in and out.  The doctor ($300 per 5 minute visit), nurses coming on and off shift, housekeepers, phlebotomists, the ladies who brought me my meals, and even someone from the hospital's insurance department came in with questions...any of these people could have been carriers yet were asymptomatic.  I don't know if the dinner ladies knew I was a transplant patient so was immunosuppressed, but it seems to me that if I was at particular risk simply because I was immunocompromised, so many people wouldn't have been allowed around me, you know?  They all had masks, but certainly they didn't have any other PPE.  And I was on a general ward, not a fancy pants sparkly clean tx ward.  So again, that made me wonder just how "immunosuppressed" I really am.  Enough to be really at risk of developing severe symptoms?

Interestingly (or maybe not), a few days after getting home, I developed a low grade fever that presented only at night and lasted only 2 nights, and a cough that lasted about a month.  I've had bronchitis only once in my life (2 years ago), and the cough I had was a lot like that.  I did wonder if maybe I had covid, but I wasn't ill enough to investigate.  But, maybe I DID have it!
Title: Re: COVID-19
Post by: UkrainianTracksuit on October 19, 2020, 05:04:43 PM
Ah see, my experience with a big teaching hospital was much different. It was like 5 people (4 medical: nurse, doctor + fellow, PSW that also did meal delivery for all meals when the food arrived + 1 housekeeper). I think I was the cause of a lot of PPE waste because I have contact precautions (MRSA, yes, it's been attempted to be treated) so even at my clinic appointments, they wear gowns and gloves prior. I know that is not the standard. Different set up, I guess.

But anyway, this is a really interesting article. It seems like how badly corona affects transplant patients is not a typical "immune suppressed + virus = OMG, bad news" but rather based on other factors, like age and overall health. Don't forget viral load: you can a little, or you can have a lot. The way my doctor presented it to me was that my outcome would be similar to a diabetic on dialysis (bad), but still in the safe age range. Doesn't mean I'll be out dancing, but it is something to consider.

Anyway, according to the findings: "Thus, 42% of patients with a kidney transplant and with COVID-19 were diagnosed on antibody testing without significant clinical symptoms", so in this one case, it is obvious to be immune suppressed and have mild symptoms. "Thirty-five of the 97 patients (36.1%) diagnosed by SARS-CoV-2 IgG did not recall having any symptoms suggestive of COVID-19 during the peak of the pandemic and the remaining patients had mild symptoms that did not require medical evaluation."

https://www.kidney-international.org/article/S0085-2538(20)31202-3/fulltext (https://www.kidney-international.org/article/S0085-2538(20)31202-3/fulltext)
Title: Re: COVID-19
Post by: MooseMom on October 19, 2020, 07:38:43 PM
Thanks so much for that link, UT, and thanks for the synopsis because I'm really tired and probably couldn't make heads or tails of the entire study right now. I'll give it a go tomorrow.

I don't think I understand your reference to MRSA; what do you mean by having "contact precautions"?  Did you have MRSA at some point?  Sorry, like I said, I'm tired and don't want to misunderstand your post.
Title: Re: COVID-19
Post by: UkrainianTracksuit on October 20, 2020, 04:07:05 AM
For the MRSA, I have never had an active infection of it, but I've been colonized, meaning I carry it around. It has been attempted to be "decolonized" but the treatment didn't take care of it. I'm not exactly sure where I got it - having any intrusive medical devices is one cause (dialysis catheter on dialysis, and then a whole slew of tubes for serious hospitalization) and prior to testing positive, I spent a lot of time in an old age home too (was looking after someone).

Anyway, on my file, it states contact precautions so nurses/doctors have gowned up and wore gloves ever since.
Title: Re: COVID-19
Post by: MooseMom on October 20, 2020, 07:58:41 AM
Ah, OK.  I understand now.
Title: Re: COVID-19
Post by: Simon Dog on October 20, 2020, 12:43:23 PM
Just hanging around a hospital is a risk factor for MRSA.
Title: Re: COVID-19
Post by: justagirl2325 on October 22, 2020, 08:57:20 AM
And CMV and VRE.  Hospitals are the worst at virus control.
Title: Re: COVID-19
Post by: enginist on November 02, 2020, 05:58:35 PM
If your hospital offers Telehealth for a consultation, would you use it or prefer an in-person appointment?  Which do you think your practitioner would prefer?  Do you think that hospitals are germ factories, to be avoided at all costs?  What if it's your first appointment with a new doctor?  What if you personally like and respect the members of your care team but haven't seem them since the pandemic began?  Do you think there is any value in a face-to-face encounter?
Title: Re: COVID-19
Post by: MooseMom on November 02, 2020, 08:41:12 PM
If your hospital offers Telehealth for a consultation, would you use it or prefer an in-person appointment?  Which do you think your practitioner would prefer?  Do you think that hospitals are germ factories, to be avoided at all costs?  What if it's your first appointment with a new doctor?  What if you personally like and respect the members of your care team but haven't seem them since the pandemic began?  Do you think there is any value in a face-to-face encounter?

I had a telehealth consultation for my first appointment with a hematologist and felt comfortable with that, as did the doctor.  I was very grateful that this alternative was on offer.  But mine was a pretty straightforward case, so for me, it was perfect. 

I plan to ask for a telehealth consult with my tx neph next month for my annual checkup.  I get labs done regularly as I am supposed to, and I've had my tx long enough to recognize issues if I had them.  I have no issues so feel no need to put myself or others at risk with an in-person visit when those appointments mostly are just reviewing my labs and answering the usual questions.  If I felt the need to discuss something in person, then that's what I would do.

Yes, I think there is value in a face-to-face encounter if a patient has concerns or questions they may not quite know how to ask.  For someone with a new transplant or with ongoing issues, definitely there is value in such a visit.  I personally like and respect the members of my care team, but I don't want to put them at risk, just as I don't want to put myself at risk.  I also think about the other patients in the waiting room, the nurses, and the support staff, and that's just too many people involved in the whole in-person appointment adventure.

I do think hospitals are germ factories, but that does not mean I think they should be avoided at ALL costs.  I had to go to one or else I may have lost my kidney from severe dehydration, and I made the decision to take the risk that hospitals pose. 




I

Title: Re: COVID-19
Post by: kristina on November 03, 2020, 03:10:49 AM
If your hospital offers Telehealth for a consultation, would you use it or prefer an in-person appointment?  Which do you think your practitioner would prefer?  Do you think that hospitals are germ factories, to be avoided at all costs?  What if it's your first appointment with a new doctor?  What if you personally like and respect the members of your care team but haven't seem them since the pandemic began?  Do you think there is any value in a face-to-face encounter?

Hello enginist, this is an interesting question and I was wondering about it as well. Perhaps the consultation needs to be conducted according to your particular medical needs at this moment? If, for example, you are in pain and/or have swollen limbs i.e. swollen ankles etc. you most certainly need a medical examination by the doctor in person. Whereas if you just have a medical question and/or medical check-up, which only needs to be verbally explained and/or talked over, it might be much more safe for you to talk about it over the phone and/or see the doctor over the computer-facility?

Best wishes and good luck from Kristina. :grouphug;
Title: Re: COVID-19
Post by: enginist on November 03, 2020, 09:03:13 AM
Thanks, Kristina and MM.  For their sake as well as mine, I'll keep the visit virtual.
Title: Re: COVID-19
Post by: enginist on November 13, 2020, 02:46:29 AM
I had a teleconference with my new urologist.  The medium was effective but the communication was not.  The call was rushed and the guy didn't listen.  Few things are as bad as doctor who doesn't listen.  This was odd because he was recommended by my previous urologist, an outstanding physician.  Maybe the new one was having an off day.  Or maybe he doesn't have a good phone-side manner.  Either way, I hope it improves.  I don't want to go doc shopping, which involves a lot of luck and is often unproductive.
Title: Re: COVID-19
Post by: fifal9 on November 13, 2020, 10:07:42 AM
I'm really sorry to hear that, enginist.
I guess I'm lucky that I've found the opposite to be true. I feel like when I went into the office the Dr was constantly looking at papers and not really listening to me.
Now he seems to listen and look me in the eye more often. I feel like we have almost real conversations and he is less rushed.
Maybe you can get them to do a tele-health appt. instead of a phone call. That way they can see you and have to look you in the eye.
Title: Re: COVID-19
Post by: enginist on November 13, 2020, 02:27:05 PM
Hey Jules--

You're probably right.  A doctor always has something to distract him in the clinic, even if he's on the phone.  I think my guy was trying to read and talk at the same time.  But something like FaceTime would force him to provide his full attention.

Hope you're still at Stage 3.
Title: Re: COVID-19
Post by: UkrainianTracksuit on November 27, 2020, 07:58:18 PM
Covid outbreak has spread to a transplant unit; one of the most active in the country: https://www.cbc.ca/news/canada/london/outbreak-at-university-hospital-spreads-to-organ-transplant-and-cardiac-units-1.5818957 (https://www.cbc.ca/news/canada/london/outbreak-at-university-hospital-spreads-to-organ-transplant-and-cardiac-units-1.5818957)

Public health authorities are pinpointing staff saying they let their guards down during work breaks (I guess de-masking and getting close) and in other stories I read stating that the workers should have limited social contacts outside of work, but they didn't.

Hopefully the transplant patients currently on the floor (as well as the other sick patients) will be as okay as can be considering the situation.
Title: Re: COVID-19
Post by: Simon Dog on December 05, 2020, 10:32:39 PM
Looks like a victory from the CA vaccine death panel:

https://www.cnn.com/2020/12/05/health/first-covid-vaccine-shipments-inadequate/index.html (https://www.cnn.com/2020/12/05/health/first-covid-vaccine-shipments-inadequate/index.html)

Quote
The Covid-19 vaccine in California will now go first to acute care facilities, nursing homes, dialysis centers and first responders before going to groups like home healthcare workers.
Title: Re: COVID-19
Post by: Hereware on December 10, 2020, 09:52:25 PM
Looks like a victory from the CA vaccine death panel:

https://www.cnn.com/2020/12/05/health/first-covid-vaccine-shipments-inadequate/index.html (https://www.cnn.com/2020/12/05/health/first-covid-vaccine-shipments-inadequate/index.html)

Quote
The Covid-19 vaccine in California will now go first to acute care facilities, nursing homes, dialysis centers and first responders before going to groups like home healthcare workers.

OMG!
Title: Re: COVID-19
Post by: PrimeTimer on December 12, 2020, 11:33:13 PM
I apologize if this has already been addressed on the site, let me know and please direct me to the correct thread if it has...TIA. 

Question: If someone has recently been hospitalized for surgery, will they be asked to self-quarantine somewhere when they are discharged?

I suppose the answer/requirement will vary state-to-state or city-to-city, depending on where the person was hospitalized but, I am wondering if any of you have ran into this situation or know someone who has.

Title: Re: COVID-19
Post by: Xplantdad on December 13, 2020, 08:07:31 AM
My next door neighbor whose mom is on dialysis, just had surgery this past week, during the huge spike of cases here in AZ. He had to get a Covid test that showed negative before surgery-but is not required to quarantine

My daughter who is a transplant has to quarantine for 20 days due to being immunosuppressed (per Mayo and the CDC). Her quarantine is up on Tuesday...
Title: Re: COVID-19
Post by: UkrainianTracksuit on December 13, 2020, 09:58:39 AM
It varies across jurisdiction to be honest. Not in the US, so take this with a grain of salt.

Prior to surgery, my husband had to self-isolate for 14 days (he managed most of that, but not all) and had two COVID tests (both negative). This was required of anyone prior to surgery, local or not.

We traveled outside our region (same province) to a hot zone with a lockdown so that he could have surgery. As a public health requirement, we have to self-isolate for 14 days. However, had he been a local with no travel involved, no self-isolation was required post-surgery.
Title: Re: COVID-19
Post by: PrimeTimer on December 13, 2020, 10:44:50 PM
Thank you for your replies, Xplantdad and UT. Hubby has been in the hospital all week for a toe amputation and it got me thinking. So far they haven't said anything to him about self-quarantine but I am a little concerned because of the surge at hospitals and the fact that we are both immunocompromised. I've stayed away but wonder about when he is discharged.
Title: Re: COVID-19
Post by: UkrainianTracksuit on December 14, 2020, 01:12:42 AM
I know that the issue has been a firestorm south of the border, but one good question to ask is whether the hospital your Mister Man is in has had an outbreak of covid recently? No space is 100% virus-proof but many have done well with preventing spread in the hospital.

Next time you speak with him (I Imagine that you are calling) advise him to ask directly to his doctor, or one leading his care, one with authority that pops in to see him, what will happen post-discharge in regard to isolation. That way he will be advised for sure (even if the med team don't mention it) and both of you can plan ahead.

Take care, Pea Tea.  :cuddle;
Title: Re: COVID-19
Post by: kristina on December 15, 2020, 12:51:38 AM
Thank you for your replies, Xplantdad and UT. Hubby has been in the hospital all week for a toe amputation and it got me thinking. So far they haven't said anything to him about self-quarantine but I am a little concerned because of the surge at hospitals and the fact that we are both immunocompromised. I've stayed away but wonder about when he is discharged.

Dear PT,
Please ask the medics about this, but to me it would sound like common-sense for your husband to self-quarantine after his operation, especially during the Covid-Fear right now. He seems especially vulnerable at this moment because of his immunological-self-defence-mechanism being compromised for a while during the healing process after the operation. Please take great care and best wishes from Kristina.  :grouphug;