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3 hours ago, chemgeek said:

these are my recommendations:

 

Thanks! And yay, I have been doing it almost correctly. I sort of "pinched" the other glove while my first hand was still half into the glove, held both gloves with that first hand and discarded the gloves (I made sure to be nearby a bin when I took them off). 

 

Though at times I felt a bit panicky after long grocery shopping+queues when my brain sort of 404'ed and I didn't know what to do with my hands & mask anymore. All is well though. I think. When I have doubts about how correctly I have removed the gloves, I touch as little as possible (mostly with my then clean still clean pinky & ring finger to open a car door) and spray my hands as well as I can. Then make sure to not touch the hand sanitiser bottle until I get home and can wash IT with soap. (Because, if we're going to be precautious, and assume my thumb/indexfinger/middle finger is/are "contaminated" then I got some of "it" on the bottle as well. So spray, discard, disinfect both hands.) So. Much. Hassle. But we'll survive.

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On 5/19/2020 at 1:03 PM, Scalyfreak said:

Remember, no matter how much it sometimes feel like it, idiocy is not actually contagious! 

 

On 5/20/2020 at 8:24 AM, chemgeek said:

I would argue in most cases it's more ignorance (thankfully curable), in some cases it's denial (also curable), and in a small portion of cases, it's willful disregard for the wellbeing of others (which appears to be contagious given how many otherwise compassionate & caring humans I know start taking that tack if exposed to far right propaganda outlets for too long). 

I mean, if you want to get REAL technical there are cases of mass hysteria where you can get conversion disorders and verrry technically you have a neurologic/psychologic problem manifesting physically that not only is contagious, but can be cured with the appropriate neuropsychological approach to the affected community (case example: Le Roy, NY, 2011-2012). 

 

But yeah we still don't have a vaccine for stupid.  Ain't no funding for incurable diseases.

 

53 minutes ago, Scalyfreak said:

 

 

I may have misunderstood, but my understanding is to treat gloves like hand sanitizer... They are a fallback for when you don't have access to soap and water for proper hand washing, but they don't replace hand washing, or make it unnecessary. And for me, who has no idea how to remove them properly, they add little to no additional protection. 

THIS.  For PPE, it acts as an additional barrier that has to be removed properly, and the person underneath has to be cleaned properly too.  If they are not removed correctly, you've just contaminated your hands, and you've wasted a pair of gloves someone else could have used.  

 

21 hours ago, chemgeek said:

PSA: if wearing a mask, it needs to cover your mouth and nose. If you can't breathe like that & the mask you're using is home made, odds are it's made from a non breathable fabric. Make sure to make your mask out of something breathable like cotton. 

 

For info on fabric selection, see below:

https://news.illinois.edu/view/6367/808377

 

If it's a commercial mask or if you have made sure you chose the right fabric, please expect some degree of resistance - air isn't going to flow as quickly through a permeable barrier as it will in open air.  If it's an anxiety trigger, try to take slow, deep breaths and also try to wear it a little each day. I sympathize - having stuff over my face triggers medical trauma for me (long story). Desensitization and getting used to it in an environment that feels safe helps. 

A follow up too: Masks (especially the ones people are wearing outside) are very important for protecting the people around you.  For the most part, if you are in a non medical setting, you do not need a hallowed N95.  If you are working with ill people, you do need the N95.  A regular mask will be much easier to breathe through.  Chemgeek is right to suggest practicing wearing your mask in safe settings if it makes you uncomfortable, in increasing amounts every day.

And your mask should always cover your mouth and nose to be effective.  There are aerosols and droplets that come out of your nose as well as your mouth.  

 

On 5/19/2020 at 7:27 AM, chemgeek said:

(no offense to Americans but your federal government hasn't so much dropped the ball as chucked it into the sun).

I mean, defunding the pandemic response team the minute the current POTUS came into office....really...really helped with that.

 

Updates from the Trenches:  I am not your doctor, please contact your PCP for all your healthcare needs.  The following does not constitute medical advice.

 

Numbers--Overall, we are not starting to plateau, and are still on a slow climb.  However, in some hospitals we are starting to see a decrease in our COVID+ cases.  These numbers will depend on your state, JHU has been doing a solid job of tracking numbers in lieu of the crippled CDC.  It's been difficult to tell how early the virus began circulating here. 

Case fatality rates continue to depend on comorbidities and age.  We don't have any highly specific comorbidities that would help us risk stratify people early on into who will get sick, who will need intubation, and who will die. 

 

Symptoms and Complications: The CDC has a good list of symptoms to look out for.  The important ones that some people may not be as familiar with are anosmia and loss of taste.  Anosmia means loss of smell, and sometimes that can be the only symptom.  It isn't necessarily a reason to panic, but it's an unusual symptom that you can monitor yourself for.  

Some interesting complications that have come out in the news are a rash of strokes that occurred in young people in new york city.  We don't know yet if there's a specific stroke risk increase in patients, but we have been seeing an increase in "thrombotic" (clot forming) events.  Scientists are still researching why the virus causes people with no risk factors to form clots.  This is why you may hear people talking about more strokes.

 

Medications and treatments: There has been some talk of ACE-I (angiotensin converting enzyme inhibitors) being important due to a way the virus uses to enter human cells.  Right now, the current recommendations are if you are on an ACE or an ARB (like lisinopril or losartan), keep taking it.  If you're not on one, don't start.  

Hydroxychloroquine has been pretty well debunked.  It has a bad toxicology profile, and we have seen an increase in hydroxychloroquine overdoses since the start of the epidemic.  If it's not a home med for you, don't take it.  We've also seen a 30-40%  increase in bleach ingestions and poisonings as compared to 2019, according to my hospital's toxicologist.   Hydroxychloroquine has a very very dangerous tox profile, and it worries us more than bleach ingestions.

Remdesivir has shown to decrease time spent ill in patients who can take it early.  There has been difficulty having it equitably distributed to hospitals that need it.  It seems to be a business run issue, rather than a doctor or hospital run issue.

Convalescent plasma is also being used.  This is like a blood donation from a person who has recovered from the virus to someone who is very sick.  There are antibodies in the donated plasma that we hope will help people recover.  I still have to check up on the studies for this to see how well the trials are doing.

 

We are still working on how to best provide supportive care.  Right now, ARDS lung protective strategies are being followed (this is a mathematical rule about how much air should be put into the lungs based on a person's height and ideal body weight).  Most critical care and pulmonolgists will follow this closely.  We are still sorting out the actual picture of the lung.  It doesn't look like high altitude injuries, may look like an acute lung injury (ARDS), but it has it's own unique problems.  Mostly, people who are intubated stay intubated....and stay intubated....and stay intubated.  Getting people's lungs healthy to take them off the vent is taking a long time, and we are still learning about why.  The good news is, our understanding of how to provide supportive care to people with viral respiratory illnesses isn't killing patients right now--but we don't know yet the best ways to improve it to get patients better more quickly.   

 

PPE: If we use it right, it works.  People who get sick go into aerosolizing procedures (like intubations) without gear.  As many of us have been told, this isn't Ebola.  Use the PPE right, and you should do ok.

 

Staying Up to Date: the NYT is doing a great job of offering their COVID related news for free to anyone who signs up.  the WHO and CDC are still posting updates. CovidLit is the NCBI's/PubMed's hub for all literature involving COVID, and I believe all of that is free access.  Most medical and scientific journals are making their literature on COVID free.  For those who are interested, I can post citations in a hot minute.

 

As always, avoiding crowded areas, especially indoors, is a great way to stay safe.  If you have to go indoors, a droplet mask (regular face mask) will help protect everyone from your droplets, and you from everyone else's large droplets.  Soap and water works just as well as hand sanitizer.  Bleach and EtOH is for the outside, not the inside.  Except if it's gin, and then it's definitely ok for the inside in appropriate responsible doses.

 

Stay safe gang.

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4 minutes ago, analoggirl said:

All is well though. I either touch as little as possible (mostly with my then clean still clean pinky & ring finger to open a car door) and spray my hands as well as I can. Then make sure to not touch the hand sanitiser bottle until I get home and can wash IT with soap. So. Much. Hassle. But we'll survive.

 

I have never used my travel sized hand sanitizer bottles as much as I do these days... they go in a jeans pocket, so I can sanitize my hands before I touch anything else, after I leave the grocery store. Then I get home, sanitize the outside of the bottle, wash the clothes I wore, and wash my hands and the rest of me, depending on how many people there were at the places I visited.

 

Serious question: Am I the only one here who sometimes feels silly for treating everything as a deadly biohazard, including my clothes and hair when I've been out? Intellectually I know that we are living in the middle of a pandemic and we have to be super-careful, but I also know that a lot of the people I work with, and a lot of friends and family, are less careful and they seem to be doing perfectly fine and are not ill. Are we too paranoid? 

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2 minutes ago, Scalyfreak said:

Are we too paranoid? 

 

My justification is: I am inconveniencing myself with all these measures. So I better do it properly and leave as little gaps as possible with my current knowledge/capability/sanity.

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7 minutes ago, Treva said:

Staying Up to Date: the NYT is doing a great job of offering their COVID related news for free to anyone who signs up.  the WHO and CDC are still posting updates. CovidLit is the NCBI's/PubMed's hub for all literature involving COVID, and I believe all of that is free access.  Most medical and scientific journals are making their literature on COVID free.  For those who are interested, I can post citations in a hot minute.

 

As far as I have seen (I follow several different news sources), every serious news outlet in Europe and the US has moved all their COVID content to outside the paywall. No one wants to be accused of withholding potentially life saving information.

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Returning to the subject of masks again: 

1. Wearing a mask with your nose uncovered is like wearing safety monacle instead of glasses. It doesn't work.

 

2. A mask is useless:

* Hanging off one ear

* Under your chin

* Hanging off your fingers

 

(I am venting while in line to get into a grocery store. In this line more people are wearing masks incorrectly than correctly and this is how I don't make a disturbance over it.)

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25 minutes ago, chemgeek said:

In this line

 

Way to go avoiding disturbances when you won't be able to quickly get away in case people react without understanding. :) How much distance is there between people in your line?

 

During a particularly long outing I opted to pull my mask down (by the upper part/where the metal is) when there was no-one near, i.e. a lot over 6 feet so I had time to pull it down carefully again. 

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40 minutes ago, analoggirl said:

 

Way to go avoiding disturbances when you won't be able to quickly get away in case people react without understanding. :) How much distance is there between people in your line?

 

During a particularly long outing I opted to pull my mask down (by the upper part/where the metal is) when there was no-one near, i.e. a lot over 6 feet so I had time to pull it down carefully again. 

Barely 6' if that. It was a masking is appropriate setting.

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40 minutes ago, Sloth the Enduring said:

Start coughing, see how quickly people remember how to wear a mask.

Funny to think about but they're actually charging ppl for stuff like that here.

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1 hour ago, Sloth the Enduring said:

Start coughing, see how quickly people remember how to wear a mask.

 

19 minutes ago, chemgeek said:

Funny to think about but they're actually charging ppl for stuff like that here.

 

They don't here. And I can tell you from experience that while coughing does not make people pull up their mask, it does make them very enthusiastic about social distancing.

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On 5/22/2020 at 10:00 AM, Scalyfreak said:

 

I have never used my travel sized hand sanitizer bottles as much as I do these days... they go in a jeans pocket, so I can sanitize my hands before I touch anything else, after I leave the grocery store. Then I get home, sanitize the outside of the bottle, wash the clothes I wore, and wash my hands and the rest of me, depending on how many people there were at the places I visited.

 

Serious question: Am I the only one here who sometimes feels silly for treating everything as a deadly biohazard, including my clothes and hair when I've been out? Intellectually I know that we are living in the middle of a pandemic and we have to be super-careful, but I also know that a lot of the people I work with, and a lot of friends and family, are less careful and they seem to be doing perfectly fine and are not ill. Are we too paranoid? 

 

I wash down groceries with soap and water, though it annoys me. Then I just try not to touch my face while coming home from the groceries. I haven't been so careful about my clothes and hair, though I do wash my clothes after going grocery shopping. I put my hair up so I don't have to touch it. I read that spending time in enclosed spaces is the main mechanism of transmission. I know things can be transmitted by surfaces, but I don't think there's a 100% transmission rate from object to object forever. I'm not sure if clothing would do a good job of transmitting it.... I don't know. 

Wait... are you supposed to wear masks outside even if you're just going for a walk in the suburbs? I only wear one when grocery shopping. I don't have enough masks to wear a fresh one every single day. And I only pass people fleetingly and from a six foot distance on the footpath/road. Most people get out of the way or let me get out of the way, but some people just walk right past, though... 

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On ‎5‎/‎25‎/‎2020 at 10:56 AM, Harriet said:

Wait... are you supposed to wear masks outside even if you're just going for a walk in the suburbs? I only wear one when grocery shopping. I don't have enough masks to wear a fresh one every single day. And I only pass people fleetingly and from a six foot distance on the footpath/road. Most people get out of the way or let me get out of the way, but some people just walk right past, though... 

 

My understanding at this time is that the concern for spread is more for enclosed environments with relatively prolonged exposure to lots of people. It doesn't jump quite as far as fast as we might have initially thought, so you can pass people on the street without a mask and be okay, but if you're hiking in a large crowd, that could be a problem.

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2 minutes ago, Kishi said:

My understanding at this time is that the concern for spread is more for enclosed environments with relatively prolonged exposure to lots of people. It doesn't jump quite as far as fast as we might have initially thought, so you can pass people on the street without a mask and be okay, but if you're hiking in a large crowd, that could be a problem.

 

This is my understanding as well. I wear masks when I go into buildings filled with other people.

 

If I was going to an outdoor sporting event where I was going to stand in a crowd for several hours, I would be very uncomfortable and probably not attend unless the crowd was wearing masks though (and I would as well)

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19 hours ago, Kishi said:

 

My understanding at this time is that the concern for spread is more for enclosed environments with relatively prolonged exposure to lots of people. It doesn't jump quite as far as fast as we might have initially thought, so you can pass people on the street without a mask and be okay, but if you're hiking in a large crowd, that could be a problem.

 

19 hours ago, Scalyfreak said:

This is my understanding as well. I wear masks when I go into buildings filled with other people.

 

If I was going to an outdoor sporting event where I was going to stand in a crowd for several hours, I would be very uncomfortable and probably not attend unless the crowd was wearing masks though (and I would as well)

 

Good to know, thanks. I was just wondering because a lot of people do wear masks on their evening walks. I have only a couple of disposable masks and some very badly fitting cloth masks that would be too heavy to wear for more than a few minutes. I should probably order some better ones but it's hard to tell just from pictures which is going to fit well and which is going to be crap.

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2 hours ago, Harriet said:

Good to know, thanks. I was just wondering because a lot of people do wear masks on their evening walks. I have only a couple of disposable masks and some very badly fitting cloth masks that would be too heavy to wear for more than a few minutes. I should probably order some better ones but it's hard to tell just from pictures which is going to fit well and which is going to be crap.

 

It's all a question of where you can reasonably reduce your risk, and paying attention to the size of the risk. Yes, it does reduce some risks to wear them all the time you're outside, and some cities require it now. But there's already a lot of risk reduction simply from being outside in a less densely occupied area.

 

Me personally, I'd say don't get upset that you're not doing it, it's not an irresponsible thing to do. It's an extremely modest, and very circumstantial, risk. I often get my mail without a mask, because the risk of running into anyone in my building is low, and we can keep it brief and mostly distant if we do. But I'd also recommend getting used to the idea of being masked 100% of the time you're off your own property; it was often required in the 1918 flu, many places are requiring it now. It's where the tested public health advice leads, so it's better to go there sooner rather than later.

 

It's also good to normalize it. If we could get to 80% masking, we could knock out the virus. I'm just buying them to match my work clothes now. Part of a standard wardrobe. I kind of feel required to do what I can on that front, given how ridiculously bad the organized prevention response has been.

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6 hours ago, sarakingdom said:

 

It's all a question of where you can reasonably reduce your risk, and paying attention to the size of the risk. Yes, it does reduce some risks to wear them all the time you're outside, and some cities require it now. But there's already a lot of risk reduction simply from being outside in a less densely occupied area.

 

Me personally, I'd say don't get upset that you're not doing it, it's not an irresponsible thing to do. It's an extremely modest, and very circumstantial, risk. I often get my mail without a mask, because the risk of running into anyone in my building is low, and we can keep it brief and mostly distant if we do. But I'd also recommend getting used to the idea of being masked 100% of the time you're off your own property; it was often required in the 1918 flu, many places are requiring it now. It's where the tested public health advice leads, so it's better to go there sooner rather than later.

 

It's also good to normalize it. If we could get to 80% masking, we could knock out the virus. I'm just buying them to match my work clothes now. Part of a standard wardrobe. I kind of feel required to do what I can on that front, given how ridiculously bad the organized prevention response has been.

 

Thanks for sharing your thoughts on this; what you say seems sensible. I did try leaving my mask on after leaving the grocery store today, and just wearing it on the way home. The good was that it prevented me touching my face (after being in the shop). The bad was I had to breathe in the warm humid air I'd just breathed out, while carrying a backpack that was much too heavy for me. It wasn't a super comfortable walk. But it probably wouldn't have been comfortable without the mask, either. 

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Irritatingly, I have had an unexplained cough for about four days. And live in a major hotspot.

 

I'm not too worried about it; it's mild, I don't have a temperature, and my exposure risk is very small. It's probably some kinda nasal drip irritating my throat. But this is not a fun time to have unusual symptoms of things, man.

 

I might break into the covid kit to make this thing go away. I'm pretty well stocked up on Mucinex and cough drops.

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On the plus side, most of the US has just engaged in a large experiment in the efficacy of masks. A lot of the protestors have been testing after protests. The results of large outdoors gatherings with nearly full masking are about 1% positive tests. That's pretty good. Right now, a lot of states are running 10%+.

 

Sadly, it's mostly the people around the masked person who benefit, not the masked person themselves. So ironically we're probably safer from covid at a protest than we are getting groceries.

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As someone with chronic seasonal allergies I can sympathize. Any throat tickle, even if my sinus hurts and I *know* it's allergic postnatal drip and there's basically no activity in my region, gets me worrying.

 

Thou apparently all else being equal asthma is actually protective against severe covid so... Yay?

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42 minutes ago, Tanktimus the Encourager said:

What? I'm asthmatic and work in a hospital. Where did you see this info?

 

From several papers I have read, this being one (published in Allergy): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7300712/

 

Tl;dr asthmatic ppl and other ppl with type 2 eosinophilic illnesses get severe covid-19 at rates far lower than would be otherwise expected (3/275 hospitalized patients in the cited study vs 12-16% of general population - and in papers that study cites out of Wuhan China they had yet to have an asthmatic admitted to ICU for covid-19. During the worst of it. Now some of that might be selection bias but I am hard pressed to explain that much discrepancy as pure chance and it seems more likely something's real happening there, especially since it's being reported across multiple unrelated research groups and different continents). Science still isn't settled on why or how but I have seen enough on the epidemiology to make me think my asthma is probably good for something for a change!

 

Edit: that said I am still acting under the assumption that if I get covid I will get extremely sick or die because it's the less risky assumption to make. 

Edit the sequel: I am precisely the kind of massive science nerd that reads scientific papers in my spare time. 

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2 hours ago, chemgeek said:

Edit the sequel: I am precisely the kind of massive science nerd that reads scientific papers in my spare time. 

 

I am understanding of everyone who does not, but glad to know people that read non-essential readings in their spare time haha

 

The other day I read in the news that there is a correlation between a blood group locus in the DNA of those diagnosed with Covid and... having "severe symptoms"?

 

EDIT: I am trying to word the correlation better, but I cannot think of a way. The point is that e.g. there is a higher % of people diagnosed (and severe symptoms) that have blood type A or O. But then again, there are also simply more people in the world with blood type O and A, I think?

 

Cited studies:

I have not taken the time to read them, though.

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Oh! And it might be that people with asthma and other respiratory illness/in the risk group (and people around them) are significantly more cautious than those that do not have such illnesses. Just throwing that in here, don't know how much weight this factor carries haha

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