Coronavirus Updates, Important Information, and Ancedotal Experience

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Captain Suave

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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're probably talking about this:


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
 
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Sanrith Descartes

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You're probably talking about this:


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
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.
 

Sanrith Descartes

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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.

Screenshot_20200412-182811_Samsung Internet.jpg
 

Kiroy

Marine Biologist
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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.

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.
 
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Sanrith Descartes

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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.
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.
 

Sanrith Descartes

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It's Sunday and a holiday to boot. Would be great if this were a legitimate number but it is very likely not.
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 ".
 
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Hoss

Make America's Team Great Again
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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.

View attachment 262052

So (rounding) 103k cases, 7k deaths, 10k recovered. Does that mean 86k in the hospital or suffering from home? Maybe they fail to track the people who are enver hospitalized or something?
 

Khane

Got something right about marriage
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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 ".

We've had a lack of good numbers reporting for 3-4 Sundays in a row. It's not about people not getting sick, hospitalized or dying on Sundays. It's that the reporting seems to take a day off on Sundays.
 
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AngryGerbil

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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.

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.

-----

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.

-----


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.
 
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Sanrith Descartes

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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.

-----

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.

-----


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.
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.
 
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Izo

Tranny Chaser
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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.
 

AngryGerbil

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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.

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?
 

Vanessa

Uncle Tanya
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I'm glad you're well AG; I was thinking about you recently and was worried when you weren't posting as frequently as you usually do.

(Disclaimer: I haven't read this entire thread, I'm really sorry if these vids are reposts)

These two videos really stood out amongst the swath of information videos out there:





Stay safe out there!
 

AngryGerbil

Poet Warrior
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I've already seen the first video and it describes the generally understood pathway of how most viruses work. They hijack a cell and command it to replicate the virus. Yes. But that doesn't mean that he knows exactly how COVID works. I commend him for trying to explain it, but I think he's a bit premature.

That second video... maybe I will watch it tomorrow when I have more time. But in the first 20 seconds the guy makes like 9 different appeals to authority and that really makes me want to puke. Every Hospitalist Doctor on Earth will tell you that Surgeons are not the same thing as them. Surgeons are awesome people and they know a lot of things and are very skilled, to be sure, but they are Mechanics not Medical Doctors.

Don't give me titles and degrees and awards and past achievements, give me actual real and present objective knowledge. You uppity self-conscious little fuck.

I suspect he will be regurgitating the same basic evolutionary viral pathways as Kurtzengatz does. When someone goes through that much trouble to show you how big his dick is in only the first 20 seconds..... well.... color me skeptical.
 

Izo

Tranny Chaser
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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?
No, it’s a mix of both. Here, let me quote LITFL:

https://litfl.com/prone-position-and-mechanical-ventilation/ said:
PHYSIOLOGICAL EFFECTS

Supine position

  • reduction in VC
  • reduction FRC
Prone position

  • 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
 

Burren

Ahn'Qiraj Raider
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@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.

I don't understand this. You're at once stating it's completely true and completely false at the same time?

Also: NYC is indeed a shit hole, regardless of WTF is going on in the world.