I read it wasnt removed but under moderation, i do not want to know about HCQ but the disease , is it being treated correctly, are ventilors being used correct, or delaying intubation a better option.
I read it wasnt removed but under moderation, i do not want to know about HCQ but the disease , is it being treated correctly, are ventilors being used correct, or delaying intubation a better option.
In European countries intubation is being done by ABG parameters, GCS of the patient and respiratory efforts. Not the CT findings. In fact we are not being able to do the CT scans for most patients here in Spain as they are developing type 2 respiratory failure ( extreme drowsiness due to CO2 retention)
It's getting difficult to find the cause of pulmonary oedema specially in younger patients ( can very well be cardiogenic in nature i.e not ARDS)
Wish we could do early intubations!! We have lost few with cerebral hypoxic injury due to late intubation ( nurses, doctors are exhausted, being stretched thin to their absolute limits for days)
Intubation ( specially if the ET tube stays for more than 14 days) has few complications for sure ( mostly tracheal injury, VAP etc) tracheostomy would have been best after 2 weeks.
We are doing percutaneous tracheostomy in some, but not every doctor knowd how to do it and there's enormous pressure on just 3 of us to do all the tracheostomies.
But try to understand one thing, we are trained to work in war/ epidemics, but most of the other doctors ( who are extremely knowledgeable) never have seen this kind of surge in patients.
We all are making mistakes, but early intubation is not one of them ( I am doing at least 8-10 tracheostomy/ day, it's very very stressful and don't know what my friends in India are going to do. It's hard man, I've worked during ebola outbreak in West Africa, but it doesn't get easy. My insomnia is killing me)
But please don't get scared by my personal experience. There must be thousands of doctors everywhere, who are working more calmly and efficiently than me.
Please don't loose faith in your doctors at this time of need. As you need them, they also need your cooperation even more.
There will be more transmissions in India, health system will be stretched to the limits. I have zero faith in Modi and other politicians, but have more faith in Indian doctors than their European counterparts.
Despite the poor infrastructure, constant political interference, general lack of patient- doctor trust, they are doing exceedingly well in all areas of medicine.
Our healthcare is broken, but the medical education system is rock solid ( though government is trying very hard to destroy it by establishing private medical colleges, allowing medical graduates from sub par Russian and Chinese colleges to practice in India) and the products of that system will carry the nation forward in this strange situation.
Just be careful and please don't treat the infected as criminals. I have seen cases of doctors commuting suicide after being tested positive and sent to quarantine. I've seen the extreme depression and alcohol abuse in my wife.
And if possible, stop reading random internet articles. It won't make you more knowledgeable.
Some will make you more scared and the dangerous ones will make you think it as flu, which it is DEFINITELY NOT.
@red dragon: Hey, any information if any vacant building goes as isolation point. What precautions nearby buildings have to take?.
BMC official visited premises of our society and asked our Builder for a proposal to use the empty building, which is pending OC. If it happens, do we have to take extra precautions related to disinfectants?
@red dragon: Hey, any information if any vacant building goes as isolation point. What precautions nearby buildings have to take?.
BMC official visited premises of our society and asked our Builder for a proposal to use the empty building, which is pending OC. If it happens, do we have to take extra precautions related to disinfectants?
I'm not very sure of this. Will ask the experts and get back to you ASAP.
In Madrid they have used two school buildings. But I haven't gone into them.
On a different note, this thing is already taking a toll on the nurses and doctors, this is lack of exposure to stress of this magnitude.
Please tell everyone you know to cooperate with them. They may snap, make nasty remarks , even get violent. Please be patient with them. They are human with families and friends.
Psychologists are of zero help at this point, but only the general public and patients can help them.
I've been trained for situations like these for many years, still feeling the pressure all the time, had plenty of time, but sleep still eluding me.
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HCQS is not an antiviral and it doesn't have any antiviral property. How it is working is still unknown, all we know, it increases intracellular zinc level which inhibits first step of reverse transcriptase.
However most of the other reverse transcriptase inhibitors ( anti HIV) are not working.
How azithromycin is working is another mystery.
Macrolides are known to have some immuno modulatory actions, but what exactly is happening is a major topic of debate.
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Regarding the Bhilwara model, it is nothing new. China implemented even stricter methods. It can never be implemented in a civilized nation. It is Kerala, which is doing things humanely and scientifically.
Is it effective though ? If it is then it counts as an achievement.
Bhilwara was as strict as Wuhan and Wuhan was the most strict in all of China.
What impresses me is 850 teams, conducting surveys of 56,025 houses of 280,937 people in a town of 3.5 million
This is no easy task and they stemmed the outbreak by hunting it ruthlessly within a week. Random samples taken so ensure community transmission does not occur. So Stage 3 never happened. Intensive contact tracing of those found positive.
6,645 people in home quarantine. Out of circulation. I keep pointing out that India's relatively low number of tests does not tell the full story.
Between Mar 22 & 27, nearly half a million homes and over 2 million people surveyed. How do they do that many so fast ??
What's notable about Bhilwara is the initial positive cases were all doctors.
Ruthless containment sounds cool and all but Is this model sustainable ? a lot of people involved for just one town.
How scalable is such a model for the rest of the country. Six months from now will we still be playing whack a mole.
It makes no sense to shut the entire country down. Areas that have less to no cases should be open for business.
You don't want to know what the Chinese did in Wuhan...it is highly possible that super strict containment , tying up people/ shoot on sight etc. are most effective ways to stop an epidemic.
But honestly after seeing so much of sufferings, death, destruction etc I'm not sure of anything anymore.
All of our efforts are just going down the drain. Last night alone heard about 5 suicides in this area.
People are getting reckless, not following anything....and can't blame them.
Nothing much to post, mate. I am completely exhausted.
We are loosing the battle. NOTHING IS WORKING. Though death counts are slightly less, infection is progressing relentlessly, it's defying many basic rules of epidemiology.
Getting positive results from patients who came to ER with appendicitis, pancreatitis, stroke, myocardial infarction, even a child with GB syndrome.
We were testing like crazies and I ordered tests for every ER patient ( separate building from COVID19) for a 8 hour shift, since we had some excess kits...and all these in 8 hours!!
Few of them will suddenly develop severe SOB and will drop dead...this the real picture of Spain... people are dying suddenly ( some are getting tested, some are not)...it's complete chaos.
Same thing is happening with USA, people are just dropping dead within the first day of symptoms.
Thinking of going back as I'm pretty useless at this point.
Even thinking of going to India , will email tonight.
Thanks, hope is all we have now. I was very proud of our work in Czech Republic. Thought how worse can Spain be...now it feels like those Ebola days, only far worse. Economy was already gone there, it was only struggle for life from a virus.
Here it's more complicated, more educated people, fear of loosing more than life.
A owner of a popular coffee shop here, passed away yesterday. He was more worried about his employee's salaries, than his own family ( as they have enough, according to the great man)
How many such beautiful people will we loose in this??
Really I'm wishing the virus to catch me, so that I can lay down on a bed without thousands of thoughts...
I don't know what to say to you as I have no idea about this kind of a life-or-death situation. If its this bad can WHO pull you out of there?
I know that you will make it out okay physically... I just hope you don't get PTSD.
You don't want to know what the Chinese did in Wuhan...it is highly possible that super strict containment , tying up people/ shoot on sight etc. are most effective ways to stop an epidemic.
But honestly after seeing so much of sufferings, death, destruction etc I'm not sure of anything anymore.
All of our efforts are just going down the drain. Last night alone heard about 5 suicides in this area.
People are getting reckless, not following anything....and can't blame them.
I have a fairly good idea if what went on in Wuhan since i've followed people who live there and post about it since Jan. What's fake and what isn't.
Nobody got shot on sight in China. Even the anti-CCP sites don't mention it. But there are reports of that happening in the US during the flu pandemic. Was the US considered civilized then ? lol
What did happen is if you were caught on the street without a mask you got hauled into detention for 14 days. NO exceptions. Families supposed to go int quarantine not showing up were taken out of their homes. Families that would not home quarantine got barricaded in. This is all well known.
Tell me how does Kerela contain hot spots in a humane way ?
Bhilwara means 6k people in quarantine. You said 10 - 20 hot spots.. If they followed the same model we're close to another 100k quarantined bringing the total close to 200k
I have a fairly good idea if what went on in Wuhan since i've followed people who live there and post about it since Jan. What's fake and what isn't.
Nobody got shot on sight in China. Even the anti-CCP sites don't mention it. But there are reports of that happening in the US during the flu pandemic. Was the US considered civilized then ? lol
What did happen is if you were caught on the street without a mask you got hauled into detention for 14 days. NO exceptions. Families supposed to go int quarantine not showing up were taken out of their homes. Families that would not home quarantine got barricaded in. This is all well known.
Tell me how does Kerela contain hot spots in a humane way ?
Bhilwara means 6k people in quarantine. You said 10 - 20 hot spots.. If they followed the same model we're close to another 100k quarantined bringing the total close to 200k
No mate, you know nothing about what was done in Wuhan. Very few unfortunate people do and there was nothing they could do.
I'm tired of arguing with you and giving up. You are a better epidemiologist than me. Congratulations!!
Yes, I can apply for an early exit but won't. They will have to send another consultant to replace me.
Me and my wife are the youngest consultants working in this area of Europe, they will have to send someone much older...that will be very unfair for that person.
I will try to keep on going till next Sunday. Just trying to take one day at a time. Thanks everybody, take care.
