[AGL] What's the death rate for us? Read on. Do the math.

[Frances Morey]

Looks to be about 10% of those who get it.
Best,
Frances

On Mon, Mar 16, 2020 at 3:53 PM Charles Loving <lovingigor at gmail.com> wrote:

> Mask of the Red Death by Poe 1842. We are not there yet.
>
> On Mon, Mar 16, 2020 at 12:46 PM J. David Moriaty <moriaty at sbcglobal.net>
> wrote:
>
>> Friend of mine is a medical professional, says this is one of his trusted
>> sources—sort of a digest of actual medical journals.
>>
>>
>>
>> This is your daily JournalFeed.
>> View this email in your browser
>> <https://us3.campaign-archive.com/?e=df48a27992&u=827fa052009e49f904cc3c386&id=2db64b23a8>
>> [image: JournalFeed]
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=4968b0860b&e=df48a27992>
>> COVID-19 | Spoon-Feed Version
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=914031d937&e=df48a27992>*Mar
>> 16, 2020 01:00 am*
>>
>> *Updated March 16, 2020*
>>
>> Written by Clay Smith
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=3de6c67779&e=df48a27992>
>> Spoon Feed
>>
>> This post compiles the most authoritative answers to your questions about
>> COVID-19 all in one place.
>> Why does this matter?
>>
>> COVID-19 is considered a global pandemic
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=ad5a770cb7&e=df48a27992>.
>> In the U.S. alone, there are 330 million people
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=f5526e1401&e=df48a27992>.
>> Estimates are that 60-70% of the population will become infected. That’s
>> between 160 million and 214 million infected in the U.S., of which an
>> estimated 200,000 to 1.7 million may die
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=01ebd46bb8&e=df48a27992>.
>> The U.S. has only 924,000 staffed beds
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=c0be9079c2&e=df48a27992>.
>> These numbers assume no mitigation strategies and may be better than
>> expected. This is a very important topic.
>> COVID-19 - Authoritative Answers In One Place
>>
>> We have previously written about COVID-19 in a broad overview
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=56b1f848ac&e=df48a27992> and
>> a deep dive on the clinical presentation.
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=a1f72e4a61&e=df48a27992> This
>> post is a quick way to find the most reliable sources of information to
>> answer your clinical questions about COVID-19. If you see something that
>> should be added, please help me and leave a comment or use the website’s contact
>> form
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=53bfe46738&e=df48a27992> to
>> let me know.
>> Basic Science
>>
>> *Where can I learn about the coronavirus, SARS-CoV-2, that causes the
>> disease COVID-19?*
>>
>>    -
>>
>>    This article in Nature takes a deep dive into the basic science of
>>    coronaviruses
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=f145b059b7&e=df48a27992>.
>>    Free full text.
>>    -
>>
>>    Mark Denison, MD, Vanderbilt Pediatric Infectious Disease, has been
>>    researching coronaviruses for almost 30 years. See this treasure
>>    trove of publications from the Denison Lab
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=7e7b2fcf8a&e=df48a27992>
>>    .
>>    -
>>
>>    For more on taxonomy and where SARS-CoV-2 fits among other
>>    coronaviruses, see this from Nature Microbiology
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=5e60c44556&e=df48a27992>.
>>    Free full text.
>>
>> Epidemiology
>>
>> *What is the incubation period?*
>>
>>    -
>>
>>    It is 2-14 days
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=293f2f0a8e&e=df48a27992> (CDC);
>>    median 4-5 days.
>>
>> *How is COVID-19 spread?*
>>
>>    -
>>
>>    Respiratory droplets
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=d62f4c5fa4&e=df48a27992>
>>     (CDC)
>>    -
>>
>>    SARS and MERS can live on surfaces for days
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=1139e7aa27&e=df48a27992>.
>>    SARS-CoV-2 is likely to behave similarly.
>>    -
>>
>>    Here is a list of EPA-approved disinfectants with activity against
>>    SARS-CoV-2
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=47a9d445a6&e=df48a27992>
>>    .
>>
>> *If I am infected, can I get infected again?*
>>
>>    -
>>
>>    We don’t know yet
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=1ba55d7ad2&e=df48a27992>
>>    .
>>    -
>>
>>    If other coronaviruses are any indication, immunity wains and
>>    reinfection is common.
>>
>> *What is the case fatality rate for COVID-19?*
>>
>>    -
>>
>>    It depends on the age of the patient.
>>    -
>>
>>    There was 0% mortality in children 0-9 years and 14.8% mortality over
>>    age 80. It was a little worse than seasonal influenza in those aged 10 - 39
>>    years, with case fatality rate of 0.2%. But case fatality steadily rose
>>    with age over ≥40.
>>    -
>>
>>    Case fatality among healthcare providers was 0.3%.
>>    -
>>
>>    This came from the China CDC
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=666809af9c&e=df48a27992>,
>>    which loads *very slowly*. Here is a PDF version
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=11ad509022&e=df48a27992> you
>>    can rapidly download. Citation credit: The Novel Coronavirus Pneumonia
>>    Emergency Response Epidemiology Team. The Epidemiological Characteristics
>>    of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China,
>>    2020[J]. China CDC Weekly, 2020, 2(8): 113-122.
>>
>> *How do I protect myself as a healthcare provider?*
>>
>>    -
>>
>>    See this guidance from the CDC
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=76f20a3897&e=df48a27992>.
>>    Wear a surgical mask, gown (if possible), eye protection, and gloves.
>>    -
>>
>>    If intubating or doing a procedure that creates aerosols, an N-95
>>    mask is recommended
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=e89fefc070&e=df48a27992>
>>    .
>>
>> *What are general ways to protect myself and my family?*
>>
>>    -
>>
>>    The basics make a big difference
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=c20f22ca48&e=df48a27992>
>>     (CDC).
>>    -
>>
>>    Keys: Handwashing (or hand sanitizer with 60% alcohol); social
>>    distance (6 feet); don’t touch eyes, nose, or mouth; avoid close contact
>>    with sick people (obviously meant for a non-healthcare audience); stay home
>>    if sick; cover coughs and sneezes; wear a facemask if sick; disinfect
>>    high-touch surfaces like counters, doorknobs, etc.
>>
>> *Who is at higher risk from infection with COVID-19?*
>>
>>    -
>>
>>    Older patients and those with comorbidities are at greatest risk
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=5b3c3e59c3&e=df48a27992>
>>    .
>>    -
>>
>>    Comorbidities may include diabetes, heart disease, receiving
>>    immunosuppressive medications, chronic lung disease, chronic kidney disease.
>>    -
>>
>>    It is unknown if COVID-19 is more dangerous in pregnancy. The WHO
>>    stated, “pregnant women do not appear to be at higher risk
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=232a8d5d91&e=df48a27992> of
>>    severe disease. In an investigation of 147 pregnant women (64 confirmed, 82
>>    suspected and 1 asymptomatic), 8% had severe disease and 1% were critical.”
>>    The CDC has an entire section devoted to pregnancy and breastfeeding
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=2322792423&e=df48a27992>
>>    .
>>
>> *How widespread is the disease, COVID-19?*
>>
>>    -
>>
>>    The best map is from Johns Hopkins
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=f563db5bff&e=df48a27992>
>>    .
>>    -
>>
>>    The WHO map
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=55efda2ed7&e=df48a27992> is
>>    here.
>>    -
>>
>>    The New York Times
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=9f6293854f&e=df48a27992> has
>>    a frequently updated map as does the CDC
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=7203484ef6&e=df48a27992>
>>    .
>>
>> *What are the best sites to keep informed about this emerging pandemic?*
>>
>>    -
>>
>>    CDC
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=1180cdc8a4&e=df48a27992>
>>     | WHO
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=08876a378d&e=df48a27992>
>>     | NEJM
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=6b6fecf077&e=df48a27992>
>>     | Lancet
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=154e06e644&e=df48a27992>
>>     | BMJ
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=01f88a32f7&e=df48a27992>
>>     | JAMA
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=47ce181adf&e=df48a27992>
>>     | UpToDate
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=125702aca1&e=df48a27992>
>>
>> Clinical Pearls
>>
>> *What is the clinical presentation?*
>>
>>    -
>>
>>    Acute cough is common.
>>    -
>>
>>    Fever on initial presentation was noted in 44% of patients and in
>>    almost 90% during hospitalization at some point. “Fever” was defined as an
>>    axillary temperature ≥ 37.5°C in this large Chinese case series
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=ba75991602&e=df48a27992>
>>    .
>>    -
>>
>>    Some patients had fatigue, headache, myalgia, sore throat, or
>>    shortness of breath. (NEJM).
>>    -
>>
>>    GI symptoms were uncommon. Rhinorrhea, conjunctival injection, tonsil
>>    swelling, and rash were also uncommon.
>>    -
>>
>>    Around 80% have mild disease. They may be treated at home
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=b01df9adf0&e=df48a27992>
>>    .
>>    -
>>
>>    Approximately 14% will develop severe disease
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=971d8ab91d&e=df48a27992> requiring
>>    hospitalization, and 5% will need critical care
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=70c52e6a0c&e=df48a27992>
>>     (JAMA).
>>    -
>>
>>    83% of hospitalized patients with pneumonia had lymphocytopenia,
>>    <1,100. About one-third of these patients had leukopenia and
>>    thrombocytopenia.
>>    -
>>
>>    Over half of early presenters (in the first 2 days) may have no CT
>>    changes
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=dbba92f6c9&e=df48a27992>.
>>    However, most hospitalized patients with pneumonia from COVID-19 develop
>>    bilateral consolidation and ground glass opacities. See these images
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=f22a171b08&e=df48a27992> (AJR).
>>    The American College of Radiology
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=9e09bacaa7&e=df48a27992> does
>>    not recommend CT be used to screen for COVID-19.
>>
>> *Which patients should be tested for possible COVID-19?*
>>
>>    -
>>
>>    The CDC recommendations are found here
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=88af2c4ad5&e=df48a27992>.
>>    These are evolving over time.
>>    -
>>
>>    Patients who have symptoms and are hospitalized, those with
>>    comorbidities, and healthcare workers should be prioritized.
>>
>> *How do I test for it?*
>>
>>    -
>>
>>    This is what you need to know
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=fb090d5910&e=df48a27992> from
>>    the CDC. We use universal viral transport medium and FLOQSwabs in my
>>    facility.
>>    -
>>
>>    If collecting a specimen, you need to watch this 41 second video
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=00f68d84dc&e=df48a27992> on
>>    proper nasopharyngeal sampling technique.
>>
>> *What lab test is done to test for SARS-CoV-2?*
>>
>>    -
>>
>>    It is a Real-Time RT-PCR test.
>>    -
>>
>>    Here are all the details
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=04949d6fed&e=df48a27992>
>>    .
>>
>> *How is COVID-19 treated?*
>>
>>    -
>>
>>    There are no drugs approved for use yet.
>>    -
>>
>>    The CDC recommends avoiding corticosteroids if possible.
>>    -
>>
>>    Trials of remdesivir
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=b23c5db3af&e=df48a27992> are
>>    underway.
>>    -
>>
>>    For now, it is supportive care.
>>
>> *How long do infected patients remain infectious?*
>>
>>    -
>>
>>    According to the WHO-China Joint Mission on Coronavirus Disease 2019
>>    (COVID-19)
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=e445dadbfc&e=df48a27992>,
>>    “ virus can initially be detected in upper respiratory samples 1-2 days
>>    prior to symptom onset and persist for 7-12 days in moderate cases and up
>>    to 2 weeks in severe cases.”
>>
>> *What should healthcare workers do if they are exposed to patients with
>> confirmed COVID-19?*
>>
>>    -
>>
>>    It depends on the risk of the exposure.
>>    -
>>
>>    See this CDC guidance
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=a8f7f1cc55&e=df48a27992>
>>    .
>>
>> *What should healthcare workers do if they develop symptoms?*
>>
>>    -
>>
>>    You should be tested
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=0c1ea6b83a&e=df48a27992>
>>     (CDC).
>>
>> *When should healthcare workers return to work if they test positive for
>> COVID-19?*
>>
>>    -
>>
>>    This must be determined by your employer on a case-by-case basis at
>>    this point.
>>
>> *How should EMS handle confirmed or potential cases of COVID-19?*
>>
>>    -
>>
>>    Here are recommendations for EMS
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=0fbc4124a9&e=df48a27992> related
>>    to COVID-19.
>>
>> *Will there be a vaccine for COVID-19?*
>>
>>    -
>>
>>    It will likely be a while
>>    <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=f411565f94&e=df48a27992>
>>    .
>>    -
>>
>>    But phase 1 trials may begin has early as April.
>>
>>
>> *What additional questions would you like to see answered here?*
>>
>> Please contact us
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=bdc2e383b6&e=df48a27992>.
>> We would love to hear from you.
>>
>>
>> Read in browser »
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=1e8f8c3c09&e=df48a27992>
>> [image: share on Twitter]
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=d08232d887&e=df48a27992>
>>  [image: Like COVID-19 | Spoon-Feed Version on Facebook]
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=e09b67377d&e=df48a27992>
>> Recent Articles:Vascular Access in a Code - IO or IV?
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=227e0a315d&e=df48a27992>
>> IV or IO Antiarrhythmics for OHCA?
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=e53d6a846d&e=df48a27992>
>> Point | Counterpoint - IV Beats IO Epinephrine for OHCA
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=25e6e5fd7f&e=df48a27992>
>> Point | Counterpoint - IO Beats IV Epinephrine for OHCA
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=5b62927ac2&e=df48a27992>
>> Ultrasound for Central Line Placement
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=cef3e6b028&e=df48a27992>
>>
>> [image: Twitter]
>> <http://twitter.com/intent/tweet?text=COVID-19%20%7C%20%20Spoon-Feed%20Version%20-%20http%3A%2F%2Feepurl.com%2FgWlOSb>
>>  [image: Facebook]
>> <http://www.facebook.com/share.php?u=https%3A%2F%2Fus3.campaign-archive.com%2F%3Fu%3D827fa052009e49f904cc3c386%26id%3D2db64b23a8&t=COVID-19%20%7C%20%20Spoon-Feed%20Version>
>>  [image: Pinterest]
>> <http://www.pinterest.com/pin/find/?url=https%3A%2F%2Fus3.campaign-archive.com%2F%3Fu%3D827fa052009e49f904cc3c386%26id%3D2db64b23a8>
>>  [image: LinkedIn]
>> <http://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fus3.campaign-archive.com%2F%3Fu%3D827fa052009e49f904cc3c386%26id%3D2db64b23a8&title=COVID-19%20%7C%20%20Spoon-Feed%20Version>
>>  [image: Google Plus]
>> <https://plus.google.com/share?url=https%3A%2F%2Fus3.campaign-archive.com%2F%3Fu%3D827fa052009e49f904cc3c386%26id%3D2db64b23a8>
>>  [image: Instapaper]
>> <http://www.instapaper.com/hello2?url=https%3A%2F%2Fus3.campaign-archive.com%2F%3Fu%3D827fa052009e49f904cc3c386%26id%3D2db64b23a8&title=COVID-19%20%7C%20%20Spoon-Feed%20Version>
>> Share JournalFeed
>> [image: Share]
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=8bdce10bd2&e=df48a27992>
>> Share
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=0e3b98929c&e=df48a27992>
>> [image: Tweet]
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=d70ed3e28d&e=df48a27992>
>> Tweet
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=def05680ae&e=df48a27992>
>> [image: Forward]
>> <http://us3.forward-to-friend.com/forward?u=827fa052009e49f904cc3c386&id=2db64b23a8&e=df48a27992>
>> Forward
>> <http://us3.forward-to-friend.com/forward?u=827fa052009e49f904cc3c386&id=2db64b23a8&e=df48a27992>
>> Follow JournalFeed
>>
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=779c3588d5&e=df48a27992>
>>
>> <https://journalfeed.us3.list-manage.com/track/click?u=827fa052009e49f904cc3c386&id=9cef60ab65&e=df48a27992>
>> Update Your Email
>> <https://journalfeed.us3.list-manage.com/profile?u=827fa052009e49f904cc3c386&id=a751efdf4b&e=df48a27992>
>> *Copyright © 2020 JournalFeed, All rights reserved.*
>> You are receiving this email because you opted in to the JournalFeed
>> Article-a-day Email list.
>>
>> *Our mailing address is:*
>> JournalFeed
>> 1313 21st Ave S
>> 703 Oxford House
>> Nashville, TN 37232
>>
>> Add us to your address book
>> <https://journalfeed.us3.list-manage.com/vcard?u=827fa052009e49f904cc3c386&id=a751efdf4b>
>>
>>
>> Want to change how you receive these emails?
>> You can update your preferences
>> <https://journalfeed.us3.list-manage.com/profile?u=827fa052009e49f904cc3c386&id=a751efdf4b&e=df48a27992>
>>  or unsubscribe from this list
>> <https://journalfeed.us3.list-manage.com/unsubscribe?u=827fa052009e49f904cc3c386&id=a751efdf4b&e=df48a27992&c=2db64b23a8>
>>
>>
>>
>>
>
> --
> Charlie Loving
>
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <https://pairlist1.pair.net/pipermail/austin-ghetto-list/attachments/20200316/e2d82141/attachment-0001.html>