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feevers


Registered: 12/28/10
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Re: Viral outbreak in China [Re: morrowasted] 2
#26587202 - 04/08/20 08:00 PM (3 years, 10 months ago) |
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Quote:
morrowasted said: shes on a fuckload of ketamine and lets see if you still wanna give her dose of roc

Do suspected COVID cases at your hospital come into the ER first or get triaged beforehand?
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morrowasted
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Re: Viral outbreak in China [Re: feevers]
#26587230 - 04/08/20 08:11 PM (3 years, 10 months ago) |
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They have a triaging tent in the parking lot. Patients with suspected covid are being trasnported or just told to go to methodist until they reach capacity. But there arent many. Most people call their PCP or something first and they are all directing them to methodist straight away. Methodist has set up a bunch of covid exclusive units. They also have all the studies going on. Remdesivir, the plasma, the inhaled preventative medicine for healthcare workers
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Seriously_trippin
Cosmic Guru Ganesh



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Re: Viral outbreak in China [Re: morrowasted]
#26587257 - 04/08/20 08:24 PM (3 years, 10 months ago) |
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Quote:
morrowasted said:
Quote:
feevers said: That's pretty ugly if 99% of doctors are handling this wrong, and possibly causing further lung damage and even cognitive damage from ventilation/sedation
From a vent supply standpoint it'd be a relief if we weren't so reliant on them. Sounds like a push for early detection and intervention will be crucial, assuming we figure out the right drugs to use.
Hate to say it but ime most doctors operate out of protocol because it is easier and they are less likely to be held liable for poor outcomes.
Also they rely on the data we collect like a motherfucker in the ER. orders start flying in before the doctor has ever laid eyea on the patient just based on our phonecalls. Most of them just get into a kind of autopilot. You call em up and tell em a newly intubated patient just rolled in and before you can finish they are telling you the orders for roc and fent and versed are in the system and i wanna be like woah motherfucker slow down wait til i get to the part where i tell you shes on a fuckload of ketamine and lets see if you still wanna give her dose of roc
Anyway that really had nothing to with anything i am just deliriously rambling. Obviously some doctors are great and wonderful and brilliant
Ps all scenarios involving a patient depicted in this post are 100% fictionalized and not based on actual events
We all see how hard medical staff has been hit by this specifically and emotionally plus the exposure risk we can't imagine what it's like. Have you seen a lot of competence and people stepping up to the plate or is it overwhelmingly just protocol?
-------------------- R.I.P Zombi3, Blue Helix Modest Mouse Zappa Slothie That Kid With The face ShLong Le Canard split_by_nine & Big Worm Forever Etched in the sands of time in the shroomery and ever so beloved and deeply missed by many
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morrowasted
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Quote:
We all see how hard medical staff has been hit by this specifically and emotionally plus the exposure risk we can't imagine what it's like. Have you seen a lot of competence and people stepping up to the plate or is it overwhelmingly just protocol?
It is honestly an exciting time to be in medicine. Most people are eager to learn as much as possible in order to be as helpful as they can.
Edited by morrowasted (04/08/20 08:49 PM)
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koods
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Re: Viral outbreak in China [Re: morrowasted] 2
#26587297 - 04/08/20 08:38 PM (3 years, 10 months ago) |
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I’ve suspected this for a while. The source of the New York City outbreak was Europe, not China.
https://apple.news/At3gGTSERSeCglcFmAddRCg
Quote:
Coronavirus in New York came mainly from Europe, studies show. New research indicates that the coronavirus began to circulate in the New York area by mid-February, weeks before the first confirmed case, and that it was brought to the region mainly by travelers from Europe, not Asia. “The majority is clearly European,” said Harm van Bakel, a geneticist at Icahn School of Medicine at Mount Sinai, who co-wrote a study awaiting peer review. A separate team at N.Y.U. Grossman School of Medicine came to strikingly similar conclusions, despite studying a different group of cases. Both teams analyzed genomes from coronaviruses taken from New Yorkers starting in mid-March. The research revealed a previously hidden spread of the virus that might have been detected if aggressive testing programs had been put in place.
Trump ignored what was happening in Europe for weeks thinking he had solved the problem with his feckless Chinese ban.
--------------------
NotSheekle said “if I believed she was 16 I would become unattracted to her”
Edited by koods (04/08/20 08:43 PM)
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morrowasted
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Re: Viral outbreak in China [Re: koods] 1
#26587417 - 04/08/20 09:22 PM (3 years, 10 months ago) |
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i think i just had a eureka moment in my delirium
this is not medical advice or anything researched just some "i havent slept in a long time and my thoughts probably seem smarter than they actually are" speculation. but here goes
one of the main DX criteria for COVID19 is shortness of breath.
the primary driver of breathing effort is these sensors in the hypothalamus that pick up on how much carbon dioxide is in the blood. the secondary driver is some sensors that pick up on how much oxygen is in the blood.
patients with COVID generally have good enough alveolar gas exchange that their co2 levels remain normal
nevertheless their oxygen saturation in their blood drops. the oxygen is going into the alveoli but there is not enough viable hemoglobin to pick it up and a lot of it just gets exhaled
because of the fact that low O2 levels are not a major driver of breathing effort compared with high CO2 levels, shortness of breath indicates pretty severe hypoxemia
this explains why covid patients are frequently able to have full conversations despite having O2 sats in the 70s. anytime i've seen someone with a sat that low, they could barely get a word out because so much respiratory distress. with patients who are satting that low because of edema in the lungs or whatever you can see the co2 levels rise at the same time o2 levels fall
erythropoeitin probably will not work because i suspect the problem is the virus is interfering with the RBC maturation. that maturation process takes like 5 days hence insidious progression of symptoms even after acute signs of infection like fever may have gone away. oxygen transport relies on existing RBCs which live a few months but are constantly being replaced. older people and obviously people with anemia/thalassemia (see: african americans) already have fewer viable circulating RBCs.
BUT
this is not actually what is primarily killing patients, at least not ON ITS OWN. patients ALSO develop disseminated intravascular coagulation in response to the cytokine storm. these are basically random little blood clots that form all throughout the smaller blood vessels of your body. the patients already have increased oxygen demand to the heart and decreased oxygen supply to heart b/c of hypoxemia, so when these clots get into the coronary artery they can precipitate a heart attack or pulmonary embolism in circumstances where they otherwise wouldnt
they need better admission criteria because by the time a COVID19 patient is short of breath they are already in serious trouble. on this account
again just me spinning my wheels yall keep listening to the experts
Edited by morrowasted (04/08/20 09:33 PM)
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koods
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Re: Viral outbreak in China [Re: morrowasted]
#26587429 - 04/08/20 09:27 PM (3 years, 10 months ago) |
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Quote:
this explains why covid patients are frequently able to have full conversations despite having O2 sats in the 70
🤔
Nearly every description I’ve heard people say they were out of breath just from talking
This is literally from the guidelines of how to assess covid patients:
Quote:
Ask the patient to describe the problem with their breathing in their own words, and assess the ease and comfort of their speech. Ask open-ended questions and listen to whether the patient can complete their sentences.
--------------------
NotSheekle said “if I believed she was 16 I would become unattracted to her”
Edited by koods (04/08/20 09:29 PM)
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morrowasted
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Re: Viral outbreak in China [Re: koods]
#26587475 - 04/08/20 09:45 PM (3 years, 10 months ago) |
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so I think where that is coming from is that at first only very severe covid patients were presenting at the hospital and those patients are indeed short of breath and have a hard time talking. back in february when the clinical descriptions were still being developed a lot less people were going to the hospital thinking they had covid because it just wasn't something on peoples' minds. when this first started emerging I remember nurses posting photos of vital signs from COVID patients and they were satting down in the 40s and 50s which i have literally only seen once.
now that covid19 is on everyones minds constantly a lot of people are showing up to the hospitals with much milder symptoms than those original cases. they are throwing a pulse ox on these patients who say basically "I just feel really really bad. like I am going to die." very intelligibly and wham, they are satting 77. it's unprecedented except apparently in altitude sickness
also I am not suggesting other pathologies arent at play too. obviously cytokines, sepsis etc all collude to impair tissue perfusion
I'm just seeing these ER docs from NYC on twitter saying, "Hey we dont need to throw the paradigm about patho out completely but there seems to be a major non respiratory component of this illness that I think most of my colleagues have been failing to consider"
"This originally came to me when we had a patient who had hit what we call our trigger to put in a breathing tube, meaning she had displayed a level of hypoxia of low oxygen levels where we thought she would need a breathing tube. Most of the time, when patients hit that level of hypoxia, they're in distress and they can barely talk; they can't say complete sentences. She could do all of those and she did not want a breathing tube."
the other thing is the folks who do have diabetes or heart failure will present with shortness of breath for downstream reasons. patients in DKA are short of breath due to metabolic acidosis- the lungs are trying to expel CO2 to alkalinize the blood- and the virus precipitates DKA in patients that already have high fasting blood sugar. patients with heart failure are already short of breath for a variety of reasons depending on which parts of their heart isnt working. the cytokine storm and anemia exacerbate the heart failure so shortness of breath is worse
but in a patient without those comorbidities it is believable that they could have very low o2 sat without being SOB if their lungs are still expelling CO2 normally.
the basic message of this doctor seems to be "don't intubate all these patients just because the hypoxia alarm goes off. look at the patient. talk to them. does your patient want to be intubated? is the evidence really there that doing it is even going to help? if not, why? you know how all these healthy folk are dropping dead... what would have happened if we HADN'T put them on a ventilator? what can we do better?" they are definitely still gonna be putting those patients with HF and DKA on vents. and theres a lot of em in America
Edited by morrowasted (04/08/20 10:26 PM)
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mycosis


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Re: Viral outbreak in China [Re: koods] 6
#26587480 - 04/08/20 09:46 PM (3 years, 10 months ago) |
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Quote:
koods said: US intel agencies knew about the novel coronavirus in November and Trump still sat on his fat ass until the end of January before doing a fucking thing.
https://abcnews.go.com/Politics/intelligence-report-warned-coronavirus-crisis-early-november-sources/story?id=70031273
Yeah, so it turns out that never happened.
Quote:
"As a matter of practice the National Center for Medical Intelligence does not comment publicly on specific intelligence matters. However, in the interest of transparency during this current public health crisis, we can confirm that media reporting about the existence/release of a National Center for Medical Intelligence Coronavirus-related product/assessment in November of 2019 is not correct. No such NCMI product exists," the statement said.
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morrowasted
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Re: Viral outbreak in China [Re: mycosis] 1
#26587505 - 04/08/20 09:58 PM (3 years, 10 months ago) |
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https://emcrit.org/ibcc/COVID19/
yoooooo this website is so dope 
everything you could wanna know about what is being attempted for COVID19 critical care
apparently it can attack the pancreas too which will precipitate DKA if youre insulin resistant dont wanna be doing that now do we. everyone hold on to your pancrei
recommends ketamine for intubated patients on the following rationale
(2) Ketamine attenuates the development of opioid tolerance and opioid-induced hyperalgesia, thereby blunting opioid side-effects. (Barr 2013, Angst 2003). (3) Ketamine exerts anti-depressant effects which may improve patient mood, even at low doses (Rasmussen 2013, Zarate 2006).


reading through the page will give you a better idea of just how much docs are winging it right now though
i really ought be sleeping
Edited by morrowasted (04/08/20 10:16 PM)
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imachavel
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Re: Viral outbreak in China [Re: morrowasted]
#26587516 - 04/08/20 10:01 PM (3 years, 10 months ago) |
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Quote:
morrowasted said: i think i just had a eureka moment in my delirium
this is not medical advice or anything researched just some "i havent slept in a long time and my thoughts probably seem smarter than they actually are" speculation. but here goes
one of the main DX criteria for COVID19 is shortness of breath.
the primary driver of breathing effort is these sensors in the hypothalamus that pick up on how much carbon dioxide is in the blood. the secondary driver is some sensors that pick up on how much oxygen is in the blood.
patients with COVID generally have good enough alveolar gas exchange that their co2 levels remain normal
nevertheless their oxygen saturation in their blood drops. the oxygen is going into the alveoli but there is not enough viable hemoglobin to pick it up and a lot of it just gets exhaled
because of the fact that low O2 levels are not a major driver of breathing effort compared with high CO2 levels, shortness of breath indicates pretty severe hypoxemia
this explains why covid patients are frequently able to have full conversations despite having O2 sats in the 70s. anytime i've seen someone with a sat that low, they could barely get a word out because so much respiratory distress. with patients who are satting that low because of edema in the lungs or whatever you can see the co2 levels rise at the same time o2 levels fall
erythropoeitin probably will not work because i suspect the problem is the virus is interfering with the RBC maturation. that maturation process takes like 5 days hence insidious progression of symptoms even after acute signs of infection like fever may have gone away. oxygen transport relies on existing RBCs which live a few months but are constantly being replaced. older people and obviously people with anemia/thalassemia (see: african americans) already have fewer viable circulating RBCs.
BUT
this is not actually what is primarily killing patients, at least not ON ITS OWN. patients ALSO develop disseminated intravascular coagulation in response to the cytokine storm. these are basically random little blood clots that form all throughout the smaller blood vessels of your body. the patients already have increased oxygen demand to the heart and decreased oxygen supply to heart b/c of hypoxemia, so when these clots get into the coronary artery they can precipitate a heart attack or pulmonary embolism in circumstances where they otherwise wouldnt
they need better admission criteria because by the time a COVID19 patient is short of breath they are already in serious trouble. on this account
again just me spinning my wheels yall keep listening to the experts
This has been the most descriptive thing I have heard lately. Probably the most "expert" description so far. Like I said based on what you have said it seems very very lung based in its attack. The flu gets to the lungs but seems to have this thing with incubating in a persons stomach. This corona virus according to what you are describing seems to just tear apart a persons lungs. I don't think of any of the "experts" on tv lately have given this much of a description to what this actually is and does so I will primarily take this as the most informal medical report I have gotten so far.
Of course what really matters is if your doctor understands all this if you actually contract it. So here is a to all the people who have not gotten this so far and continue to not get it. Stay alive and obviously the longer this is treated the more people will learn about it and know how to deal with it and what medicines and vaccines work and which don't.
I heard at this point they are trying to experiment with vaccines they used to treat people 100 years ago when the Spanish flu was still in wide circulation. It may sound like I am making it up and I cannot find the links I read this at before but its true they are using really old vaccines in trials with new corona virus patients and having really good results so far I guess. But the testing phase seems to be really really early. The longer the population can withstand this better the chance the methods having a really good effect will become better known and spread out. This thing just caught a lot of very unprepared people by surprise. Unfortunate how unprepared our health care system is but it is the truth.
Corona viruses are not new by any means. But they seem to be so limited in who gets them or not that the world was basically caught with its pants down. I wish history learned from history. If people had taken the likely hood of a runaway corona virus seriously this may have been better dealt with. But everything is based on statistics so the rare cases of people who have run into these types of things has apparently not been well studied. Well they have the statistics now. I hope the worlds health care system is drastically remodeled after this.
I feel that is probably a hope that will fall on deaf ears. People seem to learn by panicking one day then not giving a fuck the day after as long as they can sweep it into the past. I for one will never forget this experience. Never been in a world lockdown before where so many people were completely in the dark. Thanks for the knowledge marrowasted
--------------------
I did not say to edit my signature soulidarity! Now forever I will never remember what I said about understanding the secrets of the universe by paying attention to subtleties!
I'm never giving you the password again. Jerk
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morrowasted
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Re: Viral outbreak in China [Re: imachavel]
#26587532 - 04/08/20 10:09 PM (3 years, 10 months ago) |
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Quote:
I don't think of any of the "experts" on tv lately have given this much of a description to what this actually is and does so I will primarily take this as the most informal medical report I have gotten so far.
please take everything I am saying with a massive grain of salt. I have always had a tendency to pay attention to the fringe parts of whatever field I am interested in. I really think in this case because it is new and a lot of the interventions were just based on standard pneumonia/ARDS protocols that whoever ends up being right about the pathology is a fringe element right now- until they're not. It's just a matter of figuring which fringe element is full of shit and which isn't.
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morrowasted
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Re: Viral outbreak in China [Re: morrowasted]
#26587582 - 04/08/20 10:37 PM (3 years, 10 months ago) |
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Quote:
Side question when you put a needle into a vein does part of your skin get injected into your blood stream? How does the body still function with tons of holes in the veins or even collapsed veins?
lmao I just saw this. i have no idea about the skin thing. that second one is a damn good question I have always wondered myself. I've seen IV drug users with no useable veins at all in their arms and legs and I'm just like... how does blood get back your heart??? how are your arms not rotting away??
they do get skin infections super easy though
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imachavel
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Re: Viral outbreak in China [Re: morrowasted]
#26587594 - 04/08/20 10:46 PM (3 years, 10 months ago) |
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But it seems very likely to you from the massive amounts of compiled data that this disease is really good at creating lung infections right? Usually flu patients who die of pneumonia seem to get sick then weeks later when they just suck at fighting it off the bronchitis turns into pneumonia etc.
With covid it seems like it just goes straight to the lungs and BAM! everything from there depends on if the person can recover breathing functions. Its like the people who survive have very healthy lungs and the people who don't are anyone but people with the strongest lungs.
Obviously I am no expert and neither are you. None of what you or I are saying can be extremely accurately confirmed by anything but a health expert. Still though, the information you are posting is really helpful. I would imagine even a young healthy 20 year old who smokes cigarettes could be in danger if he is a chronic smoker. I would imagine very very healthy breathers have a lot less to worry about with this. All I am saying is the information you are posting seems a lot more accurate in knowing how it goes through its method of attack. It makes sense a virus that targets lungs would be something that lives in bats. I think the lungs make up a majority of a bats body. All bats do is fly and eat and sleep and hang upside down basically. Anything that flies and has wings that is more wings then anything else must have some pretty hardcore lungs.
Bats are basically rodents that fly and rodents are known to be serious carriers of diseases. I can imagine a virus like this having a mostly symbiotic relationship with a bat where possibly it doesn't even hurt the bat but lives with it mostly peacefully. Perhaps the bat itself has major immunity in their lungs where a persons lungs are probably much more sensitive. This is all assumptions at this point. But kind of like how they traced HIV back to monkeys yet HIV seems to not destroy a monkey the way it does a person as the virus more slowly attacks the monkeys T cells where they can reproduce their T cells faster then the virus destroys them. These weird mutated viruses jump into people and whatever evolved immunity we do not have that the animal does gives them the virus this super advantage to be able to target weaker DNA sectors that animals have a stronger resistance to. Its a fucking bummer that people still eat animals known to be loaded with parasites and at the same time enjoy their meat cooked medium rare.
How fucking strange is that? Sure people that eat cows can get mad cow disease. Yet even mad cow disease is so rare and once again I believe its based on people eating their meat as rare as possible. Like WTF its like if I cooked chicken and the inside was pink and I got hard salmonella and was surprised about it. The thing with that scenario is that the salmonella would damage me and not really jump to anyone else. These mutated animal-to-person diseases seem to only come about in very rare scenarios in filthy conditions where the viruses somehow develop these serious resistance to living out of the body of its host and start rapidly evolving their DNA to try and enter any host after living in dead corpses and shit on the ground while their host has died and people seem to harvest fresh animals living near these filthy conditions and the virus has jumped in and out of hosts over and over and finally the mutated little beasts enter a person and fucking game over the person gets on a plane and gives it to half the world.
I know I am going a little far with this. Just amazing to me how stupid people can be. Honestly its fucking unbelievable. These little pieces of genetic code just want to evolve into a more advanced lifeform. Yet I am speaking in the most basic terms. The lifeform they want to evolve into is always and in its most basic sense simply a more advanced virus. And after thousands of years of people with experience of how diseases form disease filled areas of the world still exist where all society can do when a new epidemic forms in such a place is to just fucking like never before while everyone just takes it in the ass because hey fuck it misery loves company.
Some people who continue living surprise the fuck out of me. I mean living in such a filthy way to me would be mentally inviting to just commit suicide. Why sleep in bat shit and get up and eat the bat? Why not just blow your head off? But eh it is what it is eh?
Check out the last time this happened
https://www.shroomery.org/forums/showflat.php/Cat/0/Number/10231227
I guess that did not end nearly as badly
--------------------
I did not say to edit my signature soulidarity! Now forever I will never remember what I said about understanding the secrets of the universe by paying attention to subtleties!
I'm never giving you the password again. Jerk
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Kizzle
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Re: Viral outbreak in China [Re: morrowasted] 1
#26587624 - 04/08/20 11:10 PM (3 years, 10 months ago) |
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Quote:
I heard at this point they are trying to experiment with vaccines they used to treat people 100 years ago when the Spanish flu was still in wide circulation. It may sound like I am making it up and I cannot find the links I read this at before but its true they are using really old vaccines in trials with new corona virus patients and having really good results so far I guess. But the testing phase seems to be really really early. The longer the population can withstand this better the chance the methods having a really good effect will become better known and spread out. This thing just caught a lot of very unprepared people by surprise. Unfortunate how unprepared our health care system is but it is the truth.
https://www.sciencemag.org/news/2020/03/can-century-old-tb-vaccine-steel-immune-system-against-new-coronavirus
Says here they're testing a TB vaccine. There's no way and a vaccine for another disease is going to teach the body to make antibodies against SARS-CoV-2 but maybe it could mobilize the immune system in some sense so it would be ready to adapt and start producing antibodies sooner. It sounds like their grasping at straws to me but who know.
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deucedbi9
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Re: Viral outbreak in China [Re: imachavel] 1
#26588041 - 04/09/20 05:28 AM (3 years, 10 months ago) |
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Quote:
imachavel said: I heard at this point they are trying to experiment with vaccines they used to treat people 100 years ago when the Spanish flu was still in wide circulation. It may sound like I am making it up and I cannot find the links I read this at before but its true they are using really old vaccines in trials with new corona virus patients and having really good results so far I guess. But the testing phase seems to be really really early. The longer the population can withstand this better the chance the methods having a really good effect will become better known and spread out. This thing just caught a lot of very unprepared people by surprise. Unfortunate how unprepared our health care system is but it is the truth.
Thanks for the knowledge marrowasted
I was sure I posted this but I can't find it. "How blood plasma from recovered patients could help treat the new coronavirus"
https://www.statnews.com/2020/03/05/how-blood-plasma-from-recovered-patients-could-help-treat-coronavirus/
I thought it would be common sense...that, people that have recovered from the virus would have the antibodies to it. I know I asked such a question along those lines in this thread...I am so common as to believe that giving this treatment to people that are so ill that thay are on the verge of requring ventilation is like, shutting the stable door after the proverbial ship has sailed, as it were.
Why not at least trial this therapy on the healthy people on the front line, in the hope it gives their immune system a 'head start' if / when they inevitably become infected.
Good luck and good health morrow', to you, and all your colleagues.
-------------------- whether low pressure sucks or high pressure blows... it's a bugger to cycle in. even though I'm feeling good Something tells me I'd better activate my prayer capsule
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koods
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Re: Viral outbreak in China [Re: mycosis]
#26588057 - 04/09/20 05:39 AM (3 years, 10 months ago) |
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Quote:
mycosis said:
Quote:
koods said: US intel agencies knew about the novel coronavirus in November and Trump still sat on his fat ass until the end of January before doing a fucking thing.
https://abcnews.go.com/Politics/intelligence-report-warned-coronavirus-crisis-early-november-sources/story?id=70031273
Yeah, so it turns out that never happened.
Quote:
"As a matter of practice the National Center for Medical Intelligence does not comment publicly on specific intelligence matters. However, in the interest of transparency during this current public health crisis, we can confirm that media reporting about the existence/release of a National Center for Medical Intelligence Coronavirus-related product/assessment in November of 2019 is not correct. No such NCMI product exists," the statement said.

I’ll believe the media over the trump administration every single time. Seriously. Do you beeieve anything these assholes say to cover their asses.
Edited by koods (04/09/20 05:41 AM)
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PumpJackTeX
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Re: COVID19 PSA : BOOF ON AT HOME [Re: koods] 5
#26588086 - 04/09/20 06:04 AM (3 years, 10 months ago) |
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Electing a reality TV host for president of the USA litterly destroyed this country.
-------------------- Life. 2008 Ascension Energy | UFOs | 2021
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Asante
Mage


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Re: COVID19 PSA : https://www.youtube.com/watch?v=Dvmj8t [Re: PumpJackTeX] 3
#26588094 - 04/09/20 06:09 AM (3 years, 10 months ago) |
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A COVID-19 PSA by Samuel L Jackson:
-------------------- Omnicyclion.org higher knowledge starts here
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PumpJackTeX
livin life



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Re: COVID19 PSA : https://www.youtube.com/watch?v=Dvmj8t [Re: Asante] 2
#26588114 - 04/09/20 06:27 AM (3 years, 10 months ago) |
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-------------------- Life. 2008 Ascension Energy | UFOs | 2021
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