Coronavirus Tidbits #25 3-31-20

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Coronavirus Tidbits #   

News:

Please take the time to do this: It is a travesty that publicly funded research is behind a paywall!

@WHOSTP  has extended the comment period on the request for information on public access to peer-reviewed scholarly publications, data, & code resulting from federally funded research to May 6, 2020. 
Comments submitted in response to this notice may be submitted online to Lisa Nichols, Assistant Director for Academic Engagement, OSTP, at publicaccess@ostp.eop.gov. Email submissions should be machinereadable [pdf, doc, txt] and not copyprotected. Submissions should include ‘‘RFI Response: Public Access’’ in the subject line of the message.

Travesty: Captain of aircraft carrier with growing coronavirus outbreak pleads for help from Navy

https://www.sfchronicle.com/bayarea/article/Exclusive-Captain-of-aircraft-carrier-with-15167883.php?

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And another WTH???

DoD said it was making 2,000 ventilators available — Today we learn not one ventilator has shipped because Pentagon hasn’t been told where to send them. And only 2 mill of 5 mill masks shipped. DOD needs to know where to ship we are told. – Barbara Starr, CNN

more at https://www.pbs.org/newshour/health/hhs-holding-up-delivery-of-2000-u-s-ventilators-pentagon-says

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Another sad commentary and indictment of our society’s values:

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For my scrapbook: Not sure whether to post this here or under comic relief for those who know me.

Endearing myself once again in this interview with Teresa McMinn. She’s been doing very good coverage and I appreciate her not censoring or spinning my comments. Health Dept boasts of no cases, having just 228 results back w pop of 71,615 in #Allegany County. Lack of testing means zero cases. It undermines trust for the health system here to treat people like they are toddlers. “Infectious disease specialist: COVID-19 ‘almost certainly’ in Allegany County

I’m not sure whether I should just be proud of her or terrified: RBG is still working with her trainer twice a week!  They use Supreme Court’s private gym, while taking precautions. “The only reason why I didn’t shut the justice down is because, hey, she ain’t having it.”

Diagnostics:

nothing new

Drugs:

No evidence for or against the use of non-steroidal anti-inflammatory drugs such as ibuprofenStudy, led by researchers at King’s College London, also found other types of drugs, such as TNF blockers and JAK inhibitors safe to use.

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Evidence suggests that ACE inhibitors and angiotensin receptor blockers may improve prognosis in COVID-19 hypertensive patients

Recent concerns that common antihypertensive drugs may have a negative effect in COVID-19 patients are not supported by the evidence, report scientists in a new review published in Mayo Clinic Proceedings

Patients with hypertension should continue taking anti-hypertensive medications.

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Shortages of medicines needed for placing patients on ventilators

The medicines include more than a dozen sedatives, anesthetics, painkillers, and muscle relaxants…There has been a 51% increase in demand so far this month for half a dozen different sedatives and anesthetics: propofol, dexmedetomidine, etomidate, ketamine, lorazepam, and midazolam. But the fill rate —  the rate that prescriptions were able to filled and shipped to hospitals —dropped from 100% at the beginning of the month to just 63% on March 24.

Similarly, the demand for three analgesics — hydromorphone, fentanyl, and morphine — rose 67% so far this month, while the fill rate fell from 82% to 73%. Meanwhile, the demand for four neuromuscular blockers — cisatracurium, rocuronium, succinylcholine chloride, and vecuronium — rose 39% while the fill rate plummeted to 70%.

The drug supply chain is one of just-in-time production and supplies…I am not sure that manufacturers are ramping up for the surge…nobody is talking about shortages due to a huge spike in demand.”

“Manufacturers also need time. An injection is going to need at least 21 days in quarantine after it’s manufactured — even if suppliers are ramping up ‘- Erin Fox, Director of drug-information service at University of Utah

This is also part of the fallout from the misguided War on Drugs.”

Devices:

Watch: Ventilators are in high demand for Covid-19 patients. How do ventilators work?

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Masks: If you rep a hospital, put your facility on the map and list what you need. If you have medical equipment that you can provide, click on a hospital to see if they need what you make. Share: protectanurse.com

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DIY Face Shields from my cyberfriend

Epidemiology/Infection control:

See above re devices.

Also

https://twitter.com/racheljulie/status/1245114069339852802?s=20

Nurses/docs are also reporting being issued 1 N-95 mask per week.

Criminal neglect by Trump et. al.

Tips, general reading for public:

Elderly person who lives alone:  I gave her 3 color pieces of paper for her window which faces our window. Green is for I’m OK, yellow for need help with an errand, and red for emergency. Isolation Communication.

Politics:

Trump is escalating his war with governors and will soon blame them for deaths. This is the only certainty in my life at the moment.

Elizabeth Warren: Trump told states they were on their own to purchase medical equipment, so that’s what MA tried to do. But then the federal government outbid MA at least 3 times – and reports show two of our orders were seized by federal authorities.

MA requested supplies from the Strategic National Stockpile nearly a month ago. Only a fraction ever came. Without Trump’s full & consistent use of the DPA, state officials are still scrambling to find essential equipment but the federal govt has created a logistical black hole.

 

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@samaritanspurse won’t hire Jewish, Muslim, Hindu, atheist, agnostic docs to treat #COVID19 patients in its tents in #NYC‘s #CentralPark.

Feel good du jour:

Comic relief:

Perspective/Poem

Thread by ever-thoughtful Sayed A Tabatabai, MD @TheRealDoctorT

https://threadreaderapp.com/thread/1245034272735576065.html

Highly recommend following him.

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Bits of beauty:

IMG_5427 daffodil w orange center

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