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Reports of protests are overblown. A few incidents around the country, but nothing major.

5 (45.5%)

A few major incidents in capitals, but nothing much in DC.

5 (45.5%)

A major incident in DC, but nothing much around the country.

0 (0%)

More than 10 capitals have major upheavals, but nothing much in DC.

0 (0%)

A major incident in DC plus more than 10 capitals with significant upheavals.

1 (9.1%)

More than half the capitals around the country have problems with protesters, but DC is quiet.

0 (0%)

DC has major problems, while more than half the capitals around the country also have considerable trouble with protesters.

0 (0%)

Huge disruption to the day.

0 (0%)

Total Members Voted: 9

Voting closed: January 19, 2021, 10:49:21 PM

[bodiddley]

I chatted with my doctor friends for a while this afternoon.
They are pretty sharp and usually well-informed.

My computer died during Chinese New Year, which was then extended an additional week, making it hard for me to find computer repair.  I got my computer back late Monday night and then flew to Europe for a two week vacation Wednesday night.  So from roughly Jan 28 to March 2 I had limited access to news.  Just what I read using my phone and some TV news on vacation (as Italy and Iran outbreaks flared up).

So I was largely out of the loop on what was going on in China during the main part of the outbreak in Hubei.

[bodiddley]

Here's the main takeaways from talking with Shanghai surgeons:

- China did have face mask shortages in the beginning, but being the first country afflicted, they sourced production from all over the world, ramped up domestic production, and went one step beyond by actually buying up some companies and factories abroad that manufactured masks.  That's the Chinese way!  All good foresight, because if Chinese workers got sick and couldn't work at the mask factories, they ensured a supply form overseas.  And ensured a supply even if an overseas sourced country got hit badly with the virus -- and would likely stop exporting masks.  Interesting.

- Standard policy in China is to test anyone who:
1) came into contact with a person who tests positive, going back to 14 days.  Basically what I said the US should do. 
2) otherwise I believe just one symptom -- fever, cough, other flu-like symptoms -- are enough to be eligible for testing.  Though I'd have to get more details about maybe how high the fever needs to be, etc.
3)  has had contact with anyone who has been in Wuhan or Hubei within 14 days prior to any such contact.  That city and province is supposed to be in full mandatory lockdown.

- tests results are generally available within 4 or 5 hours.  Though some cities in China give next day test results.  So quickly it's known if someone should be isolated.  Plus less anxiety awaiting test results.

[barton]

heh

Its not about his use of chloroquine.  Its chugging it that likely killed him.  I knew someone would tie it to the thought process that the drug isnt safe.

And I wasn't disappointed.

What did he win, Mod?

My point wasn't about this particular story,  but rather that randomized clinical trials are needed to determine actual effect,  DOSAGE,  best chemical formula, interaction, etc.   When people self prescribe before this process happens,  even if they aren't using aquarium cleaner,  they can have real problems.   If a TV quack hadn't jumped the gun,  before randomized clinical trials,  and then the "president" chimed in,  there would be less chance of mistakes that,  in the cited story,  proved fatal.   

[barton]

Hey mom and dad! Take one for Applebees!

https://www.cnn.com/2020/03/23/politics/coronavirus-texas-social-distancing-guidelines/index.html

That Calvin Coolidge quote comes to mind.   

[bodiddley]

Apparently it's quick and easy to find out if someone has the virus by taking  a pulmonary CT scan.  The virus leaves a signature pattern, referred to as "ground glass opacities" due to liquid filling and collapsing small air sacs (alveoli) in the lungs.  Apparently the location of such lung damage makes it easy to diagnose a coronavirus case with a high degree of accuracy (as good or better than DNA testing.  So a CT scan can even detect people who are asymptomatic.   

Shanghai apparently has mobile health units equipped with CT scanners, and all or most ambulances as well.  So a city variation of mobile testing where the testing center comes to you.  The conversation moved on, so I didn't get lots of details about this, but quite interesting.  I had seen one report about distinctive lung damage caused by the disease, but I skimmed it real quick and didn't realize that allowed for a quick and accurate testing method.

I hadn't heard anything about that from the US news.  No doubt the US has a shortage of CT scan machines and/or CT technicians and/or people who can read and write.   Basically a CT scan involves taking Xrays from varying angles which are then combined via the magic of computers to make a 3D image.

In Shanghai for those with serious symptoms, they are using pulmonary CT scans to confirm a coronavirus diagnosis and check the extent of lung damage.  As fluid fills your lung air sacs and they collapse, it gets hard to breathe as your lungs can't process respiration as it should.

A good article on this:
https://www.iflscience.com/health-and-medicine/ct-scans-show-what-covid19-can-do-to-your-lungs/

https://radiopaedia.org/articles/ground-glass-opacification-3?lang=gb

Radopaedia is a good source.  Here's their entry on the new coronavirus, which I only quickly skimmed so far:
https://radiopaedia.org/articles/covid-19-3?lang=gb

[barton]

So a CT scan can even detect people who are asymptomatic.       

Are you sure that patients with ground glass opacities could be asymptomatic?   I can see it as a test for differential diagnosis,  but am wondering if someone with scan-visible GG opacities could possibly not be experiencing at least shortness of breath and coughing.   Usually the only people who feel normal with GGO are people who've had years of pulmonary fibrosis or similar problems,  where their O2 perfusion is already a lower baseline.   

[bodiddley]

Not sure.  Maybe they are just asymptomatic for fever which is the primary telltale symptom mostly being looked for to identify possibly infected people.   I'd also assume they would probably have some shortness of breath and likely coughing from the mucus build-up in the lungs.  And fatigue can't be far behind.

At this point, I really don't know at what stage such signature lung damage typically occurs.  I thought it was a secondary later stage. 

I would think the CT scan could be useful to deal with potential false negatives, when a patient seems to have the covid-symptoms and breathing difficulty, but the genetic test comes back negative.

[bodiddley]

I know my one surgeon friend specifically said that a CT scan could even detect asymptomatic cases, as I found that very interesting.  And while they are cerebral aneurysm surgeons, they work in the DSA (digital subtraction angiography) Dept, and so are quite familiar with radiologic procedures.

I'll email him and see if he can qualify or explain that more.  You make a good point, but I don't know enough about lung functions to have an informed opinion.  It is unpleasant when you get bronchitis or similar and there's mucus in your lungs making breathing uncomfortable.  And I imagine actual pneumonia is worse.

[bodiddley]

Maybe we should rev up the Science forum here.  I read lots of articles about Alzheimer's and brain issues, and plenty of other interesting science articles and studies.  And would be happy to follow links to other medical articles that others find. 

I think I have about 5 different science article aggregator sites that I occasionally check in on.  Good places to skim headlines and find the occasional article that blows your mind.  My favorite from the last 5 or 10 years is the study on pigeons who with a little training can detect cancer in mammograms as well as (2 weeks training) or better than trained doctors (after 4 weeks of study).  Absolutely true, absolutely mind-blowing.  It's basically what they do all day -- scan complex patterns on the ground to detect food.  For the last few years whenever I see pigeons, or more often when I see the score of morning doves in my garden, I think, well there's a bunch of little radiologists ...

[bodiddley]

I forget if I linked to this before:
Testing blunders crippled US response as coronavirus spread
Should be mandatory reading, with the timeline of what went wrong.

Be interesting to find out how/why the normally solid CDC flailed.

[barton]

I'm getting tired of the radiologists on our roof who keep shitting on my car.

[bodiddley]

It's actually quite interesting that birds excrete nitrogen waste as white uric acid instead of yellow liquid urea . . .

[josh]

https://www.cnn.com/2020/03/24/politics/anthony-fauci-donald-trump-coronavirus-task-force/index.html

Are Fauci's days in the White House Coronavirus Task Force going to end soon?

It sounds like they may be.

That would be unfortunate, but given the current drift of Trump's thoughts (we don't say don't drive anymore) on the slowdown of the economy, I doubt he will tolerate Fauci's insistence that Trump is dead wrong on this.

Maybe Trump should hire Lt. Gov. Dan "Let's live again!" Patrick as his "medical expert," instead.

[josh]

Meanwhile, it looks as if some doctors are hoarding the supposed cure, to the point of writing prescriptions for themselves and family members. It's so bad in some states that the government is taking action.

https://www.nytimes.com/2020/03/24/business/coronavirus-doctors-hoard-drugs.html?action=click&module=RelatedLinks&pgtype=Article&fbclid=IwAR0fkm57pzVFR6R4YJT7yUoQri2OYOa7csGEBYUdDKe_3DVBTD0BQypgIUI

Which states, in particular?!

The stockpiling has become so worrisome in Idaho, Kentucky, Ohio, Nevada, Oklahoma, North Carolina, and Texas that the boards in those states have issued emergency restrictions or guidelines on how the drugs can be dispensed at pharmacies. More states are expected to follow suit.

Four red states. Three purple states. It will be interesting to see which other states appear on the list, as the restrictions spread (and need to).

[josh]

From the Boston Globe's Fast Forward newsletter:

So what about chloroquine? Trump says there is very strong evidence that it works. No, there isn't. CNN's Dr. Sanjay Gupta took a close look at the one study that was done in France that involved following 20 people for just six days.

Only six of them showed any improvement, and according to former FDA commissioner Scott Gottlieb, that improvement was that the amount of virus detectable in their noses decreased. It could be that the drug reduced so-called "viral shedding," he said, but had no effect on the actual illness. We just don't know.

Gupta said that originally, 26 people started the trial. One left the hospital before the trial finished; another couldn't tolerate the medicine. Three ended up in the intensive care unit, an 11 percent critical care rate. One died, which is a 4 percent mortality rate. Both of those rates are higher than what happens to the general population of people infected with the coronavirus.