Coronavirus Updates, Important Information, and Ancedotal Experience

AngryGerbil

AngryGerbil

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Tuco said:
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So far as I can tell, and maybe I've missed some stuff, Sean Hannity has been consistently wrong about COVID since day one.

He was right about Michael Brown. He is wrong about this.
 
AngryGerbil

AngryGerbil

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Denamian said:
That was my first thought. Why make a ton of people leave their homes and all come through a single location?
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If items of general use are still going to be distributed to the populace, in the age of a pandemic, then it seems to me that dispersed delivery is vastly preferable to centralized brick and mortar.

Either that or we simply do not allow the populace access to items of general use at all, which seems like a recipe for civil war and/or armageddon.
 
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Stave

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Kuriin said:
I cannot stress this enough. We have tents outside our emergency department where we mass triage patients with acute respiratory disorders, regardless of travel. DO NOT go to the hospital unless you are feeling short of breath or you cannot take fluids for longer than a day. If you decide to call 911, let them know the symptoms before paramedics come in without masks.

If you've a fever, take tylenol and motrin combined and then alternate the two. Drink lots and lots of WATER (not tea nor coffee, limit sugar) and electrolytes.

The CDC is decreasing its isolation precautions BECAUSE WE ARE OUT OF MASKS. It IS by definition AIRBORNE, DROPLET, and CONTACT. This means you need an N95, eyewear, gown, booties, and a buffon. We are reusing our N95s as well as PAPRs because of the shortage. Meaning, we are walking into YOUR room with droplets and particles from another patient.
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Wait, I thought ibuprofin or any NSAID was bad to take for the fevers from this and can make it worse? According to the French health minister and some youtube video on here recently.
 
AngryGerbil

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Stave said:
Wait, I thought ibuprofin or any NSAID was bad to take for the fevers from this and can make it worse? According to the French health minister and some youtube video on here recently.
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Fever reducers are a double edged sword.

Typically, it is good advice to reduce the fever because a fever is the body's way of killing the infection.... but can also kill the body. Much like a cytokine storm it's a 'good thing' that can go too far and become a 'bad thing'.

When it comes to taking NSAIDs for COVID.... I probably still need to do some homework, personally. I would not trust any government's advice and would only trust actual real scientific findings. Maybe the government you are listening to (whichever one it might be) is totally on-point and correct. But maybe it's not.

My point being, if you are going to recommend or discourage NSAIDs to yourself or your family, it should not be because this government said to do it or that government said not to do it. It should be because you actually have a functioning understanding of the underlying pathology involved.
 
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AngryGerbil said:
I would not trust any government's advice and would only trust actual real scientific findings. Maybe the government you are listening to (whichever one it might be) is totally on-point and correct. But maybe it's not. ... It should be because you actually have a functioning understanding of the underlying pathology involved.
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Unfortunately, those of us who are not specialized medical researchers are left to rely on the conflicting advice of governments and half-baked (by necessity, since there hasn't been time) anecdotal observations. No one has a detailed, peer-reviewed understanding of the pathology for this particular case. I've asked a number of doctor friends of various specialties, and the response is universally, "Dunno, jury's out."

But in the interim, we have to choose one way or the other.
 
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AngryGerbil

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Captain Suave said:
Unfortunately, those of us who are not specialized medical researchers are left to rely on the conflicting advice of governments and half-baked (by necessity, since there hasn't been time) anecdotal observations. No one has a detailed, peer-reviewed understanding of the pathology for this particular case. I've asked a number of doctor friends of various specialties, and the response is universally, "Dunno, jury's out."

But in the interim, we have to choose one way or the other.
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Yeah the NSAID thing is a tough one.

My gut advice probably aligns with Kuriin Kuriin 's. You want to reduce the fever because it stops the runaway effect of cooking your own brain to death AND it actually makes you feel better.

But I could see a potential scenario in which maybe it is best to not takes NSAIDs because maybe, just maybe, the temperature/fever you produce actually DOES kill the virus you have and the biological system you have evolved is working as intended.

My fear is that the 'don't take NSAIDs' advice is coming from the same people who tell you not to take vaccines or the same people who tell you that garlic can cure cancer.

I don't actually know one way or the other. It's an area I absolutely need to do more homework on.
 
Stave

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This is the video talking about the NSAIDs. Seems like good medical advice and not just an anti-vaxxer type.
 
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Hoss

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Can they test for antibodies for this? My wife thinks she had it back in either December or January. She thought she had a really bad flu. They tested her for that and strep and were like "Who knows, here's some antibiotics, take aspirin if the fever gets bad". I think it lasted about a week. It would be interesting to know if that's what it was.
 
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Burns

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AngryGerbil said:
When it comes to taking NSAIDs for COVID.... I probably still need to do some homework, personally. I would not trust any government's advice and would only trust actual real scientific findings. Maybe the government you are listening to (whichever one it might be) is totally on-point and correct. But maybe it's not.
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Here is where the info originates & contains the references to papers published in notable journals (WHO is now citing this as the basis for their recommendation):


The Lancet said:
Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?


The most distinctive comorbidities of 32 non-survivors from a group of 52 intensive care unit patients with novel coronavirus disease 2019 (COVID-19) in the study by Xiaobo Yang and colleagues were cerebrovascular diseases (22%) and diabetes (22%). Another study included 1099 patients with confirmed COVID-19, of whom 173 had severe disease with comorbidities of hypertension (23·7%), diabetes mellitus (16·2%), coronary heart diseases (5·8%), and cerebrovascular disease (2·3%). In a third study, of 140 patients who were admitted to hospital with COVID-19, 30% had hypertension and 12% had diabetes. Notably, the most frequent comorbidities reported in these three studies of patients with COVID-19 are often treated with angiotensin-converting enzyme (ACE) inhibitors; however, treatment was not assessed in either study.

Human pathogenic coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and SARS-CoV-2) bind to their target cells through angiotensin-converting enzyme 2 (ACE2), which is expressed by epithelial cells of the lung, intestine, kidney, and blood vessels. The expression of ACE2 is substantially increased in patients with type 1 or type 2 diabetes, who are treated with ACE inhibitors and angiotensin II type-I receptor blockers (ARBs). Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2. ACE2 can also be increased by thiazolidinediones and ibuprofen. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. These data suggest that ACE2 expression is increased in diabetes and treatment with ACE inhibitors and ARBs increases ACE2 expression. Consequently, the increased expression of ACE2 would facilitate infection with COVID-19. We therefore hypothesise that diabetes and hypertension treatment with ACE2-stimulating drugs increases the risk of developing severe and fatal COVID-19.

If this hypothesis were to be confirmed, it could lead to a conflict regarding treatment because ACE2 reduces inflammation and has been suggested as a potential new therapy for inflammatory lung diseases, cancer, diabetes, and hypertension. A further aspect that should be investigated is the genetic predisposition for an increased risk of SARS-CoV-2 infection, which might be due to ACE2 polymorphisms that have been linked to diabetes mellitus, cerebral stroke, and hypertension, specifically in Asian populations. Summarising this information, the sensitivity of an individual might result from a combination of both therapy and ACE2 polymorphism.

We suggest that patients with cardiac diseases, hypertension, or diabetes, who are treated with ACE2-increasing drugs, are at higher risk for severe COVID-19 infection and, therefore, should be monitored for ACE2-modulating medications, such as ACE inhibitors or ARBs. Based on a PubMed search on Feb 28, 2020, we did not find any evidence to suggest that antihypertensive calcium channel blockers increased ACE2 expression or activity, therefore these could be a suitable alternative treatment in these patients.
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Aychamo BanBan

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Stave said:
Wait, I thought ibuprofin or any NSAID was bad to take for the fevers from this and can make it worse? According to the French health minister and some youtube video on here recently.
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You are right, in COVID-19 do NOT take NSAIDs.

www.sciencealert.com

Updated: WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms

Editor's note (19 March 2020): Since the publication of this article, the World Health Organization has updated its advice on the official Twitter account: "Based on currently available information, WHO does not recommend against the use of ibuprofen."...
www.sciencealert.com www.sciencealert.com
 
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Aychamo BanBan

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AngryGerbil said:
Fever reducers are a double edged sword.

Typically, it is good advice to reduce the fever because a fever is the body's way of killing the infection.... but can also kill the body. Much like a cytokine storm it's a 'good thing' that can go too far and become a 'bad thing'.

When it comes to taking NSAIDs for COVID.... I probably still need to do some homework, personally. I would not trust any government's advice and would only trust actual real scientific findings. Maybe the government you are listening to (whichever one it might be) is totally on-point and correct. But maybe it's not.

My point being, if you are going to recommend or discourage NSAIDs to yourself or your family, it should not be because this government said to do it or that government said not to do it. It should be because you actually have a functioning understanding of the underlying pathology involved.
Click to expand...

www.sciencealert.com

Updated: WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms

Editor's note (19 March 2020): Since the publication of this article, the World Health Organization has updated its advice on the official Twitter account: "Based on currently available information, WHO does not recommend against the use of ibuprofen."...
www.sciencealert.com www.sciencealert.com
 
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ver_21

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Falxy-US said:
www.sciencealert.com

Updated: WHO Now Doesn't Recommend Avoiding Ibuprofen For COVID-19 Symptoms

Editor's note (19 March 2020): Since the publication of this article, the World Health Organization has updated its advice on the official Twitter account: "Based on currently available information, WHO does not recommend against the use of ibuprofen."...
www.sciencealert.com www.sciencealert.com
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Spoke with my GP about this. Dropped daily low dose aspirin. Wondering about lisinopril (ace inhibitor).
Also there is a decent chance our dogs are harboring covid19.
 
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Qhue

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In theory the ace inhibitor is there to bring you to parity with non hypertensive folks yes? If there is overshoot and the ace level is inhibited well past that of baseline then I could see how that presented a risk.

Then again hypertension is its own risk.


Significant other (germaphobe and hypochondriac) had the sniffles and an elevated temperature yesterday but after some enforced actual proper sleep is right as rain this AM. I fear that people are going to see normal elevated temperature as a 'fever' and freak out.
 
Aychamo BanBan

Aychamo BanBan

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ver_21 said:
Spoke with my GP about this. Dropped daily low dose aspirin. Wondering about lisinopril (ace inhibitor).
Also there is a decent chance our dogs are harboring covid19.
Click to expand...

I had read about 5 days ago that currently they were not recommending patients on ACE inhibitors or ARBs to be switched to something else, but that article seems to suggest differently. What did your GP say? My thoughts are that if you're on an ACE inhibitor for renal protection (diabetes) or cardiac (ie post myocardial infarcation to inhibit ventricular wall remodeling), or CHF, etc, and you are low risk for getting COVID-19, I would not be inclined to switch you. But if you are just on an ace inhibitor for hypertension and not really getting any other benefit from it, I'd be totally fine switching you to something else. The article interestingly mentioned calcium channel blockers. Norvasc (amlodipine) is my goto medication for HTN due to the low number of relatively benign side effects, even though it's not usually recommended as the first line medication.
 
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ver_21

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Falxy-US said:
I had read about 5 days ago that currently they were not recommending patients on ACE inhibitors or ARBs to be switched to something else, but that article seems to suggest differently. What did your GP say? My thoughts are that if you're on an ACE inhibitor for renal protection (diabetes) or cardiac (ie post myocardial infarcation to inhibit ventricular wall remodeling), or CHF, etc, and you are low risk for getting COVID-19, I would not be inclined to switch you. But if you are just on an ace inhibitor for hypertension and not really getting any other benefit from it, I'd be totally fine switching you to something else. The article interestingly mentioned calcium channel blockers. Norvasc (amlodipine) is my goto medication for HTN due to the low number of relatively benign side effects, even though it's not usually recommended as the first line medication.
Click to expand...

I had really hard to treat hypertension until about 3 months ago when I was switched from hydrochlorithiazide to chlorthalidone. So my regimen currently consists of chlorthalidone for diuretic, diltiazem for calcium channel blocker, and 20mg lisinopril as the ace inhibitor.

My doc had no problem saying drop the daily low-dose aspirin. But I didn't know to ask specifically about the lisinopril at the time. Leaving a message about it now. My thought is that the chlorthalidone and diltiazem are doing enough of the heavy lifting to drop lisinopril, but what do I know?
 
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