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  1. #9026
    dangerous floater Winehole23's Avatar
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    BOP incompetence will turn prisons into death camps. Hopefully ICE has a better handle on it.


    When coronavirus began ripping through the federal prison in Oakdale, Louisiana, Senior Officer Aubrey Melder was on the front lines. On March 19, he transported a sick prisoner to the local community hospital for tests, spending six hours in close contact with the ailing man. The officer’s only protection for most of that time? A pair of gloves.Melder expected to go into quarantine, especially after the prisoner’s test for COVID-19 came back positive on March 21, according to his union representatives. But within a day, the Bureau of Prison’s chief health officer in Washington ordered him back on the job, according to an email reviewed by The Marshall Project.
    https://www.themarshallproject.org/2...of-coronavirus

  2. #9027
    Mahinmi in ? picnroll's Avatar
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    Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients

    While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery.

    In addition to lung damage, many COVID-19 patients are also developing heart problems — and dying of cardiac arrest.

    As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress.

    That could change the way doctors and hospitals need to think about patients, particularly in the early stages of illness. It also could open up a second front in the battle against the COVID-19 pandemic, with a need for new precautions in people with preexisting heart problems, new demands for equipment and, ultimately, new treatment plans for damaged hearts among those who survive.

    “It’s extremely important to answer the question: Is their heart being affected by the virus and can we do something about it?” said Dr. Ulrich Jorde, the head of heart failure, cardiac transplantation and mechanical circulatory support for the Montefiore Health System in New York City. “This may save many lives in the end.”

    Virus Or Illness?
    The question of whether the emerging heart problems are caused by the virus itself or are a byproduct of the body’s reaction to it has become one of the critical unknowns facing doctors as they race to understand the novel illness. Determining how the virus affects the heart is difficult, in part, because severe illness alone can influence heart health.

    “Someone who’s dying from a bad pneumonia will ultimately die because the heart stops,” said Dr. Robert Bonow, a professor of cardiology at the Northwestern University Feinberg School of Medicine and editor of the medical journal JAMA Cardiology. “You can’t get enough oxygen into your system and things go haywire.”

    But Bonow and many other cardiac specialists believe a COVID-19 infection could lead to damage to the heart in four or five ways. Some patients, they say, might be affected by more than one of those pathways at once.

    Doctors have long known that any serious medical event, even something as straightforward as hip surgery, can create enough stress to damage the heart. Moreover, a condition like pneumonia can cause widespread inflammation in the body. That, in turn, can lead to plaque in arteries becoming unstable, causing heart attacks. Inflammation can also cause a condition known as myocarditis, which can lead to the weakening of the heart muscle and, ultimately, heart failure.

    But Bonow said the damage observed in COVID-19 patients could be from the virus directly infecting the heart muscle. Initial research suggests the coronavirus attaches to certain receptors in the lungs, and those same receptors are found in heart muscle as well.

    Initial Data From China
    In March, doctors from China published two studies that gave the first glimpse at how prevalent cardiac problems were among patients with COVID-19 illness. The larger of the two studies looked at 416 hospitalized patients. The researchers found that 19% showed signs of heart damage. And those who did were significantly more likely to die: 51% of those with heart damage died versus 4.5% who did not have it.

    Patients who had heart disease before their coronavirus infections were much more likely to show heart damage afterward. But some patients with no previous heart disease also showed signs of cardiac damage. In fact, patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage.

    It’s unclear why some patients experience more cardiac effects than others. Bonow said that could be due to a genetic predisposition or it could be because they’re exposed to higher viral loads.

    Those uncertainties underscore the need for closer monitoring of cardiac markers in COVID-19 patients, Jorde said. If doctors in New York, Washington state and other hot spots can start to tease out how the virus is affecting the heart, they may be able to provide a risk score or other guidance to help clinicians manage COVID-19 patients in other parts of the country.

    “We have to assume, maybe, that the virus affects the heart directly,” Jorde said. “But it’s essential to find out.”

    Facing Obstacles
    Gathering the data to do so amid the crisis, however, can be difficult. Ideally, doctors would take biopsies of the heart to determine whether the heart muscle is infected with the virus.

    But COVID-19 patients are often so sick it’s difficult for them to undergo invasive procedures. And more testing could expose additional health care workers to the virus. Many hospitals aren’t using electrocardiograms on patients in isolation to avoid bringing additional staff into the room and using up limited masks or other protective equipment.

    Still, Dr. Sahil Parikh, an interventional cardiologist at Columbia University Irving Medical Center in New York City, said hospitals are making a concerted effort to order the tests needed and to enter findings in medical records so they can sort out what’s going on with the heart.

    “We all recognize that because we’re at the leading edge, for better or for worse, we need to try to compile information and use it to help advance the field,” he said.
    Indeed, despite the surge in patients, doctors continue to gather data, compile trends and publish their findings in near real time. Parikh and several colleagues recently penned a compilation of what’s known about cardiac complications of COVID-19, making the article available online immediately and adding new findings before the article comes out in print.

    Cardiologists in New York, New Jersey and Connecticut are sharing the latest COVID-19 information through a WhatsApp group that has at least 150 members. And even as New York hospitals are operating under crisis conditions, doctors are testing new drugs and treatments in clinical trials to ensure that what they have learned about the coronavirus can be shared elsewhere with scientific validity.

    That work has already resulted in changes in the way hospitals deal with the cardiac implications of COVID-19. Doctors have found that the infection can mimic a heart attack. They have taken patients to the cardiac catheterization lab to clear a suspected blockage, only to find the patient wasn’t really experiencing a heart attack but had COVID-19.

    For years, hospitals have rushed suspected heart attack patients directly to the catheterization lab, bypassing the emergency room, in an effort to shorten the time from when the patient enters the door to when doctors can clear the blockage with a balloon. Door-to-balloon time had become an important measure of how well hospitals treat heart attacks.

    “We’re taking a step back from that now and thinking about having patients brought to the emergency department so they can get evaluated briefly, so that we could determine: Is this somebody who’s really at high risk for COVID-19?” Parikh said. “And is this manifestation that we’re calling a heart attack really a heart attack?”
    New protocols now include bringing in a cardiologist and getting an EKG or an ultrasound to confirm a blockage.

    “We’re doing that in large measure to protect the patient from what would be an otherwise unnecessary procedure,” Parikh said, “But also to help us decide which sort of level of personal protective equipment we would employ in the cath lab.”
    Sorting out how the virus affects the heart should help doctors determine which therapies to pursue to keep patients alive.

    Jorde said that after COVID-19 patients recover, they could have long-term effects from such heart damage. But, he said, treatments exist for various forms of heart damage that should be effective once the viral infection has cleared.

    Still, that could require another wave of widespread health care demands after the pandemic has calmed.

    https://apple.news/AX2mbJqXXTiSahm6rDAhv7Q

  3. #9028
    Alleged Michigander ChumpDumper's Avatar
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    Hmmm, I wonder what's happening in NY that's lowering hospitalization?
    Probably locking the place down, as late as that happened. If it's some miracle treatment before hospitalization, hooray!

  4. #9029
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    I am really encouraged by the new projections and some of the signs of slowing/plateauing in places like NY. I am worried that people and governments are going to let down their vigilance too soon.
    As long as Copeland keeps destroying Covid-19 with the power of God we should keep heading in the right direction


  5. #9030
    dangerous floater Winehole23's Avatar
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    HHS IG report at the link. It's not pretty.

    https://www.politico.com/news/2020/0...ovid-19-167853

  6. #9031
    TRU 'cross mah stomach LaMarcus Bryant's Avatar
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    Mysterious Heart Damage, Not Just Lung Troubles, Befalling COVID-19 Patients

    While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery.

    In addition to lung damage, many COVID-19 patients are also developing heart problems — and dying of cardiac arrest.

    As more data comes in from China and Italy, as well as Washington state and New York, more cardiac experts are coming to believe the COVID-19 virus can infect the heart muscle. An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress.

    That could change the way doctors and hospitals need to think about patients, particularly in the early stages of illness. It also could open up a second front in the battle against the COVID-19 pandemic, with a need for new precautions in people with preexisting heart problems, new demands for equipment and, ultimately, new treatment plans for damaged hearts among those who survive.

    “It’s extremely important to answer the question: Is their heart being affected by the virus and can we do something about it?” said Dr. Ulrich Jorde, the head of heart failure, cardiac transplantation and mechanical circulatory support for the Montefiore Health System in New York City. “This may save many lives in the end.”

    Virus Or Illness?
    The question of whether the emerging heart problems are caused by the virus itself or are a byproduct of the body’s reaction to it has become one of the critical unknowns facing doctors as they race to understand the novel illness. Determining how the virus affects the heart is difficult, in part, because severe illness alone can influence heart health.

    “Someone who’s dying from a bad pneumonia will ultimately die because the heart stops,” said Dr. Robert Bonow, a professor of cardiology at the Northwestern University Feinberg School of Medicine and editor of the medical journal JAMA Cardiology. “You can’t get enough oxygen into your system and things go haywire.”

    But Bonow and many other cardiac specialists believe a COVID-19 infection could lead to damage to the heart in four or five ways. Some patients, they say, might be affected by more than one of those pathways at once.

    Doctors have long known that any serious medical event, even something as straightforward as hip surgery, can create enough stress to damage the heart. Moreover, a condition like pneumonia can cause widespread inflammation in the body. That, in turn, can lead to plaque in arteries becoming unstable, causing heart attacks. Inflammation can also cause a condition known as myocarditis, which can lead to the weakening of the heart muscle and, ultimately, heart failure.

    But Bonow said the damage observed in COVID-19 patients could be from the virus directly infecting the heart muscle. Initial research suggests the coronavirus attaches to certain receptors in the lungs, and those same receptors are found in heart muscle as well.

    Initial Data From China
    In March, doctors from China published two studies that gave the first glimpse at how prevalent cardiac problems were among patients with COVID-19 illness. The larger of the two studies looked at 416 hospitalized patients. The researchers found that 19% showed signs of heart damage. And those who did were significantly more likely to die: 51% of those with heart damage died versus 4.5% who did not have it.

    Patients who had heart disease before their coronavirus infections were much more likely to show heart damage afterward. But some patients with no previous heart disease also showed signs of cardiac damage. In fact, patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage.

    It’s unclear why some patients experience more cardiac effects than others. Bonow said that could be due to a genetic predisposition or it could be because they’re exposed to higher viral loads.

    Those uncertainties underscore the need for closer monitoring of cardiac markers in COVID-19 patients, Jorde said. If doctors in New York, Washington state and other hot spots can start to tease out how the virus is affecting the heart, they may be able to provide a risk score or other guidance to help clinicians manage COVID-19 patients in other parts of the country.

    “We have to assume, maybe, that the virus affects the heart directly,” Jorde said. “But it’s essential to find out.”

    Facing Obstacles
    Gathering the data to do so amid the crisis, however, can be difficult. Ideally, doctors would take biopsies of the heart to determine whether the heart muscle is infected with the virus.

    But COVID-19 patients are often so sick it’s difficult for them to undergo invasive procedures. And more testing could expose additional health care workers to the virus. Many hospitals aren’t using electrocardiograms on patients in isolation to avoid bringing additional staff into the room and using up limited masks or other protective equipment.

    Still, Dr. Sahil Parikh, an interventional cardiologist at Columbia University Irving Medical Center in New York City, said hospitals are making a concerted effort to order the tests needed and to enter findings in medical records so they can sort out what’s going on with the heart.

    “We all recognize that because we’re at the leading edge, for better or for worse, we need to try to compile information and use it to help advance the field,” he said.
    Indeed, despite the surge in patients, doctors continue to gather data, compile trends and publish their findings in near real time. Parikh and several colleagues recently penned a compilation of what’s known about cardiac complications of COVID-19, making the article available online immediately and adding new findings before the article comes out in print.

    Cardiologists in New York, New Jersey and Connecticut are sharing the latest COVID-19 information through a WhatsApp group that has at least 150 members. And even as New York hospitals are operating under crisis conditions, doctors are testing new drugs and treatments in clinical trials to ensure that what they have learned about the coronavirus can be shared elsewhere with scientific validity.

    That work has already resulted in changes in the way hospitals deal with the cardiac implications of COVID-19. Doctors have found that the infection can mimic a heart attack. They have taken patients to the cardiac catheterization lab to clear a suspected blockage, only to find the patient wasn’t really experiencing a heart attack but had COVID-19.

    For years, hospitals have rushed suspected heart attack patients directly to the catheterization lab, bypassing the emergency room, in an effort to shorten the time from when the patient enters the door to when doctors can clear the blockage with a balloon. Door-to-balloon time had become an important measure of how well hospitals treat heart attacks.

    “We’re taking a step back from that now and thinking about having patients brought to the emergency department so they can get evaluated briefly, so that we could determine: Is this somebody who’s really at high risk for COVID-19?” Parikh said. “And is this manifestation that we’re calling a heart attack really a heart attack?”
    New protocols now include bringing in a cardiologist and getting an EKG or an ultrasound to confirm a blockage.

    “We’re doing that in large measure to protect the patient from what would be an otherwise unnecessary procedure,” Parikh said, “But also to help us decide which sort of level of personal protective equipment we would employ in the cath lab.”
    Sorting out how the virus affects the heart should help doctors determine which therapies to pursue to keep patients alive.

    Jorde said that after COVID-19 patients recover, they could have long-term effects from such heart damage. But, he said, treatments exist for various forms of heart damage that should be effective once the viral infection has cleared.

    Still, that could require another wave of widespread health care demands after the pandemic has calmed.

    https://apple.news/AX2mbJqXXTiSahm6rDAhv7Q
    Haven't MD's been saying since early March that multiple pts are dying of very quick onset severe myocarditis? I thought this was established already.

  7. #9032
    e^(i*pi) + 1 = 0 MannyIsGod's Avatar
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    I don't think HAPE is very well understood. At least it wasn't a decade ago when I was really into hiking and backpacking.

    Its definitely not. All my field work is at 13k feet and sometimes I"m fine and this past Jan when I was out there I had a day that just ing floored me and I couldn't go out and do any of my work. I was fine after a day in, but JFC it hit me all of a sudden and hard. The first time I was out at this field side 3 years ago I woke up feeling like everyday but was able to function.


    I remember when you got it though. In Yellowstone right?

  8. #9033
    Derrick White fanboy FkLA's Avatar
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    City has been made aware. I can't give you the details but it all starts with one home health company that to this day thinks Covid is overblown and is still sending people out to see pts with no PPE. They even send them to see known covid positive pts without telling them.
    Why is this home health company still being allowed to operate?

  9. #9034
    R.C. Drunkford TimDunkem's Avatar
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    Why is this home health company still being allowed to operate?
    Why is the rehab and retirement center in question still open period? They've had countless demerits after numerous inspections and are still allowed to operate. Over the years they have pretty much failed at everything you can think of when it comes to protecting the health of their patients.

  10. #9035
    Alleged Michigander ChumpDumper's Avatar
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    Another thing I just read about is that places with overwhelmed health care systems aren't able to test those who die in their homes for COVID-19, so that could lower the daily death count by the hundreds.

  11. #9036
    R.C. Drunkford TimDunkem's Avatar
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    My girlfriend lives out near E.Southcross and I always pass by that retirement center. Last time I did I wondered what they were doing - if anything- to protect the people inside. Now, unsurprisingly, it's looking like the new Kirkland. Damn.

  12. #9037
    R.C. Drunkford TimDunkem's Avatar
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    Another thing I just read about is that places with overwhelmed health care systems aren't able to test those who die in their homes for COVID-19, so that could lower the daily death count by the hundreds.
    Read yesterday that Florida in particular is having this problem. Shocker...not.

  13. #9038
    Alleged Michigander ChumpDumper's Avatar
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    Read yesterday that Florida in particular is having this problem. Shocker...not.
    Jesus, those retirement communities....

  14. #9039
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    Why is the rehab and retirement center in question still open period? They've had countless demerits after numerous inspections and are still allowed to operate. Over the years they have pretty much failed at everything you can think of when it comes to protecting the health of their patients.
    I'm not talking about the actual retirement center. Another home health rehab company that serves that nursing home.

  15. #9040
    R.C. Drunkford TimDunkem's Avatar
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    Jesus, those retirement communities....
    Yep. Not that I can verify how true this is or anything...but would anyone really be surprised?

  16. #9041
    e^(i*pi) + 1 = 0 MannyIsGod's Avatar
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    Pretty sobering thread.

    It seems likely we're grossly under counting deaths as well.

  17. #9042
    R.C. Drunkford TimDunkem's Avatar
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    I'm not talking about the actual retirement center. Another home health rehab company that serves that nursing home.
    I know, but both are true. The company and the centers themselves have clearly done a horrible job. I really feel for the families that have loved ones in places like that.

  18. #9043
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    Pretty sobering thread.

    It seems likely we're grossly under counting deaths as well.
    Yep, that's the one I saw. Thanks for the link. I wouldn't be surprised by more and more horror stories outside the hospitals going forward.

  19. #9044
    Grab 'em by the pussy Splits's Avatar
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    New hospitalizations down to 358



    IMHE cut its projected hospitalizations in half

    https://covid19.healthdata.org/projections
    I'm not sure what that first graph represents? Is that new minus discharged patients?


  20. #9045
    wrong about pizzagate TSA's Avatar
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    Pretty sobering thread.

    It seems likely we're grossly under counting deaths as well.
    Possibly, or due to lack of tests possibly not.

    In cases where a definite diagnosis of COVID–19 cannot be made, but it is suspected or likely (e.g., the cir stances are compelling within a reasonable degree of certainty), it is acceptable to report COVID–19 on a death certificate as “probable” or “presumed.” In these instances, certifiers should use their best clinical judgement in determining if a COVID–19 infection was likely. However, please note that testing for COVID–19 should be conducted whenever possible.

    https://www.cdc.gov/nchs/data/nvss/vsrg/vsrg03-508.pdf

  21. #9046
    Mahinmi in ? picnroll's Avatar
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    Haven't MD's been saying since early March that multiple pts are dying of very quick onset severe myocarditis? I thought this was established already.
    It’s been described before but the first time I’ve seen the scope of the problem and long term implications described.

  22. #9047
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    Porton Johnson to spend another night at the hospital

    seems like the “getting tests” excuse was a sad case of BS

  23. #9048
    Take the fcking keys away baseline bum's Avatar
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    Its definitely not. All my field work is at 13k feet and sometimes I"m fine and this past Jan when I was out there I had a day that just ing floored me and I couldn't go out and do any of my work. I was fine after a day in, but JFC it hit me all of a sudden and hard. The first time I was out at this field side 3 years ago I woke up feeling like everyday but was able to function.


    I remember when you got it though. In Yellowstone right?
    In the Ansel Adams National Forest just outside of Yosemite. I had AMS for two days so I decided not to push on and just wait it out and only do dayhikes around where I was camping (it usually clears up and has for me in the past) but once HAPE symptoms started showing up I waited until night and hiked down to the nearest road and hitchhiked back into the park.

    You think you had AMS? Because if it's HAPE or HACE don't you just die if you don't get lower?

  24. #9049
    Mahinmi in ? picnroll's Avatar
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    I'm not sure what that first graph represents? Is that new minus discharged patients?

    So by the numbers in that chart new admissions were at least 3565 not counting any increase from discharges.

  25. #9050
    Grab 'em by the pussy Splits's Avatar
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    So by the numbers in that chart new admissions were at least 3565 not counting any increase from discharges.
    Cuomo's chart says 358 on 5 April, yesterday. The data says 1709.

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