Coronavirus!

[KB21]

Here is where the fearmongering makes my job harder.  I just had a patient with no symptoms test negative for the virus.  She was tested because her job wanted her to be tested.  She asked me if I would put her on HCQ, Azithromycin, and zinc anyway.  

NOOOOOO!!!!!  That's not how this is done!!

[warcore]

@KB21 I'm a supervisor for the DOH COVID Hotline for my respective state.... the fearmongering makes me hate my job. Thankfully it's a side gig. Sorry you have to put up with all this crap as well. 

Who you got as far as stock investment: J&J vs Pfizer vs Moderna vs Novavax?

What you previously mentioned about high flu rates has me wondering about Nova, as they've been developing a flu vaccine completely free of any egg derivatives.

[AHF]

4 hours ago, KB21 said:

In medical school, I was taught to treat the patient, not the lab test or medical test.  I have seen probably 750-800 positive tests for this virus in the past 6 months.  I have essentially been a coronavirus doctor for the most part during this time.  At one point, I was seeing 90-100 patients a day in the urgent care clinic while testing 80-90 of them.  On those days, it was nothing to have 25 plus positive tests.  That peak happened in the middle part of July.  I peaked at around 28% positivity around July 18th.  Since then, the numbers have gone down drastically.  The last three days I've been in the clinic, I've seen around 150 patients with only 3 positive cases.  Of those positive cases, no one was very sick.  The most common symptom was loss of taste and smell.  The biggest risk factors are age and obesity.  Of those 750-800 positive cases I saw, I sent only 5 to the hospital.  I had only 1 patient that passed away from this.

As far as treating this virus, I tried a few different modalities.  What I saw was that no matter what I did, people recovered from this virus with no issues.  I used HCQ on some.  I used indomethacin on some.  I used a cocktail of vitamin D, zinc, and vitamin C on some.  My clinic has around 30 personnel, and of those, only 3 actually caught this virus.  One of those three catches everything that comes around.  Another had loss of taste and smell only for around 3 days.  The other had 4-5 days of body aches and diarrhea.  

Here is where I have some issues.  I have one patient come in with cough, body aches, temp of 101, overall feels bad.  Typical flu like illness.  This patient tests negative for coronavirus.  I have another patient come in that doesn't have a single symptom.  He was just "exposed" to the virus.  Temp is normal.  Pulse rate is normal.  100% sats on his oxygen.  This patient tests positive.  Well, guess what.  The employer wants me to send the one that is sick back to work since that patient tested negative.  The one that doesn't have any symptoms has to stay at home for 14 days.  I have a big issue with sending sick people back to work and keeping nonsick people off work.  So, I quarantine the sick one despite what the employer wants.  I quarantine the nonsick one because I essentially have no choice.  

Another issue I have is repeat testing.  If you had this virus, have been quarantined for 10 days, and have been afebrile for 24 hours, you can go back to work.  You should not have to be retested, because these tests are picking up dead viral particles which triggers a positive result.  At some point though, you just stop arguing with the employers who have no idea what they are talking about and just do the test.  If they are positive, you keep them off for 5 more days.  

The decline in the numbers also doesn't have anything to do with mask mandates, no matter what politicians and the media try to tell you.  What's happening is areas are reaching community immunity to this virus.  There is a strong T cel response to this virus, and memory T cells are the key to keeping you from being reinfected.  They are also going to be the key in this virus being little more than a cold virus when it flares back up after some of the immunity wanes.  Long term, this virus isn't going to be any different than the other four human coronaviruses that cause the common cold.  There is around 95% homology between the viruses, and that's the reason some have not gotten it.  They have either had or have been exposed to the other coronaviruses.  

Another prediction of mine is that because of the methods used to "combat" this virus, we are in for a hellacious influenza season.  You may say, we have a flu vaccine that will help.  In a good year, maybe 30% of the people who get the vaccine actually develop an immunity to it.  What's more effective is the exposure to the lower level of influenza that people come into contact with during the summer months.  An exposure many haven't had this summer.

Did I read right that you wanted to send an asymptomatic Covid positive person back into their workplace?!?

I’m with you on not wanting to send a sick person back.  Just because someone doesn’t have Covid doesn’t mean they aren’t sick.

[terrell]

"President Trump, wearing a mask, rides by his supporters outside Walter Reed while in the back of a Suburban"

Wtf? Riding around(with the windows up) with 4 or 5 secret service members while infected with Covid? Just to say hello to your "fans"? Wow..This shit is getting crazier and crazier...

Edited October 4, 2020 by terrell

[terrell]

"Either he doesn't have COVID or he's the single most irresponsible and disrespectful human on the planet".

 

My thoughts exactly......

 

[KB21]

4 hours ago, AHF said:

Did I read right that you wanted to send an asymptomatic Covid positive person back into their workplace?!?

I’m with you on not wanting to send a sick person back.  Just because someone doesn’t have Covid doesn’t mean they aren’t sick.

No.  I'd rather not test anyone that is asymptomatic.  If the viral load is not big enough to cause symptoms, then it is also not big enough to be spread.

[KB21]

4 hours ago, warcore said:

@KB21 I'm a supervisor for the DOH COVID Hotline for my respective state.... the fearmongering makes me hate my job. Thankfully it's a side gig. Sorry you have to put up with all this crap as well. 

Who you got as far as stock investment: J&J vs Pfizer vs Moderna vs Novavax?

What you previously mentioned about high flu rates has me wondering about Nova, as they've been developing a flu vaccine completely free of any egg derivatives.

Honestly, I haven't paid attention.  

[Vol4ever]

On 10/3/2020 at 1:33 PM, KB21 said:

Your radar should be going off when this virus is basically nothing more than a flicker of light right now and you suddenly have a mass rush of positive tests.  

The tests are specious at best, and no decisions should be made off the results of these tests.  It should have always been a symptoms based approach.  How many of these positive tests are actually sick?  

My personal physician says the same thing.  Her response was it's nothing more than a cold or flu.  She says if you have underlying issues you can get pnuemonia and that has been a issue for many years.  In addition she said the media and politicians have politicized this.  We just had this conversation over dinner last night at Ruth's Crisp.  

Dont know if you feel the same or not KB.  

[KB21]

11 hours ago, Vol4ever said:

My personal physician says the same thing.  Her response was it's nothing more than a cold or flu.  She says if you have underlying issues you can get pnuemonia and that has been a issue for many years.  In addition she said the media and politicians have politicized this.  We just had this conversation over dinner last night at Ruth's Crisp.  

Dont know if you feel the same or not KB.  

From my standpoint, I do.  You can talk to an ER doctor and hear a different story because they tend to see the worst of this.  I see most of the ones on the front end of this thing, and honestly, it's hard to tell if it is the virus vs allergies in most.  

[macdaddy]

We can all throw out plenty of facts and theories but even if our little group the opinions basically fall strictly along ideological and political lines.  

The fact that the President of the US contracted the virus and had to hospitalized on day 1 of his illness pretty much shows how serious it can be for certain people.

[AHF]

13 hours ago, KB21 said:

No.  I'd rather not test anyone that is asymptomatic.  If the viral load is not big enough to cause symptoms, then it is also not big enough to be spread.

That is not how it works.  Please don’t spread disinformation here.  Covid can be spread by asymptomatic people.
 

Quote

"Due to the significance of asymptomatic and pre-symptomatic transmission, this guidance further reinforces the need to test asymptomatic persons, including close contacts of a person with documented SARS-CoV-2 infection," the CDC says.

 

Quote

The CDC estimates that 40% of infections are asymptomatic and 50% of transmissions occur before symptoms appear. 

This is an issue for both people who never develop symptoms and for people who will develop symptoms but have not done so yet.  The science is clear that these people in both of these buckets can transmit the disease.

[KB21]

15 minutes ago, AHF said:

That is not how it works.  Please don’t spread disinformation here.  Covid can be spread by asymptomatic people.
 

 

This is an issue for both people who never develop symptoms and for people who will develop symptoms but have not done so yet.  The science is clear that these people in both of these buckets can transmit the disease.

That's a bunch of bunk.  Viruses cannot be spread asymptomatically.  There has to be a sufficient viral load for viruses to be spread, and that viral load will have symptoms associated with it.  The WHO and CDC have flipped and flopped and have essentially been wrong about this virus every step of the way.  I'm not going to suddenly forget what I learned in virology about how viruses are spread just because a group of people is using this virus to push an agenda.  

We don't test asymptomatic patients for influenza during flu season.  I don't test asymptomatic people for strep or mono.  I don't randomly run gonorrhea and chlamydia tests on people who do not have urethritis.  

Edited October 5, 2020 by KB21

[AHF]

25 minutes ago, KB21 said:

That's a bunch of bunk.  Viruses cannot be spread asymptomatically.  There has to be a sufficient viral load for viruses to be spread, and that viral load will have symptoms associated with it.  The WHO and CDC have flipped and flopped and have essentially been wrong about this virus every step of the way.  I'm not going to suddenly forget what I learned in virology about how viruses are spread just because a group of people is using this virus to push an agenda.  

We don't test asymptomatic patients for influenza during flu season.  I don't test asymptomatic people for strep or mono.  I don't randomly run gonorrhea and chlamydia tests on people who do not have urethritis.  

You acknowledge that the CDC says otherwise, correct?

(I am also assuming you haven't seen this within your practice.  We have within our business.)

I know that the rate of transmission by asymptomatic people is the subject of conflicting studies (haven't seen any that say asymptomatic people can't transmit just that it is more rare) but there is also the bucket of pre-symptomatic people who develop symptoms and I haven't seen any study that concludes those people are only a risk to transmit after they develop symptoms (every study I've seen that has focused on the issue has been to the contrary on that point and flagged the risk of pre-symptomatic people transmitting the disease).

Example:

https://thorax.bmj.com/content/early/2020/08/28/thoraxjnl-2020-215042

Quote

Abstract

Background Asymptomatic individuals with SARS-CoV-2 infection have viable viral loads and have been linked to several transmission cases. However, data on the viral loads in such individuals are lacking. We assessed the viral loads in asymptomatic individuals with SARS-CoV-2 infection in comparison with those in symptomatic patients with COVID-19.

Methods Study participants were recruited from a community facility designated for the isolation of patients with mild COVID-19 in South Korea. The presence of symptoms was evaluated with a questionnaire-based survey. Viral loads in the upper respiratory tract were measured with real-time reverse transcription-PCR (RT-PCR) targeting the E, RdRp and N genes of SARS-CoV-2, with a cycle threshold (Ct) value of 40 for determining positivity.

Results In 213 patients with SARS-CoV-2 infection, 41 (19%) had remained asymptomatic from potential exposure to laboratory confirmation and admission; of them, 39 (95%) underwent follow-up RT-PCR testing after a median 13 days. In 172 symptomatic patients, 144 (84%) underwent follow-up RT-PCR testing. Twenty-one (54%) asymptomatic individuals and 92 (64%) symptomatic patients tested positive for SARS-CoV-2 at follow-up. Asymptomatic individuals and symptomatic patients did not show any significant differences in the mean Ct values of the E (31.15 vs 31.43; p>0.99), RdRp (32.26 vs 32.93; p=0.92) and N (33.05 vs 33.28; p>0.99) genes.

Conclusion Approximately one-fifth of the individuals without severe symptoms were asymptomatic, and their viral loads were comparable to those in symptomatic patients. A large proportion of mildly symptomatic patients with COVID-19 or asymptomatic individuals with SARS-CoV-2 showed persistent positive upper respiratory RT-PCR results at follow-up.

 

[bleachkit]

https://abcnews.go.com/Health/wireStory/10-worlds-people-infected-virus-73427817

The WHO is saying 10% of the world has been infected. As I have been saying from the beginning, confirmed cases are like roaches, for every one you see there are 50 more. People have been using an incorrect denominator, orders of magnitude below the actual number, when determining fatality rates, thus badly skewing the numbers. Why is it socially acceptable for Covid alarmists to use false or misleading data to make their case?

Edited October 5, 2020 by bleachkit

[thecampster]

1 hour ago, macdaddy said:

We can all throw out plenty of facts and theories but even if our little group the opinions basically fall strictly along ideological and political lines.  

The fact that the President of the US contracted the virus and had to hospitalized on day 1 of his illness pretty much shows how serious it can be for certain people.

Day 3 after testing positive.

[AHF]

6 minutes ago, bleachkit said:

https://abcnews.go.com/Health/wireStory/10-worlds-people-infected-virus-73427817

The WHO is saying 10% of the world has been infected. As I have been saying from the beginning, confirmed cases are like roaches, for every one you see there are 50 more. People have been using an incorrect denominator, orders of magnitude below the actual number, when determining fatality rates, thus badly skewing the numbers. Why is it socially acceptable for Covid alarmists to use false or misleading data to make their case?

The main issue I've seen is the positivity or fatality rate among confirmed cases being conflated with the true rate for the total population.  The numbers cited aren't wrong or bad data - just not data for the entire population.  People should speak to the actual data.

Biggest number for the US is 214.7k but you don't get the fatality rate for the entire population by dividing that by the number of known cases.  That only tells you the rate among known cases, not the total fatality rate.

[thecampster]

2 minutes ago, AHF said:

The main issue I've seen is the positivity or fatality rate among confirmed cases being conflated with the true rate for the total population.  The numbers cited aren't wrong or bad data - just not data for the entire population.  People should speak to the actual data.

Biggest number for the US is 214.7k but you don't get the fatality rate for the entire population by dividing that by the number of known cases.  That only tells you the rate among known cases, not the total fatality rate.

There is also plenty of evidence now that there has been a wealth of false positives as I suggested early on. The early kits were broad based tests, not specific for Covid-19.

Just one article on the subject. https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30453-7/fulltext

 

Fact remains that we don't know what we don't know and stating we know (either side) is just patently false in most cases.

 

Edited October 5, 2020 by thecampster

[AHF]

Just now, thecampster said:

There is also plenty of evidence now that there has been a wealth of false positives as I suggested early on. The early kits were broad based tests, not specific for Covid-19.

 

That would tend to increase the fatality rate while the number of unreported cases would tend to decrease it.

[AHF]

4 minutes ago, thecampster said:

Day 3 after testing positive.

From what I've seen the timeline is:

Thursday Evening (specific time unknown) Rapid Test Positive

Either Later Thursday Evening or Before 1:00 a.m. EST Friday PCR Positive Confirmation

Friday 5:15 p.m. EST Announced that Trump Is Being Moved to Walter Reed

 

[thecampster]

1 minute ago, AHF said:

That would tend to increase the fatality rate while the number of unreported cases would tend to decrease it.

Very true. However the fatality rate was overblown because in many cases Covid just accelerated already terminal conditions or was a contributing but not sole factor.

Still, the real problem is the overwhelming of health systems.

A case can be made that the actions taken slowed the virus and allowed health systems to keep pace.

But a similar case can be made that the frenzy surrounding the virus led to many people overwhelming the testing system who didn't need tests. See KB's posts.