Hand Washing the Proper Way

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According to the World Health Organization, properly washing your hands means washing as long as it takes to sing “Happy Birthday” twice — 20 seconds or so.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

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For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

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CDC blasted for removing public data on tests for coronavirus

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Lawmaker blasts CDC for removing public data on number of Americans tested for virus

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The Centers for Disease Control and Prevention has abruptly stopped disclosing the number of Americans tested for the novel coronavirus, a move one lawmaker has called “unacceptable.”

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In recent days, the agency has posted statistics to its website detailing the impact of the virus as it spread across the United States. Figures include a breakdown of confirmed and presumed patients and the total number of deaths, cases and tests administered.

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But as Rep. Mark Pocan (D-Wis.) noted Monday, one of those numbers suddenly vanished from the site.

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“Americans are dying,” Pocan wrote in a letter to CDC director Robert R. Redfield. “We deserve to know how many people have been tested.”.His letter cited comments made Sunday by Scott Gottlieb, the former commissioner of the Food and Drug Administration, who said there could be “hundreds or low thousands” of coronavirus cases in the U.S.

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Given this possibility, Pocan said, “knowing that CDC testing is keeping pace with the likely number of cases is imperative to maintaining public trust.”

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Coronavirus: Expect people you know to die. Take it seriously. Stay calm

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“Coronavirus: an email to my family”

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by an infectious disease epidemiologist.

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“I wrote this originally to share with my family.”

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…”I graduated from the CDC’s Epidemic Intelligence Service and have over 17 years of experience in the field, most of that with CDC.”

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Who should you listen to?

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The CDC and your state health department are your best place for information about COVID-19. (Listen to them before you listen to me.) Be cautious about other sources of information – many of them will not be reliable or accurate.

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How bad is this going to be?

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It’s possible that COVID-19 will be similar to a bad flu year but there are a number of indications that it will be very much like the 1918 Flu Pandemic. To put that in perspective, the 1918 flu did not end civilization as we know it but it was the second-deadliest event of the last 200 years. Expect people you know to die.

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However, there is one critical difference between COVID-19 and the 1918 flu – the 1918 flu virus hit children and young adults particularly hard. COVID-19 seems to be most severe in older adults. Children and young adults generally have mild infections. We are grateful for this.

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What can we expect?

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This is not the zombie apocalypse. Core infrastructure (e.g., power, water, supermarkets, internet, government, etc.) will continue to work, perhaps with some minor disruptions. 

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There will be significant economic disruption: a global recession is very possible and there will probably be significant shortages of some products. The healthcare system will be hit the hardest. The number of people who are likely to get sick is higher than our healthcare systems can probably handle.  

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Daily life will be impacted in important ways. Travel is likely to be limited and public gatherings will probably be canceled. Schools will probably be closed. Expect health departments to start issuing these orders in the near future, especially on the West Coast.

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The acute pandemic will probably last at least for several months and quite possibly for a year or two.

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What can we do?

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We can’t keep COVID-19 from being a global pandemic but the more we can do to slow the spread of the disease, the less severe the impact will be. With that in mind, here are the things you can do:

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Stay calm but take it seriously. This will likely be bad but it’s not the apocalypse.

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Stay home if you’re sick or someone in your house is sick. 

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Leave medical supplies for healthcare workers. You shouldn’t be stockpiling masks or other medical supplies. They are needed in hospitals to keep our healthcare workers healthy.

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Wash your hands. Get in the habit of frequently washing your hands thoroughly and covering your cough.

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Minimize your exposure. Now that we’re starting to see community transmission in the U.S., it’s probably time to start cutting back on your exposure to other people. Depending on your circumstances, consider:

• Canceling non-essential travel

• Avoiding large-scale gatherings

• Working from home if possible

• Minimizing direct contact with others including hand shakes and hugs

• Reducing your trips out of the house. If possible, shop for two weeks of groceries at once or consider having your groceries delivered. Stay home and cook instead of going to a restaurant.
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Remember, keep calm and prepare. This is likely to be bad but if we respond calmly and thoughtfully we can handle it.

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Others have added: no more fist bumps or hand shakes. Elbow bumps or, as they are doing in China, toe bumps.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

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Coronavirus Test Kits Alarming Impurities, Contaminated

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From AXIOS

Test Kits May Have Been Contaminated

 March 1, 2020

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Behind the scenes: The FDA official who visited the Atlanta lab, Timothy Stenzel, is the director of the Office of In Vitro Diagnostics and Radiological Health.

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• About a week ago, when the Secretary of Health and Human Services Alex Azar was under extreme pressure over the delays in getting coronavirus testing kits to market, Stenzel traveled to Atlanta to help troubleshoot whatever technical problems might have been occurring with the tests.

• Stenzel was alarmed by the procedures he witnessed in the Atlanta laboratory and raised concerns with multiple CDC officials, per a source familiar with the situation in Atlanta.

• Stenzel is a highly-regarded scientist and diagnostics expert. He was on the ground in Atlanta to deal with technical issues and happened to stumble upon the inappropriate procedures and possible contaminants. He is not a laboratory inspector and thus was not charged with producing an inspection report on the lab conditions.

• But he raised the concerns and they have been taken seriously and risen to the highest levels of the U.S. government.

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On Thursday afternoon, the concerns about the Atlanta laboratory were raised in a conference call that included senior government officials from multiple agencies including the Department of Health and Human Services, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.

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• The call’s purpose was to figure out ways to mass produce the testing kits and get them to market quickly.

• The Trump administration says it’s now figured out how to get over those hurdles. An HHS spokesperson promised that by the end of this week, “we will have the capacity to test up to 75,000 individuals” for the coronavirus

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What’s next: The FDA’s manufacturing concerns — which include the possible contamination of testing kits — have also resulted in the Trump administration ordering an independent investigation of the CDC’s Atlanta laboratory, according to senior officials.
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• “HHS has launched an investigation and is assembling a team of non-CDC scientists to better understand the nature and source of the manufacturing defect in the first batch of COVID-19 test kits that were distributed to state health departments and others,” said an HHS spokesperson.

• “HHS/CDC have been transparent with the American people regarding the issue with the manufacturing of the diagnostic and will be transparent with the findings of this investigation.” (But the administration was not transparent about the senior FDA official’s concerns about the conditions and procedures in the Atlanta laboratory.)

• A senior administration official added that the government also moved the manufacturing of the coronavirus tests out of the Atlanta laboratory of CDC.

• The official said that the CDC engaged with a third party contractor on Feb. 20 to help manufacture the testing kits. The official added that the FDA regulator, Stenzel, visited the Atlanta laboratory on Feb. 22.

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Between the lines: Until Thursday, the CDC’s guidance was to only test Americans for the coronavirus if they’d recently traveled to China — or had close contact with someone known to have the virus — and were symptomatic.

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• Under this policy, the CDC initially refused to test a California patient who didn’t fit this criteria but had the coronavirus, although the CDC disputes that it denied doctors’ testing request.

• As of Friday, South Korea had tested 65,000 people for the coronavirus; the U.S. had tested only 459, per Science Magazine. China can reportedly conduct up to 1.6 million tests a week.

• Although the World Health Organization has sent testing kits to 57 other countries, the U.S. decided to make its own.

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There have also been problems with the tests themselves. On Feb. 12, the FDA announced that health labs across the country were having problems validating the CDC’s diagnostic test, Science reports in an in-depth account of what went wrong with the tests.

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The FDA announced yesterday that public health labs can create their own diagnostic test. Scott Becker, the CEO of the Association of Public Health Laboratories, told Science that he expects that public health labs will be able to do 10,000 tests a day by the end of the week.

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A WHO expert explains how China did it. “It’s all about speed.”
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Wash your damn hands.

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“You’re probably doing it wrong.”
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“Wash instead of sanitizing whenever possible” – good idea to review this page:
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“As for hand sanitizer, Larson says it’s important to know that sanitizers are only active as long as they’re on your hands. So even if it makes your hands feel annoyingly wet, keep the sanitizer on for at least 10 seconds.”

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The good news is dear leader is telling his people there is no problem in his crowds. All others remember keep at least 6 feet distance from others, probably more. Ain’t gonna happen at the grocer but give it time.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

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The advertising below is not mine.

In exchange, this blog is less expensive.

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U.S. badly bungled coronavirus testing

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Quoting March 1, 2020, from Science:

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As of Friday, South Korea had tested 65,000 people for the coronavirus; the U.S. had tested only 459, per Science Magazine. China can reportedly conduct up to 1.6 million tests a week. Although the World Health Organization has sent testing kits to 57 other countries, the U.S. decided to make its own.

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.There have also been problems with the tests themselves. On Feb. 12, the FDA announced that health labs across the country were having problems validating the CDC’s diagnostic test, Science reports in an in-depth account of what went wrong with the tests.

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The FDA announced yesterday that public health labs can create their own diagnostic test. Scott Becker, the CEO of the Association of Public Health Laboratories, told Science that he expects that public health labs will be able to do 10,000 tests a day by the end of the week.

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From Common Dreams, February 27, 2020:

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“Mike Pence literally does not believe in science,” tweeted Ocasio-Cortez, a New York Democrat. “It is utterly irresponsible to put him in charge of U.S. coronavirus response as the world sits on the cusp of a pandemic. This decision could cost people their lives. Pence’s past decisions already have.”

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Ocasio-Cortez pointed to Pence’s tenure as Indiana governor, where he she said his “science denial contributed to one of the worst HIV outbreaks in Indiana’s history.”

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“He is not a medical doctor. He is not a health expert,” Ocasio-Cortez wrote. “He is not qualified nor positioned in any way to protect our public health.”

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Gregg Gonsalves—a Yale epidemiologist who co-authored a 2018 paper connecting Pence’s policy decisions as governor to the 2014 HIV outbreak in Scott County, Indiana—denounced the president’s decision to allow Pence to coordinate the administration’s coronavirus response.

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“Over 200 people were infected with HIV in an outbreak, met with ignorance, bumbling, incompetence, and ideological intransigence. Two hundred needlessly infected, now on medication for life at great costs to themselves and the state,” Gonsalves tweeted Thursday morning. “Now Donald Trump has put Mike Pence in charge of coronavirus.”

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“It’s like putting an arsonist in charge of the fire department, a bank robber in charge of the U.S. Mint,” Gonsalves added. “Donald Trump made the choice of putting someone absolutely not up to the task to this crucial position. It endangers us all. This isn’t a Republican or Democratic issue—we have the potential for coronavirus outbreak in the U.S. and we needed to rise above the partisan fray.”

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The material on this site is for informational purposes only.
.
It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

..

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Do you don’t want people to avoid tests or treatment because of a $3,000 medical bill?

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Coronavirus shows the importance of Bernie Sanders & Medicare for All.

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In a pandemic, you don’t want people avoiding getting tested or treated because they can’t afford a $3,000 medical bill. A lot of working families cannot afford that.

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We’re only as safe as the least insured person among us. Everyone has to be covered.

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One American man who flew back from Wuhan with his small daughter was hospitalized at Rady Children’s Hospital in San Diego for several days until the daughter tested negative for coronavirus. After living in Wuhan for 15 years, he did not have American insurance.

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Our CDC had no test kits available so it took many days for results to be flown to CDC and returned. England has now tested 10,000 people on national health insurance. We have tested 420 but many people were untested as kits were not available and they are in our communities spreading the highly contagious virus.

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What is the cost of high-level bio-containment units that function like ICU’s? My guess is that 6 days would easily be $60,000 if not far more.

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This poor man.

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One business man in Florida paid $3500 for a test to prove he was well after flying back from China so he did not have to quarantine for two weeks. His insurance refused to pay. Will yours pay for testing of your family?

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.ed 

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The material on this site is for informational purposes only.
.
It is not legal for me to provide medical advice without an examination.

.
It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

..

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The advertising below is not mine.

In exchange, this blog is less expensive.

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Coronavirus COVID-19 My Plan

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COVID-19   MY PLAN – NOT FOR EVERYONE

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The current coronavirus is SARS-CoV-2.

The influenza from the virus is COVID-19.

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This is not medical advice.

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This plan is not for everyone.

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Consult your doctor for that.

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Surgeon General urges public to stop buying face masks.

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CDC advises wear a mask if you have fever or cough.

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Millions who have no health insurance or who have high deductibles are at highest risk to themselves and all of us. They may work several jobs and be homeless with no ability to wash their hands or buy supplies. We need socialized healthcare that leaves no one out. Their loss could kill you. Help others if you can. Small choices can have a big impact.

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It is said:

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Be humble, for you are made of earth.

Be noble, for you are made of stars.

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I don’t have COVID-19. This is my plan. I have a long list of inflammatory autoimmune medical conditions including lung disease plus creaky debilitating old age. For those above 80 the incidence of death is near 15% vs young with incidence of death 0.2%. If intubated, critically ill mortality was 82%.

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From University of Minnesota recapping JAMA’s study from China of 72,000 cases.

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Report of China WHO Joint Mission February 28 includes mortality rate by comorbidity, i.e. co-existing conditions. Mortality really starts to rise above age 60.

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COVID-19 and Health Care Resource Capability, February 25.

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Since January, I’ve studied and read every case I could find. This is my plan. I am a doctor, sometimes able to diagnose my own condition. I am not officially recommending anything medically to others but they may consider it. Underlying lung disease always grabs me but I prefer quiet peace to recover at home. Or die. I have been deeply blessed with a good life helping others. Pneumonia is the old man’s best friend. It really really is a sweet painless way to go. Death is a decisional process. This body recovers from so many decades and decades of severe flu that hit the lungs hard. I’ve been near coma near death for days on end w flu in past since the big one in 1957. Nothing new here. Do the basics.

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This is not an excuse for suicide – stop those thoughts immediately and get professional help. You will just make it harder for others.

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My affairs are in order. Tax forms finished. Healthcare power of attorney, done. The plan is to do everything to prevent being disabled from illness tho it prolongs this old body.

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Just went thru Christmas season w dry cough – lasting 3 to 4 weeks, lungs literally felt as if caked in cement. Lot of people had exactly same. Reallly wiped out first week, too sick to eat. O2 saturation always remained 97% to 98%. Severe sore throat. No sinus involvement. very strange, widespread in community. Muscles flaring every few days from underlying disease but not clearly from this.

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PLAN

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Most people with the flu do not need hospital care or medical intervention but they are contagious and can infect others even if having no symptoms. That is what makes this flu most dangerous, the risk to others.

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It is recommended to keep a safe distance of at least 6 feet possibly more from infected people. But who are the asymptomatic infectious persons?

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Get 3 months of medication supplies – pay for it if insurance won’t. Save receipt. Get reimbursed later if you can. Shortages of 200 drugs from China may last awhile even if flu lasts only a couple weeks.

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Everyone should have an oximeter to monitor oxygen and pulse – $18 bucks.

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If oxygen is dropping below 96% —- that’s the start of trouble. Likely Pneumonia.

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I plan to wear non latex medical gloves when I’m out, to remind myself not to touch face/eyes. Keep a box in car.

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Seasonal flu is in its second major spike. Get flu vaccine if you have not already. Hospitals are overloaded with it. Don’t count on a bed.

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Coronavirus vaccine will not be available for 18 months and government should offer free to those with limited income.

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Vaccine should be denied it to those who refuse measles vaccines. Measles has a high morbidity and mortality and is the most contagious known virus: if you step into the airspace of someone with measles who passed through 2 hours ago, it is still highly contagious. Not true of anything else. Those people put all of us at extreme risk and should be isolated.

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Isolate yourself if you have the flu.

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COVID-19 Symptoms

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COVID-19 is mainly transmitted from person to person through droplets from coughing or sneezing. Contact with fecal matter from an infected person may also transmit the virus, possibly also contact with urine and tears and contact with surfaces – see disinfection below.

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It’s in the community now. Those with no known exposure including one death so far in Washington of 59 year old man who had other risks. Males seem to get this flu more than females.

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No runny nose, no sinuses involved – at least in most.

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Begins as a dry cough, followed possibly in several days by fever as high as 103.5°F, tight chest, maybe muscle aches or not.  Some said the cough was so severe it caused severe muscle pain just from cough.

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Chest pain and shortness of breath may occur with COVID-19 pneumonia. Those symptoms warrant concern about heart attack. 

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If severe, call 911 and advise you have the flu so they can safely bring you in.

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If someone drives you to ER, telephone from parking lot so they can isolate you. You have contaminated the driver too.

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Don’t contaminate your healthcare personnel! Think about the lives of others.

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STOCK UP

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Stock up on chicken soup. I have chicken broth and a drawer full of various noodles including ramen. You need the salt when dehydrated, not just water. Everyone already has the usual dry beans and canned or frozen veggies, don’t they?

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Some people have 2 years of supplies. Really? That’s sick.

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Gatorade – my niece preferred DripDrop electrolyte powder for her athlete sons. Invented by MD on a relief mission treating life-threatening dehydration. Same sodium, potassium, dextrose, it also includes fructose, vitamin C, magnesium, zinc.

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https://dripdrop.com/collections/dehydration-relief

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Ready a thermometer.

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ALWAYS have supply of  Mucinex every 12 hr. Begin early. Don’t wait, continue well after, especially if dry cough. Avoid antihistamines that dry secretions. You need the opposite.

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Drink plenty of liquids to keep kidneys flushed and loosen lungs.

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Use a humidifier.

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.Sleep apnea machines can be used as a humidifier.

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When lungs are severe, boil 2” water in a large pot w eucalyptus leaves or oregano, towel over the head/pot to capture steam, breathe thru nose or mouth..

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Some like Vick’s plasters on chest but…..

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If urine is dark, drink a lot more fluid. A lot. Keep drinking especially during fever.

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A long hot bath with epsom salts is great for muscle aches and misery.

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Some people may be contagious without ever any symptoms and spread the virus to many others.

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In one study, coronavirus struck 14% of victims again 2 weeks later after recovery and after testing negative they tested positive again. Isolate for at least 14 days, possibly 28 days after your symptoms. They have not given recommendations on this. We simply do not have enough data.

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Do not trust negative tests, nothing is 100%.

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England has tested 10,000. We have tested 420. Faulty tests. CDC guidelines had been far too strict, limiting testing in keeping with lack of supplies. The White House had 700 vacancies at CDC by the first spring after inauguration, cut CDC budget, and gutted the entire pandemic response team in 2018 including the position of Rear Adm. Timothy Ziemer who abruptly departed from his post leading the global health security team on the National Security Council in May 2018. Money ran out on epidemic prevention activities in 39 out of 49 countries – that’s where these diseases can come from.

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Expect at times Fake News from the White House and their favorite media on radio, TV. Many people in power do not believe in science and are very adept at using mind control, flooding the media until millions believe false..

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KIDS

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It may be very mild in kids – isolate them though they feel well. It may be so mild in people, kids especially, they don’t even feel they have it.

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Schools right now, yes absolutely right now, should consider shutting down til end of flu season – talk to your schools early, before this rips through communities like wildfire. Kids are great vectors and some are at risk too.

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It may take forever, but some officials will figure out how to test us at home without exposing offices and medical personnel. Health officials will need to notify others.

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CT scan is unique and definitive.

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CT signs persist after symptoms resolve and should show shrinking lesions. If not, COVID-19 is flaring again or possibly a different pneumonia, e.g. bacterial, is going on.

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Someone pointed out a package dated years ago says coronavirus. There are other coronaviruses, SARS, MERS. This one is SARS-CoV-2. It appeared in humans late 2019.

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DISINFECTION

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It is not yet clear how this coronavirus, SARS-CoV-2, behaves. Other human coronaviruses can be inactivated using common disinfectants and may dissipate at higher temperatures.

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Human coronaviruses can remain infectious on surfaces for up to nine days at room temperature. On copper and steel, about two hours.

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The CDC says it may be possible for a person to become infected by touching a surface or object that has the virus on it and then touching their own mouth, nose or eyes.

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The CDC said there is likely a very low risk of virus spread from products or packaging that are shipped over a period of days or weeks at ambient temperatures.

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Anyone have more to add? Have I said this before, this plan is not for everyone. I have some ability to diagnose as it evolves. Many will die, just as they do every year but we are responsible for the health of others especially the poor, those without medical insurance.

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Why panic? It’s only the body. You’ve had the flu before.

Not much you need to do that you haven’t already done so many times in past.

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Be at peace. Go take a walk and shake the tension off.

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Breathe deeply and do a relaxation exercise.

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Be kind to yourself and others. Love yourself. Deepen your spiritual life. Find joy. Just be.

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The material on this site is for informational purposes only.
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It is not legal for me to provide medical advice without an examination.

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It is not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider.

~~~~~

For My Home Page, click here:  

Welcome to my Weblog on Pain Management!

Please ignore the ads below. They are not from me.

..

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The advertising below is not mine.

In exchange, this blog is less expensive.

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