As for the O2 note, I was reading online about the virus impacting negatively blood cells ability to carry oxygen. Ill try to find an article.
Could be. I just recall it describing the virus adhering to blood cells and restricting their capacity to carry O2 which was driving the hypoxia.You're probably talking about this:
COVID-19:Attacks the 1-Beta Chain of Hemoglobin and Captures the Porphyrin to Inhibit Human Heme Metabolism
The novel coronavirus pneumonia (COVID-19) is an infectious acute respiratory caused by the novel coronavirus. The virus is the positive-strand RNA one with high homology to bat coronavirus. The pathogenic mechanism of the new coronavirus is still unclear, which is a significant obstacle to the...chemrxiv.org
It's a pre-print paper describing how researchers used a couple kinds of computer simulation to model possible molecular interactions with virus proteins. Importantly, not even the authors claim that this is what's actually happening in the human body. It's being spread around a lot with severe lack of context.
One doctor's rebuttal (board format keeps interpreting hyperlink as media):
medium.com/@amdahl/covid-19-debunking-the-hemoglobin-story-ce27773d1096
If it helps, my business is also in Suffolk. While the wave of applications is massive, nearly zero of the 350b has been disbursed. Its a massive shitstorm on twitter hastag #PPPloans . We worked with our bank account rep constantly to get our apps in the day our bank opened their portal (Monday). My best advice is if they haven't already is reach out directly to their account reps at the bank. Even if they have stopped "accepting apps". Hopefully the account rep will assist them with getting their apps at least put in the queue. Our govt screwed the pooch on this by ignoring all of us who were telling them their wasn't enough loan processing in the entire country to handle the amount of apps they were going to be facing. As usual the govt "knew better" and ignored what we all warned about.
Not sure who you bank with but we are with M&T. Our account rep has been giving us personal feedback. We get the boilerplate emails and then we get his emails which are nicer but basically say the same thing. He isn't lying to us though. He tells us he has no idea about timeline and nor doesn anyone else right now. They converted every warm body to loan processing and gave them some basic training.ditto, they even sent an email a couple days ago saying "uhh ya so you're application is just sitting in line and will be procssed eventually"
I submitted my shit about an hour after they opened their portal.
Only 53 new hospitalizations today in the entire state of NY.
You might be right, but I gotta think if you are dying of Coronachan, I'm think you don't say "I'll wait to go to the hospital until tomorrow because today is Easter Sunday ".It's Sunday and a holiday to boot. Would be great if this were a legitimate number but it is very likely not.
Look at NY fatality percentages. NYC is running 50% higher percentage than the other big counties. Either we believe NY city population are dying 50% more often or we believe NYC reporting is bullshit because they are coding every death as Coronachan no matter what.
Occam's Razor.
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You might be right, but I gotta think if you are dying of Coronachan, I'm think you don't say "I'll wait to go to the hospital until tomorrow because today is Easter Sunday ".
As for the O2 note, I was reading online about the virus impacting negatively blood cells ability to carry oxygen. Ill try to find an article.
You know what I think. I think this is that Zul'Gurub poison some asshole brought back to the bazaar in Wuhan on his dismissed pet bat. That's what I think.I've also heard this.
If (if) it is true, then that would explain why Ventilators are not saving lives as was previously expected.
Ventilation is the mechanical movement of air in and out of the lungs. Respiration is the molecular gas-exchange that happens once that air is in the lungs, and it also happens at the level of each individual cell. Each cell 'Respirates' individually as it interacts with the bloodstream.
Hemoglobin are the Red Blood Cells and their job is to carry oxygen from the lungs to the outer tissues, and then pick up waste carbon dioxide from the tissues and deliver them to the lungs so that the lungs can then exhale that carbon dioxide as waste molecules. So then if COVID is attacking the hemoglobin in the blood, then that would mean that it is negatively impacting Respiration both at the level of the Lungs and at the level of the End Cell. In which case, NO amount of Ventilation would solve that problem.
You could pump %100 pure oxygen into the lungs with a Ventilator and it would not matter because the hemoglobin that is tasked with picking up that oxygen and transporting it to the cells is simply not there. It would be like donating a million surgical masks to an Amazon warehouse, but then that warehouse has no trucks with which to deliver them.
I'm not saying that I know for a fact that this is how COVID works, I'm only theorycrafting and saying that IF COVID attacks hemoglobin, then this is how it kills.
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That being said I've also heard other anecdotal stories. A nurse I know at one of my most frequented ERs says that most people are dying of flash pulmonary edema. In other words, their lungs fill up with fluid so fast that it kills them. She says the only chance these people have is if they are ALREADY intubated and ventilated and under ICU observation when the flash pulmonary edema occurs. That if it were to happen to you in the home, and you called 911, it would already be too late.
This suggests that the virus is attacking lung tissue cells and that was what I originally thought I knew about it.
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I dunno. Maybe it attacks lung tissue cells, maybe it attacks hemoglobin. Maybe, for fucks sake, it does both. It is interesting to think, however, that Ventilation in both cases would not be the exact solution and it would rather be the ability of the body to Respirate rather than to Ventilate that would be the killing blow.
This seems to also match up to the reports (non-official as they are) from the EMTs coming back from New York who talk about people who are alert and walking around and breathing heavily, but who still drop dead. The fact that they are walking around and breathing heavily means that they are successfully Ventilating, but perhaps are failing, at a cellular level, to Respirate.
Mmm. We put covid respirator ptt in prone position as to better ventilate the fluidous lungs, distributes fluid more equal in the lung tissue vs supine position, less shunting, better effect of ventilation. ECMO when it’s not enough.
No, it’s a mix of both. Here, let me quote LITFL:I've also heard the about the 'prone position' thing.
Not be be a dick, but wouldn't the prone position assist in actual respiration rather than pure ventilation?
https://litfl.com/prone-position-and-mechanical-ventilation/ said:PHYSIOLOGICAL EFFECTS
Supine position
Prone position
- reduction in VC
- reduction FRC
- optimisation of V/Q matching (increased blood flow to the dependent lung)
- increase in FRC
- reduced atelectasis
- facilitates secretion drainage
- less lung deformation in the prone position (increased homogeneity) -> increased ventilation
- abdomen is less likely to distend when in prone position -> increase in FRC
- heart sits against sternum (rather than left lung) -> lung is less compressed
- decreased transpleural pressure gradient between dependent and non-dependent lung in the prone position
- plateau pressure is more uniformly distributed when prone -> more uniform alveolar ventilation
- recruitment manoeuvres have been shown to be more effective in the prone position
- alterations in chest wall mechanics -> allowing lungs to inflate at lower pressures
- dorsoventral orientation of large airways
@Bandwagon One phenomenon he described was people who were fully alert and able to ambulate, but would have a respiratory rate of 40-50 and a blood oxygen saturation of no more than %70. They would complain of weakness and then 'drop dead' right there. I know for a fact that this EMT is exaggerating, but at the same time, he is one of our better ones. I also know for a fact that there must be at least some kernel of truth to what he is telling me.