First Story on Coronavirus Mortality Rate

[UkrainianTracksuit]

I'm late to the game here but have been following the info on this thread.

We have cases in the province though none locally. No community spread as of yet. However, hand sanitizer is off all the shelves and not to be found. Masks too. It kind of peeves me off because I need sanitizer refills just for general transplant life.

The issue I've had when discussing contingencies with people pretty much comes down to the public health authorities denoting high risk groups. They are associating "severe medical conditions" only with the elderly at press conferences. And yes! I understand why simply due to the fact that the elderly are generally more at risk and the numbers of elderly outnumber those in a younger demographic with issues.

But for the people that can't connect point A to point B (for instance, friends, co-workers and boss) they do not associate "severe medical condition" with anyone of a younger demographic. Even transplant... because "immune-comprised" or "severe medical condition" has not been liked to all age groups. Which I mean, it's not rocket science, but it escapes some. I really do find this odd because when there is a salmonella outbreak they most definitely highly the immune-compromised of all age groups.

Apples and oranges, I know.

The health care system here has had a disjointed response. At the lab, they asked the 3 prescreening questions: 1. Have you traveled to x,y,z? 2. Have you been in contact with anyone that has traveled to a,b,c? 3. Are you experiencing any respiratory systems? At the hospital, no notices, and my neph team didn't even bring it up. I get it, it's not in the community yet, but...

So, I guess my main point of this babble is that I don't want to come across as a nervous wreck but I wish the public health officials would just do a better job of messaging.

[MooseMom]

Can find sanitizing wipes nor gel here, either!

Yeah, I wish there was more info for tx patients, too, but I suppose it's really the same for everyone. 

I did find this, though, but it's not particularly patient-oriented.

https://tts.org/tid-about/tid-presidents-message/23-tid/tid-news/657-tid-update-and-guidance-on-2019-novel-coronavirus-2019-ncov-for-transplant-id-clinicians

[UkrainianTracksuit]

Thanks for the link, Moose Mom. It may not be patient oriented but it was definitely an interesting read. Not that I wish any tx patient to go through any serious illness and require intervention, I guess it is just a matter of wait and see and learn from it case by case. Will follow that page as they update the info.

As nothing has reached us locally, I have not come to the point of contemplating any sort of social distancing. I guess I'm waiting for that "sign" to know when to start. A lot of it is common sense that I already practice, such as avoiding (known) sick people.

Anyway, I purposely made a trek looking for hand sanitizer today. Sold out at all major retailers, as well as masks, gloves, wipes, bottled alcohol. You name it. Just signs to say "sold out." And so, I went to the overpriced Bath and Body Works for the small PocketBacs that smell like gardenia and giraffe vomit with a dash of sparkles. They are running low there too. Many cubicles (boxes? sections? what's the word?) were empty and others were very low. While there, three people came in specifically for hand sanitizers.

I've been aware of Dr. Anthony Fauci (even as a foreign person) for years and I really appreciated on one of his media outings this morning, he identified any one that takes medications that compromise the immune system as a group that should take a little extra care right now. Feel like making a recording and handing it out to my contacts when the time comes!

[MooseMom]

One would think that any virus would avoid anything that smells of gardenia and giraffe vomit despite the attraction of sparkles.

[iolaire]

Sorry if this is a bit too morbid, but...  I saw a story or post that Italy is prioritizing patients under 80 and any one with a Charleston Comorbidity Index under 5.  So here is a calculator for that index.
https://www.mdcalc.com/charlson-comorbidity-index-cci#next-steps

And a story on the above
https://www.telegraph.co.uk/news/2020/03/14/italians-80-will-left-die-country-overwhelmed-coronavirus/

[MooseMom]

Sounds a bit like decided who gets waitlisted and who doesn't.

This is why EVERYONE needs to be careful.  If you are young and healthy, it is your moral duty to still exercise care because you could be a carrier without realizing it.  You don't know who has cancer or a transplant and who does not.  You may be signing someone's death warrant without knowing it.

I hope we don't see this scenario anywhere here in the US.  I have friends in central Italy who are in their 70s, one is in good shape but the other has diabetes and probably some cardiovascular problem.  I worry for them.

[Paul]

Can find sanitizing wipes nor gel here, either!

Try Amazon, our supermarkets and pharmacists are running out, but Amazon UK has plenty.

[Simon Dog]

Sorry if this is a bit too morbid, but...  I saw a story or post that Italy is prioritizing patients under 80 and any one with a Charleston Comorbidity Index under 5.

So persons with a CCI >=5 need to go to a hospital in a different "system" that does not have their medical records readily available and "forget" to mention about some of their comorbidities.   That would be hard for a transplant patient, but if you had a tumor successfully removed years ago with no ongoing treatment, mentioning it could cost you your life.  In my case, if I had such a tumerous history it would boost me from my +4 to a +6.

In some sense, this is a replay of the Seattle death panel of the 60s.

Here in the us the importance of the person as well as ability to pay would factor into the decision, either overtly or covertly.   I know people are denied vital organ transplants if they get a bad pathology report on their wallet biopsy.

[iolaire]

Study Calculates Just How Much Age, Medical Conditions Raise Odds Of Severe COVID-19 : Coronavirus Live Updates

https://www.npr.org/sections/coronavirus-live-updates/2020/03/22/819846180/study-calculates-just-how-much-age-medical-conditions-raise-odds-of-severe-covid

Kidney disease is also likely a big risk factor. While the research didn't pinpoint exactly how big that risk is, it suggested it's somewhere between 2- and 16-fold.

The researchers say the findings suggest doctors should give more attention and care to older patients with these underlying risk factors.
The researchers didn't explain why certain underlying conditions appeared to make patients more vulnerable to severe COVID-19 disease, though they did say that all the conditions cited above can involve an inflammatory response from the body. Patients with chronic kidney disease may be more vulnerable because their kidneys are already weak and damaged, and severe coronavirus infection can further damage those organs. It's possible such patients may have missed dialysis sessions or other regular medical care because they were under quarantine or because the local medical system had to shift resources to focus on the growing epidemic.

[iolaire]

Study of 36 transplants patients at the Bronx in NYC, wear your masks and stay home/isolated.

I wish everyone stays safe.

https://www.renalandurologynews.com/home/news/nephrology/transplantation/study-kidney-transplant-recipients-hard-hit-by-covid-19/
“Our results show a very high early mortality among kidney-transplant recipients with Covid-19 — 28% at 3 weeks as compared with the reported 1% to 5% mortality among patients with Covid-19 in the general population who have undergone testing in the United States and the reported 8 to 15% mortality among patients with Covid-19 who are older than 70 years of age,” Dr Akalin and his colleagues stated

[enginist]

A mortality rate of 28% is probably correct.  Those aren't bad odds.  Better than Vegas.  But if you have another condition, the outlook quickly darkens. 

[iolaire]

A mortality rate of 28% is probably correct.  Those aren't bad odds.  Better than Vegas.  But if you have another condition, the outlook quickly darkens.

Yes 98% had hypertension which was a big risk factor to begin with.

[enginist]

I don't think it's been determined yet whether controlled hypertension poses the same risk. 

[enginist]

The use of ARBS and ACE-i do not increase a person's odds of catching the disease.

https://www.nytimes.com/2020/05/01/health/blood-pressure-drugs-coronavirus.html?action=click&module=RelatedLinks&pgtype=Article

[Simon Dog]

If the prediction that 60%-70% of people will get it and transplant morality is 28%, then we all have a 16.8%-19.6% chance of this plague killing us off.