lavaflow99
In search of the next vacation
Under house arrest? By choice or force?
Do you! I'm not in the business of forcing anyone to do anything. We are all adults here.
Best wishes!
Under house arrest? By choice or force?
Should we trust and follow this Chinese study?
No bueno
Take home points:
- once infected, one can shed the virus up to 6 weeks from initial symptoms (was a small sample size though)
- those more likely to shed longer are those older or with underlying health issues
- 14 day isolation post infection isn't enough (the 14 day isolation should only apply to those who have been exposed to see if symptoms will appear)
Viral Shedding Continues Up to 6 Weeks After Coronavirus Symptom Onset
By Marilynn Larkin
April 28, 2020
- ADD TO EMAIL ALERTS
NEW YORK (Reuters Health) - Patients may continue to shed the SARS-CoV-2 virus for up to six weeks after symptoms emerge, a small study of recovered COVID-19 patients suggests.
"In the convalescence period, a trace of virus may still be detected," Dr. Sheng Zhang of Huazhong University of Science and Technology in Wuhan told Reuters Health by email. "However, similar to other virus infections, this is not indicative of the transmission ability of the infected individual."
Dr. Zhang and colleagues summarized their experience with 56 COVID-19 patients (median age 55; 61% men) admitted to Tongi Hospital in Wuhan in January and February. Throat or deep nasal cavity swab samples were collected on different dates after symptom onset. SARS-CoV-2 was diagnosed by real-time reverse transcription polymerase chain reaction (RT-PCR) assays All patients had mild-moderate infection.
As reported in Clinical Infectious Diseases, 299 RT-PCR assays were performed (about five tests per patient). The longest duration between symptom onset and an RT-PCR test was 42 days, whereas the median duration was 24 days.
In the first three weeks after symptom onset, the majority of RT-PCR results were positive for SARS-CoV-2. From week three onward, negative results increased. All tests were negative at week six after symptom onset.
The rate of positive results was highest at week one (100%), followed by 89.3%, 66.1%, 32.1%, 5.4% and 0% at weeks two, three, four, five and six, respectively.
Patients were further divided into non-prolonged and prolonged shedding groups based on nucleic acid conversion time (up to or more than 24 days). Patients with longer viral shedding tended to be older and were more likely to have comorbidities such as diabetes and hypertension.
No patients were transferred to an intensive care unit; all recovered and were discharged from the hospital.
Dr. Zhang said, "I would suggest three consecutive negative RT-PCR results to safely discharge, due to high false-negative rate" of nasal or throat swabs.
From a public health perspective, he added, "I need to emphasize that the public should not be scared by those seemingly 'prolonged' positive cases. It is way harder to prove 'no transmission ability' than 'potentially transmissible.'"
Dr. Jack Lipton, Chair of the Department of Translational Neuroscience at Michigan State University College of Human Medicine in Ann Arbor commented in an email to Reuters Health, "The study demonstrates that repeated testing is absolutely necessary. In our clinical trial of university personnel at MSU, we have a young healthy subject with mild symptoms who has tested positive five times over four weeks. People need to realize that a 14-day isolation is appropriate for seeing whether one will develop symptoms after a known exposure to an infected person. Fourteen days is not a sufficient amount of time to be infected, recover and then be virus free."
Dr. Robert Quigley, Senior Vice President and Regional Medical Director of International SOS, noted in an email to Reuters Health, "The question that remains is how great does the viral load need to be to infect another person if in fact the viral load actually decreases over time. Regardless, until this virologic feature is defined, it is clear that infected healthcare professionals (HCPs) should have two consecutive negative tests before returning to the healthcare arena where they could potentially infect a fragile patient."
"It is unclear when non-HCPs can return to the workplace after testing positive for COVID-19," he added. "This study implies that the absence of symptoms may not eliminate the risk of transmission to co-workers for up to 42 days post the onset of symptoms. Such conclusions could clearly impact our present practices of quarantine and isolation."
Dr. Taylor Heald-Sargent, an infectious diseases fellow at the Ann and Robert H. Lurie Children's Hospital of Chicago who studied coronaviruses for her PhD, commented by email that the study "confirms other reports that older patients with other medical issues are more at risk for severe disease. This could mean that this patient population has immune systems that are unable to efficiently clear infection. However, more research is needed to explore that hypothesis."
"One limitation is that (the study) focused on one geographic location," she told Reuters Health. "However, it seems likely that these results would be similar to other countries, including the United States."
https://www.medscape.com/viewarticl...429_MSCPEDIT&uac=117087MK&impID=2363843&faf=1
I support the quarantine measures that are in effect in my state (business and school closures, recommended face masks during limited trips to essential services). I also support consequences for people who flagrantly violate the recommendations.Under house arrest? By choice or force?
The information from the CDC is all filtered through the Trump administration. One of the first things that Trump did in this crisis was order the CDC to run all press releases by Pence's office first. That was because someone who worked for the CDC gave an early warning about the coronavirus and the stock market took a huge dip.So don't trust the information on CDC? Who do we trust?
I appreciate your views. What type of consequence do you support that you feel is appropriate?I support the quarantine measures that are in effect in my state (business and school closures, recommended face masks during limited trips to essential services). I also support consequences for people who flagrantly violate the recommendations.
Yeah I read they were allowing people to do their own front of the nose test to cut down on the amount of PPE needed. . I also read the most accurate results come from that deep swab because that area has shown to have the highest concentration of virus. I'm just trying to think about reasons for negatives when someone is symptomatic and probably positive.My Sister got the test done ... they went deeeeeeep, she said it is so painful. I believe I read somewhere they don’t need to go so deep.
Jail, because they have space after releasing inmates for fear of spreading covid 19I appreciate your views. What type of consequence do you support that you feel is appropriate?
Jail?Jail, because they have space after releasing inmates for fear of spreading covid 19
I think the consequence should be proportional to the offense. In my home state, a judge placed someone on house arrest for violating a quarantine order. I think that’s warranted.I appreciate your views. What type of consequence do you support that you feel is appropriate?
Jail?
So if I walk outside my yard right now, police should arrest me and send me to jail?
Oh you mean arrest for activities such as a house party, right or protest? What about funerals and walking in groups to get exercise?
Jail! Several cities have space vacated by criminals.Jail?
So if I walk outside my yard right now, police should arrest me and send me to jail?
Oh you mean arrest for activities such as a house party, right or protest? What about funerals and walking in groups to get exercise?
Doctors make the worst patients.I couldnt personally do a deep swab. When they tried to put a feeding tube, then a camera down my nose it was a firm nope! I almost had to fight my nurse cause I said no and she tried to continue with it. no means no lol
I don't understand why people resist the shelter in place --- I'm in the epicenter of the epicenter and I only go out for necessities --- NO ONE BOTHERS ME. This is all voluntary for the greater good. No body locked me into my apt.
I don’t get it either. I have a white colleague in Georgia and when they opened the barbershops and hair salons on Friday he proudly announced on Twitter how great it felt to get a haircut. A-hole. He’s a republican so I know he was trying to prove a point. I read somewhere some how this pandemic has turned public health into a progressive issue and economic health into a conservative issue. I have a vested interest in both as should every American.I don't understand why people resist the shelter in place --- I'm in the epicenter of the epicenter and I only go out for necessities --- NO ONE BOTHERS ME. This is all voluntary for the greater good. No body locked me into my apt.
IKR lol.. although I'm a nurse practitioner not a doctor. :0)Doctors make the worst patients.
Got it. You gotta be patient. We just don't know whats going to happen. I promise you. I'd rather have my oldest at regular school, not a day care---so she can see her friends, talk with her favorite teacher, see her Coach and other adults in her life that have impacted her greatly. My oldest daughter JUST started Kindergarten and I swear she was MADE for it...she finally has a teacher who understand her, who I really like. I wish I could keep her teacher for every single year she is in school. Homeschooling has been extremely stressful for me....I'd rather not wear a stuffy N95 or deal with clients remotely. I don't love working from home...but I can't take any chances with my kids. I watched my oldest almost die several times. She was on a ventilator the 1st 2 months of her life, only to be put back on when she was 3 mos old. She lived the first 7 months of her life in a hospital. I'm not entirely sure my kid would survive being vented again. I wouldn't survive seeing it. It was the absolute lowest part of my life to this day. I am not willing to take any chances for the sake of "trying it out and seeing." I really need some better guarantees. It doesn't mean I'm living in FEAR. It just means I'm doing my job as a parent to ensure her safety...unlike Dr. Oz who'd sacrifice 2-3% of kids for the sake of resuming school. Or this President who is all over the place.No. Lol. I am just providing the information from CDC.
I am in a damned if I do, damned if I don't situation.
Doctor takes to streets to help black communities get tested for COVID-19
2 hrs ago
a man and a woman taking a selfie in a car: Dr. Ala Stanford leans into car to test an unidentified patient for COVID-19 in Philadelphia.
‘Hallelujah that God made a way,” said Gwen Carter as she waited to be tested for COVID-19 at Mt. Airy Church of God in Christ in Philadelphia on Friday.
Stanford has tested more than 1,500 deeply appreciative residents in some of the city’s poorest neighborhoods. She does not charge a dime.
In her hometown of Philadelphia, blacks make up the majority of the population, and nearly half of the coronavirus cases.
Amid concerns in the health care community about the disproportionate impact COVID-19 is having on black and brown communities, Stanford decided to take action.
“ I just couldn't be part of another town hall meeting or watch another webinar or talk about how pervasive the social determinants of health are and not do anything,” she told ABC News Live Anchor Linsey Davis.
As a pediatric surgeon in a private practice, she had access to some tests and PPE. She rented a van and loaded it up. Her husband got in the driver's seat and they hit the streets, making ‘house calls’ to residents who badly needed tests.
“We got our team together... it took literally 48 hours to get it together,” she said.
Just like that the “Black Doctors COVID19 Consortium” was born-- a group of medical professionals who assemble in church parking lots with protective gear, and highly-coveted coronavirus tests.
“We basically set up like a triage unit... every time we go we pack up everything it comes out of the van, we put everything up, we have a registration,” Stanford said.
By car, by foot, any way they can. Hundreds and hundreds show up.
They wait while socially distanced-- hoping they will be the lucky ones to get a test.
“The need is great... It just confirms to us that we’re exactly where we need to be testing these communities,” Stanford added.
They’ve hit more than half a dozen Philadelphia area churches, and Stanford and her team of volunteers don’t plan to stop any time soon.
Philadelphia is the birthplace of America, and home to the Liberty Bell-- but the city is also the poorest big city in the country-- according to the latest U.S. Census numbers, 24.9% of the city’s nearly 1.6 million residents live in poverty.
And those in poverty-- are having a significantly harder time getting access to tests.
Epidemiologist Dr. Usama Bilal is tracking who is getting tested by zip code.
Shortage of black blood donors
And now, the Red Cross flagging a new concern for blacks, a lack of blood donors.
The Red Cross tells ABC News prior to this pandemic blood donations from African Americans accounted for four percent of overall donations. But now-- the Red Cross is facing a dire shortage of donations from black donors.
Donations have dropped by 50 percent since the pandemic began, now accounting for just two percent of donations.
“People may be more concerned about going in to donate blood. And this is particularly problematic where in urban areas you're worried that you might be exposed to COVID-19 going in to donate blood,” Dr. Kimberly Whitley, chairwoman of the Sickle Cell Center at Children’s Hospital of Philadelphia told ABC News.
Those donations are especially critical for those with sickle cell disease.
“African-American donors really need to come out and donate for children and adults living with sickle cell disease because their red cell units are going to be more likely to match those individuals who need the transfusions,” Dr. Whitley added.
Some 98% of those diagnosed with sickle cell disease are black. Many patients require blood transfusions once a month for their entire life-- that can’t be put on hold during the pandemic.
Children's Hospital of Philadelphia is one of the country’s largest comprehensive sickle cell centers, and they are donating thousands of masks and hand sanitizers to the families of young people with the disease.
Sickle cell disease patients have weaker immune systems-- making the importance of testing everyone who interacts with them for COVID-19 critical.
As it is well documented, not every COVID-19 patient has symptoms.
Pastor Alyn Waller, who leads Philadelphia’s largest church, Enon Tabernacle, was one of those.
Waller invited Stanford to test at his church, hoping to spread awareness of the importance of being tested.
© Pastor Marshall Mitchell via Black Doctors Covid19 Consortium Dr. Ala Stanford leans into car to test an unidentified patient for COVID-19 in Philadelphia.
“I was just doing it not expecting to be positive. But, expecting to just show people that it really doesn’t hurt when it goes up your nose and so the last thing I expected.. Was to get a positive result,” Pastor Waller told ABC News. That day at Enon-- Dr. Stanford and her team tested 350 people. Their positive rate has been hovering between 18-20%.
“Now I think I’m on assignment, because I don’t feel bad and I can speak up for people that may not feel good enough to speak up,” Pastor Waller added. He believes the region, and the country needs more testing.
“Had I not taken that test, I would have been walking around shedding, and potentially infecting someone who would have worse experience with the same virus,” Waller added.
He is now preaching from home to his congregation of more than 12,000 people.
His message-- the black community must take responsibility for their own health.
“We know that when America catches a cold the black community has pneumonia. And so we have to take extra steps to make sure that the message gets out... it's a challenge to the system to recognize that disparities exist already. It's a challenge to our community to recognize that this is real, and we have to take responsibility for our own health,”
Stanford says she’ll continue to test until she feels like Philadelphia officials are doing enough testing. She hopes doctors in other cities see what she’s doing, and get out there to help.
“For my doctors and friends in other cities, you can do this, you know you can do this, and hopefully you have the support of your local and state government. But if you don't, you can do it. It takes one doctor to decide that their practice is going to be about COVID-19, and you just do it,” Stanford said.
© Pastor Marshall Mitchell via Black Doctors Covid19 Consortium Dr. Ala Stanford stands on street with a colleague.
Stanford believes the government could set up a better testing infrastructure to help black communities in as little as a week, “I don’t see the resources, I don’t even see the cash, or the move into getting people tested,” she said.
Philadelphia Congressman Dwight Evans has noticed what Dr. Stanford is doing, he tells ABC News he is ‘very impressed that she took it upon herself to get this done. I needed to help push this to the city's officials. This needs to happen. She deserves the help,” he said.
Until the help comes, it’s Dr. Stanford to the rescue, with a quick tilt of their head, and a five second swab of the nose.
Further proof that in these challenging times, superheroes really don’t need capes, just a mask and a dream.
So don't trust the information on CDC? Who do we trust?
Do we trust to have forced vaccinations?
Hospitals already mandate flu shots.They will run into issues mandating it for work
Some things people are doing, like playing outsiders with their children, away from others or even alone poses no risk of spreading infectionI don't understand why people resist the shelter in place --- I'm in the epicenter of the epicenter and I only go out for necessities --- NO ONE BOTHERS ME. This is all voluntary for the greater good. No body locked me into my apt.