Corona Virus
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Medic21
Minister of Fire
I have yet to find anywhere I have worked that will treat any employee other than a number that’s replaceable at moments notice.
I try to manage people like I did in the Army minus all the bullshit games and it’s served me well. Anywhere I have been a manager every person that leaves on their own wants to come back within a year. It’s amazing how people will work for you when you give the respect, loyalty, and lead them instead of manage them.
I’ve lost a job because I wouldn’t treat employees like chit and the owners thought I was being taken advantage of. To their surprise 50% of the employees I had under me came with me within the year. Some people will never learn. Your employees will make or break your company based on how you treat them.
Sweetwater Sound is local here. The owner has grown a garage business into a multi million dollar business on the principle of treating people like family. He will surpass a Billion in profit in the next couple years. It pretty impressive what he’s accomplished.
Sawset
Minister of Fire
I have a friend in Iowa who is an actuary (ie: insurance, statistics, rates, etc). Iowa ranks #42 in testing, #16 in number of cases, no shelter in place mandate, and are about to relax what restrictions are in place currently, despite additional outbreaks at Tyson foods and a doubling in the last week for retirement homes. No evidence of hitting any kind of peak, or even coming close to flattening of a curve. She mentions they are being set up for, and likely to have, one of the worst round twos in the country. Hmm, what did she say? Round two. She's a statistician. She sees what goes on through a different lense, and is talking about round two.
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As suspected, Covid-19 is not just going for the lungs. This is is a formidable bug that needs to be taken seriously.
Medic21
Minister of Fire
This is part of the cytokine storm that is happening in a very low percentage of pts. It causes DIC, activates the clotting mechanisms on a large scale in the body. Having seen one of these pts last week it is unbelievable as to how sick they get in such a short time. Thank god this is a low frequency type of pt.
We saw, caused, DIC in our trauma pts for years with rapid volume placement with shock. It is one of the ugliest conditions with a poor outcome.
SpaceBus
Minister of Fire
Many PTs are dying from lung hemorrhaging. The virus breaks down the kind of elastic membrane on the outside of the blood vessels. Once the membrane is compromised the vessels burst causing internal bleeding. In addition to the bleeding apparently the natural blood clotting procedure is interrupted and folks just keep bleeding into their lungs. A vent won't save someone from that.
SpaceBus
Minister of Fire
Oh yeah, many folks also get life long lung damage even in "mild" cases.
www.google.com
COVID-19 Lung Damage
COVID-19 can cause lung damage and breathing problems that can persist even after recovery. An expert in lung disease explains.
Medic21
Minister of Fire
Again, this is not the virus that does this. It’s all part of the auto immune response cytokine storm.
This is a body killing itself in these few patients. VERY few patients will experience these issues but, the virus is only the trigger. The Bodybdoes it to itself.
SpaceBus
Minister of Fire
No, the virus literally destroys the Epithelial cells on the outside of the blood vessels and particularly in the lungs, which are full of blood vessels. The vessels burst from the pressure created by the heart. Certainly the neutrophils bombarding the lung tissue doesn't help, but blood pooling in the lungs and causing clotting inside of the aveoli and other lung tissue would cause a decrease in respiration, which ventilation cannot help.
Medic21
Minister of Fire
Redirect Notice
www.google.com
Deadly immune 'storm' caused by emergent flu infections
Scientists have mapped key elements of a severe immune overreaction -— a “cytokine storm” -— that can both sicken and kill patients who are infected with certain strains of flu virus. A cytokine storm is an overproduction of immune cells and their activating compounds (cytokines), which, in a...
www.sciencedaily.com
How Ebola Kills You: It's Not The Virus
Ebola has a nasty reputation for damaging the body, especially its blood vessels. But when you look at the nitty-gritty details of what happens after a person is infected, a surprising fact surfaces.
www.npr.org
I can go in for thousands of articles, publications, and medical studies going back decades. It’s the cytokine storm that does all the damage in the body not the virus itself. As with all auto immune disorders we really don’t have a way to stop it just support the body while it runs it’s course. Anaphylaxis, Addisons Disease, Lupus, etc can be supported not “cured”.
Medic21
Minister of Fire
There is more we don’t know about Cytokines than what we do know. But, the cytokine storm has been associated with poor outcomes in a lot of different viruses.
www.ncbi.nlm.nih.gov
Cytokines, Inflammation and Pain
Cytokines are small secreted proteins released by cells have a specific effect on the interactions and communications between cells. Cytokine is a general name; other names include lymphokine (cytokines made by lymphocytes), monokine (cytokines made by ...
www.ncbi.nlm.nih.gov
Medic21
Minister of Fire
Very good information on current data. At 18min they discuss the immune system and how we now have real data to drive decisions that need to be made. I think the most relevant point is we need to transition from speculation, all me had in the beginning, to know data and facts.
Very true. This virus is a serious disease, attacking or faking out the immune system on multiple fronts. In some cases, it is destroying T cells. The why and how of this is still to be determined. Most nations are pooling resources to solve these puzzles asap under the direction of the WHO. Only the US has chosen to go it alone. A very untimely response IMO. One would think we would have learned by the botched CDC testing early on that time is of the essence here.There is more we don’t know about Cytokines than what we do know. But, the cytokine storm has been associated with poor outcomes in a lot of different viruses.
Cytokines, Inflammation and Pain
Cytokines are small secreted proteins released by cells have a specific effect on the interactions and communications between cells. Cytokine is a general name; other names include lymphokine (cytokines made by lymphocytes), monokine (cytokines made by ...
Medic21
Minister of Fire
We have given cytokines a ton of dedicated research for decades. Personally I trust our research ability over the rest of the world when it comes to this. It’s time to formulate accurate data and plans on our own.
The data is out there and available in our country right now. What started as a good response has not evolved into a practical response as we get that data. Because we are relying on politicians to decide what’s best and not the right people.
Top that with the information bias, people only listen to what they believe is correct, and we have the mess we are in right now.
SpaceBus
Minister of Fire
The cytokene storm absolutely exists, but is not the sole cause of lung hemorrhaging. I'm simply saying that the virus will attack any cell with an ACE2 receptor, and that means Epithelial cells which control blood pressure.
Medic21
Minister of Fire
And, the most recent research is starting to contradict what the scientists initially thought.
That’s the information bias I posted about earlier. You believe, rightfully so, a scientist and then can’t see changes in the research as it progresses.
I subscribe to a bunch of different medical research sites and the information is being bombarded out right now. ALL initial publications 4-6 weeks ago were not peer reviewed publications. Now that peer review process is happening and information vomit is happening.
By the way, the FDA, has issued a safety warning on hydroxychlorquine in the last two days. I think that was a highly touted treatment by a bunch of people here and everywhere else. Information bias...
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But didn't it start in a nursing home in your state?
Andrew Cuomo Under Fire for Directive Requiring Nursing Homes to Accept Coronavirus Patients
New York Gov. Andrew Cuomo issued a directive requiring nursing homes to accept coronavirus patients despite the known risks to the elderly.
www.breitbart.com
Read this about the media's hero Cuomo. A doc & ceo of a nursing home called Mark Levin on 3-26 about this. He didn't believe her at first, thought she was a kook until she convinced him of her creds. Why nothing about this for a month in the news? The Post finally ran an article a few days ago.
Medic21
Minister of Fire
Just based on the number of deadly flu outbreaks in a year in nursing homes common sense should have told every elected official something. Introducing a virus that is more infectious than one that we vaccinate for will decimate nursing homes on a higher level.But didn't it start in a nursing home in your state?
Andrew Cuomo Under Fire for Directive Requiring Nursing Homes to Accept Coronavirus Patients
New York Gov. Andrew Cuomo issued a directive requiring nursing homes to accept coronavirus patients despite the known risks to the elderly.
Read this about the media's hero Cuomo. A doc & ceo of a nursing home called Mark Levin on 3-26 about this. He didn't believe her at first, thought she was a kook until she convinced him of her creds. Why nothing about this for a month in the news? The Post finally ran an article a few days ago.
Locally we had a nurse that went to work for a week with a fever that tested positive after that week. We know there is asymptomatic spread of the virus so that’s not in dispute. No residents have gotten sick or tested positive after a week and all were tested. This tells me that the PPE precautions must actually work. By that nurse wearing a mask, gloves she changed between pts, and hand washing She did not infect anyone else. She hopefully was fired but, it is also proof there is a way to be gone opening up.
Now it looks like it may have started in CA, but the first reported cases were at a nursing home, 35 miles away, in Kirkland, WA. Our local nursing home adopted strict protocols shortly afterward and has stuck with them.
It's not that I don't trust our immunologists, I know a few of them personally, including one that worked at Immunex on the first T-cell pharmaceuticals. Even though we have good internal experts, that is not a reason to not network when solving a large and difficult problem. One never knows where a solution may arise out of a conversation or obscure research. Not networking and trying to go it alone in this situation is not a good idea. There is a propensity here to favor big Pharma here that is also detrimental. This has to be a race to a solution, not a big profit.
SpaceBus
Minister of Fire
I've always said chloroquines are unsafe. What I'm talking about is a recent development. My wife being a nurse, specifically a pediatric respiratory nurse (vent specialist), is paying very close attention to this whole thing. I also basically live every day in a cytokene storm, nobody is sure why. Viruses destroy cells to reproduce. Epithelial cells have ace2 receptors and there are many in the lungs, where the virus seems to "prefer" residence. The ACE2 receptor hijacking is not a new thing either, and has little dispute to my knowledge.
Medic21
Minister of Fire
There was an initial thought that went forth that is was a bigger deal than we have determined. That was along with Motrin and steroids being bad. The fact is steroids, in enormously high dosing is the treatment I’m seeing on the very sick pts. They limit that inflammatory response. I have pushed more steroids IV in the last 6 weeks than my entire career.
SpaceBus
Minister of Fire
Steroids are the only thing that can stop my immune system when it really tries to kill me. Last time I had a crisis my platelets dropped to 5 (150-300 normal) and my neutrophils were so low as to not register. IVIG therapy, prednisone, and dexamethasone are the only drugs that will suppress my immune system enough to live. Thankfully it's been less aggressive lately and I haven't had to take anything for a year. Summer 2018 I got into some poison ivy and the only thing that would stop it was prednisone, which I hate to take. Corticosteroids suck in general and should not be given lightly
Yes and it's isn't quite as horribly irresponsible as many are making it out to be. But wow just the same. Did you?
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