SARS CoV-2 coronavirus / Covid-19 (No tin foil hat silliness please)

They are now. They did leave Auckland airport, drive to Wellington to attend a funeral but apparently they only had contact with one other person which sounds like a tiny funeral. They arrived in NZ via Brisbane so hopefully the contact tracing is happening at Brisbane airport too. They are sisters. Apparently they werent tested on arrival and one had mild sysmptoms but it was attributed to a pre existing condition. Seems madness to me that they werent tested at the airport. From now I think everyone will be tested.

They were allowed to attend the funeral AFTER testing positive. They tested positive before they started the drive. They’d already been in isolation.
 
They were allowed to attend the funeral AFTER testing positive. They tested positive before they started the drive. They’d already been in isolation.

https://www.theguardian.com/world/2...ses-after-women-arrive-from-uk-carrying-virus
"The pair were released early from government quarantine and permitted to drive from the city of Auckland to Wellington, the capital – nearly 650km away – before being diagnosed or even tested, health officials said."
 
Seeing the recent large gatherings of people at protests,raves and beaches it give me a fair bit of confidence going forward that we won't see a second wave as long as the elderly and vulnerable continue to isolate. It is obviously frustrating for them but they will be at risk until there is some kind of vaccine.
 
Seeing the recent large gatherings of people at protests,raves and beaches it give me a fair bit of confidence going forward that we won't see a second wave as long as the elderly and vulnerable continue to isolate. It is obviously frustrating for them but they will be at risk until there is some kind of vaccine.

What part of seeing the recent large gatherings has given you confidence that there will not be a second wave? It has made me feel the complete opposite.
 
So should we have seen the impact from all those large beach gatherings in the numbers by now, if they were going to have a big impact, or is testing such a mess its hard to tell?
 
Seeing the recent large gatherings of people at protests,raves and beaches it give me a fair bit of confidence going forward that we won't see a second wave as long as the elderly and vulnerable continue to isolate. It is obviously frustrating for them but they will be at risk until there is some kind of vaccine.
Speaking from a stateside perspective we are already seeing a ‘second wave’, though that term isn’t really accurate for most places yet. The trend is with places that opened up their economies early, as it was starting before any numbers from protests could’ve substantially kicked in.
 
Thats not how I understand it but I might have it wrong

I though they were allowed to leave quarantine early on the understanding they grieved with relatives but didn't attend the funeral.
 
Just seen this quote on the Beijing outbreak in the Guardian.

Yang Zhanqiu, a deputy director at the pathogen biology department at Wuhan University, told state media he believed the new outbreak involved a more contagious strain of the virus than the one that hit Wuhan at the beginning of the pandemic.

I wonder why he’s saying this?
 
So literally one week into nursery my one year old’s spiking fevers and the wife also generally unwell with loss of smell. Home testing kit it is then. Im asymptomatic.

Managers annoyed as they offered drive in but i accepted a home kit testing which will take 48 hours. Didn't really get my point of high likelihood of a false negative in getting a throat and nasa swab from a poorly one year old in a car seat.
 
Yes but they hadnt been tested at all when they left. UnrelatedPesudo was saying that they had.

Ah. Gotcha. No they hadn't. Whole scheme has now been suspended.
 
So literally one week into nursery my one year old’s spiking fevers and the wife also generally unwell with loss of smell. Home testing kit it is then. Im asymptomatic.

Managers annoyed as they offered drive in but i accepted a home kit testing which will take 48 hours. Didn't really get my point of high likelihood of a false negative in getting a throat and nasa swab from a poorly one year old in a car seat.

Fecking hell. The loss of smell seems to be almost pathognomonic, so chances are high for a positive test for your wife, right?. Be crazy if you swerved the virus while working, only to get taken down by your kid attending nursery. Hope everyone is feeling better soon.
 
Seems to be significant breaking news on a steroid called dexamethasone proven to reduce Covid deaths.

In a trial it reduced deaths by a third in ventilated patients and its claimed if it was used from start of the pandemic it could have saved approx 5,000 lives in UK.
 
Seems to be significant breaking news on a steroid called dexamethasone proven to reduce Covid deaths.

In a trial it reduced deaths by a third in ventilated patients and its claimed if it was used from start of the pandemic it could have saved approx 5,000 lives in UK.

Oh please let that be true.
 
Seeing the recent large gatherings of people at protests,raves and beaches it give me a fair bit of confidence going forward that we won't see a second wave as long as the elderly and vulnerable continue to isolate. It is obviously frustrating for them but they will be at risk until there is some kind of vaccine.

That can't go on forever though. A lot of vulnerable have jobs to return back to, and no employer is going to keep that job for the length of time we'd be talking about here. Especially when the numbers keep dropping.

I'm still holding out hope the shielding ends on the proposed date of end of June, despite knowing its 99% not going to happen.

It's the one thing through all of this that I actually can't believe, (obviously due to affecting myself personally) We're two weeks away from when shielding is pencilled in to end and there has been no confirmation or clarification on if that is going to be the case.
 
Fecking hell. The loss of smell seems to be almost pathognomonic, so chances are high for a positive test for your wife, right?. Be crazy if you swerved the virus while working, only to get taken down by your kid attending nursery. Hope everyone is feeling better soon.

Thanks man. Yes it is but we'll see. I'm hopeful its hayfever which she gets often but was also a bit viral-ly without full blown cough and temp for a few days so just hopeful its non-covid olfactory symptoms. She's less then full time so spends more time with our kid.
 
So was looking at some stats last night for ireland, kids up to the age of 16 account for nearly 10% of the infections. So much for it being an old persons virus
 
Seems to be significant breaking news on a steroid called dexamethasone proven to reduce Covid deaths.

In a trial it reduced deaths by a third in ventilated patients and its claimed if it was used from start of the pandemic it could have saved approx 5,000 lives in UK.
Significant step forward that news
Oh please let that be true.
Steroid successful in treating sickest patients, prevents 1:8 deaths.

https://www.theguardian.com/world/2...revent-deaths-of-sickest-coronavirus-patients

edit: what @Cutch said

I’m surprised this is being talked up as massive breakthrough. I would imagine most of the sickest patients have been getting treated with steroids anyway. It tends to be used to treat all illnesses that have immune mediated inflammatory aspects. Although I guess it’s good to have solid data that it helps.

Could be wrong though. Would be interested to hear opinions from people actually experienced in treating covid patients.
 
So literally one week into nursery my one year old’s spiking fevers and the wife also generally unwell with loss of smell. Home testing kit it is then. Im asymptomatic.

Managers annoyed as they offered drive in but i accepted a home kit testing which will take 48 hours. Didn't really get my point of high likelihood of a false negative in getting a throat and nasa swab from a poorly one year old in a car seat.

My work was almost forcing me to send my son to nursery (he’s one). I refused and after reading this, even more glad I did
 
New-Primark-store-in-Walsall-14.jpg
They look exactly how I expected them to look.
 
I’m surprised this is being talked up as massive breakthrough. I would imagine most of the sickest patients have been getting treated with steroids anyway. It tends to be used to treat all illnesses that have immune mediated inflammatory aspects. Although I guess it’s good to have solid data that it helps.

Could be wrong though. Would be interested to hear opinions from people actually experienced in treating covid patients.

Its been used in ITU at the hospital where I'm working as part of the Recovery trial but haven't been using it on our patient cohort so can't comment but more information here
https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf

A total of 2104 patients were randomised to receive dexamethasone 6 mg once per day (either by mouth or by intravenous injection) for ten days and were compared with 4321 patients randomised to usual care alone.

Among the patients who received usual care alone, 28-day mortality was highest in those who required ventilation (41%), intermediate in those patients who required oxygen only (25%), and lowest among those who did not require any respiratory intervention (13%).

Dexamethasone reduced deaths by one-third in ventilated patients (rate ratio 0.65 [95% confidence interval 0.48 to 0.88]; p=0.0003) and by one fifth in other patients receiving oxygen only (0.80 [0.67 to 0.96]; p=0.0021).

There was no benefit among those patients who did not require respiratory support (1.22 [0.86 to 1.75; p=0.14). Based on these results, 1 death would be prevented by treatment of around 8 ventilated patients or around 25 patients requiring oxygen alone. Given the public health importance of these results, we are now working to publish the full details as soon as possible.

Hmm I'm not sure that the NNT's of 8 and 25 as being significant breakthroughs but somebody else might think different. Also of no use in those who aren't really unwell.
 
My work was almost forcing me to send my son to nursery (he’s one). I refused and after reading this, even more glad I did

I feel you but I mean my one case (which hasn't been proven yet via swabs) might be anecdotal and not reflective of wider science/evidence-base. But don't begrudge you that decision at all.
 
Could be wrong though. Would be interested to hear opinions from people actually experienced in treating covid patients.

https://www.theguardian.com/world/2...revent-deaths-of-sickest-coronavirus-patients

“It is the only drug so far shown to reduce mortality and it reduces it significantly,” said Peter Horby, a professor of emerging infectious diseases in the Nuffield department of medicine, at the University of Oxford, and one of the chief investigators of the trial. “It is a major breakthrough, I think.”

I'll trust his judgement!
 
I’m surprised this is being talked up as massive breakthrough. I would imagine most of the sickest patients have been getting treated with steroids anyway. It tends to be used to treat all illnesses that have immune mediated inflammatory aspects. Although I guess it’s good to have solid data that it helps.

Could be wrong though. Would be interested to hear opinions from people actually experienced in treating covid patients.

Agreed as inflamation is very common. So you would assume steroids have been widely used. Although I think I remember reading something early on that said steroids didn't help SARS but could reduce the immune response.
 
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Its been used in ITU at the hospital where I'm working as part of the Recovery trial but haven't been using it on our patient cohort so can't comment but more information here
https://www.recoverytrial.net/files/recovery_dexamethasone_statement_160620_final.pdf



Hmm I'm not sure that the NNT's of 8 and 25 as being significant breakthroughs but somebody else might think different. Also of no use in those who aren't really unwell.

I remember very early on the noises coming out of Italy/China were that steroids didn’t help. Which was a surprise. So if this means a change to best practice that’s great. Still talking about marginal gains, for the sickest patients. Irrelevant to the vast majority of people who get sick (thankfully)
 
Oral systemic steroids werent/aren’t widely used in covid. Rationale being from SARS systematic reviews studied 29 studies, mostly low quality (25 said no benefit, 4 suggested harm). Even though steroids have clear benefit in sepsis, its use has been not universal as far as I know

Big part of that was WHO guidance which said to avoid systemic steroids in covid, wonder if that’ll change
https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
 
Oral systemic steroids werent/aren’t widely used in covid. Rationale being from SARS systematic reviews studied 29 studies, mostly low quality (25 said no benefit, 4 suggested harm). Even though steroids have clear benefit in sepsis, its use has been not universal as far as I know

Big part of that was WHO guidance which said to avoid systemic steroids in covid, wonder if that’ll change
https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf

Looks like it might.

As an aside, everyone’s been shitting on the UK for their response but some elements have been really impressive. They’ve had a bunch of “hibernated” trials set up and ready to roll, as soon as a pandemic hit. Which not many (any?) EU countries had in place.

I wonder if this study was one of those? This approach (plus the large number of potential subjects!) means the UK will probably be producing the best/highest quality data over the next few months. Hopefully this is just the start.
 
I remember very early on the noises coming out of Italy/China were that steroids didn’t help. Which was a surprise. So if this means a change to best practice that’s great. Still talking about marginal gains, for the sickest patients. Irrelevant to the vast majority of people who get sick (thankfully)

You're right
Just end of May, the Lancet published this
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30749-2/fulltext

Has caused a bit of controversy because joint injections for arthritis have stopped but a lot of reassurance was needed to be given to asthmatics, rheum patients and the Addisonians to continue taking their steroids because they got concerned it would mean they wouldn't do well with immunosuppresion but we told them to shield. And had to highlighted the benefits of continue, a few cases of adrenal crisis came into ED I remember from those abruptly stopping their prednisolone
 
Also. Only just read the full press release. Benefits also in people on oxygen but not ventilated. That’s great. Means a much larger pool of patients that will benefit.

Indeed.

I think methylpred and dexamethasone specifically have always been known to specifically reduce mucous production. Severe bronchorrhea is a massive problem in the weaning process of intubated covid patients, even those who have no pre-existing respiratory condition. For same reason some of the intensivist friends I have in New York swear by Indomethacin.