Covid-19, CPAP cleaning regimen

[babydinosnoreless]

Anyone who is sick should self-quarantine. Flu has killed more people than this and yet very few run to the hospital and demand a flu test. I've never been tested for flu and if I get sick now I am not going to run and get tested now. I'm going to stay home until I'm better and not infect others.

Just my own personal opinion. I'm not advocating that for anyone else. Ymmv

So lets compare typical influenza to COVID-19. For the flu, we have the rapid flu test and a few antivirals that can (to some extent) mitigate the illness. Tests are done in the doctor's office while you wait -- anybody can get the flu test. In fact there are around 35 to 40 million done each year in the USA. The tests do a have an issue with false negatives. And, while the effectiveness varies year-to-year, vaccines are widely available. And, yes, influenza causes a significant number of deaths each year.

The novel coronavirus is almost certainly more easily transmitted than the flu. It is also at least an order of magnitude more lethal than the flu. AFAIK, care is primarily supportive in nature. There is no vaccine or "cure". Testing is still extremely limited in the Seattle area. The odds of hospitalization are also much higher. Hospitals have delayed all elective surgeries. Shortages of protective equipment for health care providers is a very real concern.

In one nursing home, there are 180 employees. 47 have tested positive -- there are at least another 25 employees who were tested yesterday or today.

The public health goal is to contain (as much as possible) the number of new infections. This buys time (for vaccine developments and, perhaps, antivirals), avoids swamping the health care system (there are only so many ICU beds -- and things like trauma, stroke, and influenza still happen), and, in an ideal world also reduces the number of deaths. This is a much bigger deal than the the flu (which I would agree the public underestimates) if it gets a good toe hold.

Decent info about who should be tested at:
https://www.kingcounty.gov/depts/health ... covid.aspx

In my state 121 who were tested were negative. Only 12 were positive. That is 121 expensive tests that wasted medical resources and time. Considering all who have died have had what the medical professionals are calling ground glass in their chest , wouldn't it be more productive to use a common and simple ct scan ?

Oh but then these testing companies wouldn't be getting the big government funds.

Call me cynical but this whole thing seems over the top for something that is only really harming old sick people. As one of those high risk category individuals, my opinion is the needs of the many out weigh the needs of the few, save the economy.

https://www.foxnews.com/health/first-us ... -diagnosis

[Jas_williams]

I would think a CT scan was much more expensive than a simple blood test especially the cleanup and downtime afterwards to fully disinfect the scanner

[TropicalDiver]

In my state 121 who were tested were negative. Only 12 were positive. That is 121 expensive tests that wasted medical resources and time. Considering all who have died have had what the medical professionals are calling ground glass in their chest , wouldn't it be more productive to use a common and simple ct scan ?

Oh but then these testing companies wouldn't be getting the big government funds.

Call me cynical but this whole thing seems over the top for something that is only really harming old sick people. As one of those high risk category individuals, my opinion is the needs of the many out weigh the needs of the few, save the economy.

https://www.foxnews.com/health/first-us ... -diagnosis

CT scans have value in determining the extent of lung damage -- but that damage occurs well after the person has contracted the disease. It is also not apparent (thankfully) in milder cases. CT scans, while common, are hardly inexpensive. And from a resources perspective, a drive thru swabbing area with samples labeled, frozen, and shipped to a lab is very efficient. Compared to running folks thru a hospital, to a CT scanner, and needing to clean/sterilize after each patient. And the swab approach greatly reduces the risk of someone catching the virus just from visiting the hospital (and CT). And a CT has an added risk factor of radiation that should be weighed.

The CDC currently suggests anyone born between 1945 and 1965 be tested for Hep C. The prevalence rate in that group is approx. 2.5% -- by your standards, that means that 97 out of 100 tests are "wasted medical resources and time." But, Hep C can be cured (in most cases) and awareness can reduce the rate of subsequent infections. And you can trace back contacts and work to identify and treat those individuals. But it isn't cheap -- the drug course runs about $20k per.

The real questions with any test are how does it guide treatment of the individual and how does it help manage the overall disease in the community. Wouldn't it be good to know if 25% of a fire department can go back to work without imperiling patients calling EMS? Wouldn't it be good to know if a medical professional has a very communicable infection prior to seeing vulnerable patients? Wouldn't it be good to have an idea of the prevalence of the disease and hot spots? Ever go into a grocery store, pharmacy, or restaurant when sick (even if you were self isolating)? Wouldn't it be good to know whether certain treatments work on individuals with COVID-19 before they get to sepsis and organ failure? Wouldn't it be good to know if your kids daycare worker had COVID before your kids go visit your elderly parents? As a worker in a nursing home with patients who test positive, wouldn't you want to know your status? Wouldn't it be good to know if the problem is getting worse before you dial up more disruptive interventions in the economy?

That said, we are past containment and are working on mitigation as the strategy. And the test results don't help much with treatment decisions.

This is not harming "only old sick people." Also vulnerable is the 40 year old with MS, the teen with an organ transplant, and the 30 year old woman being treated for breast cancer. But even if true, why stop with this disease if a person is sick and elderly? CPAPs cost money. Insulin costs money. Broken hips cost money. Cancer treatment costs money. Skip those as well?

The economic impact of this will be large -- but medical costs (especially the test) won't be the driver. We started with supply shock (integrated global supply chain with China) and now have both demand destruction and likely supply shock within the US. Global exports will be down. Tourism is taking a huge hit. In Seattle hotel occupancy is around 20% (rather than 70%). Airlines, cruise lines, and restaurants are all seeing huge drops. Retail is also down. On the medical side, the cost of a test is tiny compared to a week in the ICU...

So lets assume that if no actions were taken, the infection rate was around 50% (probably the upper end although it spreads easily, there is no vaccine, and it is novel). So, 50% of 330 million is 165 million. If the fatality rate is 1%, that would be 1.6 million in the US. That would be worst case -- hence the radical steps being taken now. I am not an expert but without any actions (and to be sure actions are being taken!), it would be reasonable to assume the result would be somewhere between the avian flu in the 1950s and the 1919 event.

[colomom]

In my state 121 who were tested were negative. Only 12 were positive. That is 121 expensive tests that wasted medical resources and time. Considering all who have died have had what the medical professionals are calling ground glass in their chest , wouldn't it be more productive to use a common and simple ct scan ?

Oh but then these testing companies wouldn't be getting the big government funds.

Call me cynical but this whole thing seems over the top for something that is only really harming old sick people. As one of those high risk category individuals, my opinion is the needs of the many out weigh the needs of the few, save the economy.

https://www.foxnews.com/health/first-us ... -diagnosis

CT scans are much, much more costly then the COVID-19 test and there are not enough CT machines to perform the number of tests needed.
"Medicare has released the prices of COVID-19 tests: $35.92 for the tests developed by the Centers for Disease Control and Prevention and $51.33 for all other commercial tests."
https://www.axios.com/medicare-price-cd ... b7377.html
In addition in order to utilize a CT scan you would have to bring possibly infected patients into the hospital heightening the risk of exposure.

Here in Colorado 9 days after the first Coronavirus case was verified the number of positives hit 101, although officials have acknowledge that true numbers are projected to be in the thousands. It is Spring Break in Colorado and last night our Governor issued an executive order closing all downhill ski areas for the next week. I live in a ski town, shutting down Spring Break skiing will be economically devastating to businesses, workers, and to tax revenues. The Governor issued this dramatic measure because Coronavirus is spreading in Colorado's mountain towns and our small hospitals are not equipped to handle the number of patients that will soon overwhelm them.
Here in Colorado it is to late for containment, the focus has now shifted to management.
The $35.92 cost for a COVID-19 test is insignificant when compared to the economic and more importantly human costs of inaction.

[ChicagoGranny]

Here in Colorado it is to late for containment, the focus has now shifted to management.

[babydinosnoreless]

Everyone is entitled to their opinion and mine continues to be its overblown hype. It is good to know that the tests are cheep because reports I saw was that people were getting billed over 3 grand each. Glad that was more media bs. Guess we will all find out more in a few weeks.

[palerider]

Oh but then these testing companies wouldn't be getting the big government funds.

Call me cynical but this whole thing seems over the top for something that is only really harming old sick people. As one of those high risk category individuals, my opinion is the needs of the many out weigh the needs of the few, save the economy.

https://www.foxnews.com/health/first-us ... -diagnosis

You're watching the *WRONG* news.

[palerider]

I would think a CT scan was much more expensive than a simple blood test especially the cleanup and downtime afterwards to fully disinfect the scanner

You have a knack for understatement.

They're setting up *drive through* testing in San Antonio, we're finally catching up with South Korea.

[TropicalDiver]

Everyone is entitled to their opinion and mine continues to be its overblown hype. It is good to know that the tests are cheep because reports I saw was that people were getting billed over 3 grand each. Glad that was more media bs. Guess we will all find out more in a few weeks.

The $3k bills were not media BS -- but rather a lack of attention to detail. In the most widely reported story, the person received about $3k in billings -- the largest being from the ambulance transport. The hospital also sent a bill --which it later claimed was a mistake. The cost of the test itself was not a huge cost.

While we will find out much more in the coming months, we will never know the impact of the road not taken. The Italian health care system is getting very close to running out of ICU beds; they have started to plan for who gets treated and who doesn't. That doesn't just impact COVID 19 patients -- it will impact those with trauma, cancer, strokes, etc.

There is very credible analysis done that suggests what the pandemic would look like without social distancing. The impacts are truly sobering.

Yes, everyone is entitled to their own opinion. I am just curious what portion of that modeling work you disagree with, and why?

A nice explanation of the strategies is at https://www.washingtonpost.com/graphics ... simulator/ and the gravity of the situation at https://www.statnews.com/2020/03/11/fla ... ronavirus/

[palerider]

Everyone is entitled to their opinion and mine continues to be its overblown hype.

Your opinion is wrong about that.
Stop listening to political people and start listening to scientists.

Poke around on this:
https://gisanddata.maps.arcgis.com/apps ... 7b48e9ecf6

It is good to know that the tests are cheep because reports I saw was that people were getting billed over 3 grand each. Glad that was more media bs.

There is a *tremendous* amount of media BS, it's best to NOT watch any of it.

Here's a *doctors* take on the media BS: https://www.youtube.com/watch?v=5CRxyHU ... mb_rel_end

Guess we will all find out more in a few weeks.

Look at what's happening in Italy, they were blasé about the whole thing.

https://www.google.com/search?client=ub ... 8&oe=utf-8

MEDSCAPE, a reference that is often cited here for cpap help:
https://www.medscape.com/viewarticle/926777

I'm very sad that you have the attitude you do.

[palerider]

While we will find out much more in the coming months, we will never know the impact of the road not taken. The Italian health care system is getting very close to running out of ICU beds; they have started to plan for who gets treated and who doesn't. That doesn't just impact COVID 19 patients -- it will impact those with trauma, cancer, strokes, etc.

They are past that point, people are dying because they don't have enough beds, enough ventilators, enough resources.

[ChicagoGranny]

https://www.foxnews.com/health/first-us ... -diagnosis

You are being indoctrinated. Start reading the CDC site, Lancet and New England Journal of Medicine.

If you just must get your information from TV, try BNC and NHK.

[Jas_williams]

I would think a CT scan was much more expensive than a simple blood test especially the cleanup and downtime afterwards to fully disinfect the scanner

You have a knack for understatement.

They're setting up *drive through* testing in San Antonio, we're finally catching up with South Korea.

That’s my British reserve

Just seen the Queues for these drive through testing centres not pleasant

[palerider]

I would think a CT scan was much more expensive than a simple blood test especially the cleanup and downtime afterwards to fully disinfect the scanner

You have a knack for understatement.

They're setting up *drive through* testing in San Antonio, we're finally catching up with South Korea.

That’s my British reserve

Quite!

Just seen the Queues for these drive through testing centres not pleasant

Well, at least you're waiting comfortably in your car, not in a crowded waiting room full of coughing people

[babydinosnoreless]

I very rarely watch tv. I get my news from local (az central.com) and a variety of general yahoo and google searches.

My state is not shutting down and we have one of the oldest populations.

The Arizona Renaissance festival is open. It generally sees about 250,000 people a year. Am not sure if attendance is down but if it is the news is not covering it.

“Yesterday, Governor Doug Ducey was joined by Arizona Department of Health Services Director Dr. Cara Christ and Director of the Division of Emergency Management, Wendy Smith-Reeve who stated that, at this time, the state is not recommending that mass gatherings in Arizona be cancelled.”

There is little concern or panic here and the only thing we can't get is toilet paper and hand sanitizers. It may be that we are above the temps for this illness to thrive. Who knows. I am staying home, avoiding the gym and large crowds but I am not going to panic. More than anything I'm likely to go stir crazy.