2019 Novel Coronavirus 医学信息链接

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豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-08 18:49

https://www.forbes.com/sites/tarahaelle ... 831c2929a6
CDC最新研究把传染率从2.2 调整到5.7了.这个解释了为啥中国之外是3天翻倍。
The authors point out that not having reliable diagnostic protocols early in the outbreak, changes to how cases are identified and tracked, and overwhelmed healthcare systems can throw a wrench into how well researchers can estimate the growth of an outbreak.

The early R0 of 2.2-2.7 was based on two things: early cases recorded in Wuhan before January 4, and on international flight data combined with infected people outside China.
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tiffany
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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-04-08 21:23

CDC调的?就是2月份还在说就是个大流感的CDC,突然发现这是个超强传染率的病毒?发 Peer reviewed 文章就好,没发没人看过他算数过程,先他就那么一说。
有酒有酒 闲饮东窗

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-08 21:28

报道说了, Emerging Infectious Diseases journal。CDC 自己的期刊,是peer reviewed 的。

CDC悄悄的还做了一些别的研究,比如我们县和LA和哪儿的surveillance testing。但是现在都没脸出来声张。就本地分享一下 :mrgreen:
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simonsun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by simonsun » 2020-04-09 1:29

才说夏威夷阳性率低,我家边上医院癌症科的15个医护就集体感染了。据说不是传染科急诊室的都不许戴口罩的。唉。
Violent delights.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-09 8:10

simonsun wrote:
2020-04-09 1:29
才说夏威夷阳性率低,我家边上医院癌症科的15个医护就集体感染了。据说不是传染科急诊室的都不许戴口罩的。唉。
很不理解不许戴口罩的理由。即使是在疫情早期也知道,戴口罩就算不一定有好处也一定没有坏处,好处其实医学界也知道(第一条就是防止人摸自己的脸防止挖鼻孔),这种白赚的事情为什么要禁止。从一开头我就感觉深层原因是种族歧视,洋人心理上不肯接受亚洲人比自己正确,特抵触。

------

基因分析表明,纽约的传染源来自欧洲:

Most New York Coronavirus Cases Came From Europe, Genomes Show
Travelers seeded multiple cases starting as early as mid-February, genomes show.
Last edited by Jun on 2020-04-09 10:24, edited 1 time in total.
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-09 10:13

我不理解医院里为什么不让带。可以理解不提倡广大群众带是为了减少跟医院争抢资源。
Nevertheless, she persisted.

dropby
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Re: 2019 Novel Coronavirus 医学信息链接

Post by dropby » 2020-04-09 11:08

你们这些何不食肉糜的家伙。

不让带当然是因为没有。比如我们这里,以前是不管的,口罩放在那里随便带。然后恐慌一开始,马上用量巨增,还有PPE被盗的。然后就规定普通医护人员不接触的不让带,这个前提下认为PPE足够。然后医护都抗议,就变成都可以带,但是每人每天定量领多少,也不敢放开随便戴。就算这样也马上就不够了。

口罩够的话那当然不是问题。现在不是全世界都抢口罩嘛。川普不让3M出口口罩到加拿大。加拿大自己不产口罩,以前都是靠美国的,马上傻眼。lululemon好象都开始做口罩了。

qinger
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Re: 2019 Novel Coronavirus 医学信息链接

Post by qinger » 2020-04-09 14:26

我口罩用得不多,因为lockdown后基本不出门,平均一周用一两个?之前用完就扔,现在把用过的放车库通风处,打算回收再利用。
现在偶是胡军的扇子。

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-09 14:42

最近看到new balance 在麻州的工厂生产的口罩了, 造型真是一言难尽啊。 感觉就是两只鞋垫缝起来,再穿上鞋带就成了。
Image
一个人的性格决定他的命运。

simonsun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by simonsun » 2020-04-09 14:48

designer mask :mrgreen:
Violent delights.

Elysees
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Elysees » 2020-04-09 15:47

之前本地医院说要募捐,我联系了国内的朋友,人有生产厂商的路子,然后跟我说外科口罩10万个起卖,N95口罩3万个起卖,也有防护服卖,我找不到那么多资金遂作罢。但就觉得这么看的话,中国厂商现在确实是有货有生产能力的啊,何至于此?
我自横刀向天笑,笑完我就去睡觉。

putaopi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by putaopi » 2020-04-09 15:53

估计中国出来的口罩都被加州买了。

笑嘻嘻
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 笑嘻嘻 » 2020-04-09 17:06

非FDA 标准(中国标准或者是欧盟标准)的口罩进口,只能以个人名义,做个人使用。我们捐献都是每个人小批买。加州州长砸钱买的大批就是从中国买的。中国大陆和台湾的产量都巨增,不至于买不到。但是这种耗材,全球人民如果日抛使用,恐怕比较困难。
云浆未饮结成冰

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-10 15:20

https://www.nejm.org/doi/full/10.1056/NEJMoa2007016

人民的希望第一个临床报告。只包含同情用药。求专家科普分析。
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Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-10 15:26

只瞄了一眼 abstract,直觉这药是有效的,不过得去查查 epidemiological 数据,目前重症病人(尤其是上了 ventilator 的病人)自愈率多少。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-10 15:47

武汉25%,上海53%,上海样本小但是。武汉上了ECMO的只有一个还是两个活下来,基本忽略不计。 这个报告里75%,当然还是样本太小也没有对照。
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Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-10 15:52

对,在没有对照组的情况下,只能存疑地来看这些数据。不过这些数据看着还是不错的。30个 mechanical ventilation 和4个ECMO 的病人,一半以上好了,给人的印象是此药对重症病人的效果比较明显,对轻症者反而效果不明显(?)。It's not a miracle cure but ... I would buy their stocks if I had extra money.

Disclaimer: 最后还是需要看双盲对照试验结果。

不知道富士的 favipiravir 现在怎么样了,那个看样子也有效,而且是口服药丸,安全性可能好于 remdesivir。

https://www.wbur.org/commonhealth/2020/ ... ilm-avigan
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-11 13:45

正好今天英国发布了一些进ICU 病人的数据。接近四千个进了ICU的病人,超过20%死亡,20%不到一点康复,剩下的60%还在继续。
平均年龄大约60,72%男性。75%超重。
这些病人里一千人用了呼吸机,四分之一左右。平均年龄62。男女比例仍然是7:3。重点:66%死了。 :uhh:
An analysis of 3,883 Covid-19 patients admitted to 229 critical care units in England, Wales and Northern Ireland up to Thursday has been published by the Intensive Care National Audit & Research Centre.

Of these patients, 871 have died, 818 have been discharged, and 2,194 were last reported as still receiving critical care.

The average age of the patients was 59.8 years. Some 72.5% were male, and 27.5% female. Some 66.4% were white, 14.4% Asian, 11.9% black, and 1.3% of mixed race.

Nearly three-quarters of the patients had a body mass index higher than the recommended healthy level of 18.5 to 25. Some 35% had a BMI of 25 to 30 - the overweight range. And 38.5% had a BMI over more than 30 - putting them in the obese range.
93.2% had previously been able to live without assistance in daily activities. Only 6.7% previously needed some assistance, and just three needed total assistance.
Focusing on the 1,053 patients who needed advanced respiratory support, the average age on admission was 61.9 years. 73% were male, 27% female. Out of this group, 66.3% died, and 33.7% are alive.
Examining the final outcome for patients admitted to critical care, for the 133 aged 16-39, 76.7% were discharged alive, and 23.3% died. For the 484 aged 60-69, 43.6% were discharged alive, and 56.4% died. For the 434 aged 70-79, 31.3% were discharged alive, and 68.7% died. And for the 107 aged over 80, 27.1% were discharged alive, and 72.9% died.
Nevertheless, she persisted.

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-11 14:19

二三月份的时候好像湖北的临床医生就发现呼吸机和大量吸氧不能缓解病情,有的反而加剧。
目前看来人民的希望对重症虽然有点效果,但是副作用也很大。
氯喹其实副作用也很大的, 最近听说Sanofi 也捐了不少出来了。
中国的一个腺病毒做载体的疫苗上二期临床了, 应该是疫苗领域最快的。
https://www.fiercepharma.com/vaccines/c ... afety-data
一个人的性格决定他的命运。

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-11 19:11

英国首相进了一轮ICU也是很惊险了。
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Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-12 3:13

BJ 没用呼吸机,而且进了两三天就出来了,应该不是特别严重。年龄来看,他五十五岁,六十岁以上才特别凶险。

lucoco wrote:
2020-04-11 14:19
中国的一个腺病毒做载体的疫苗上二期临床了, 应该是疫苗领域最快的。
https://www.fiercepharma.com/vaccines/c ... afety-data
这是好消息啊!川皇有打电话来说要买这个公司吗?

来个花边新闻:
英国小姐重披战袍作医生,她是印度裔移民,九岁以难民身份跟随父母搬来英国。毕业做呼吸科医生同时参加选美,去年10月请长假、参与在伦敦举办的世界小姐选美比赛,获胜后前往外国展开慈善之旅。现在毅然停止回英国重回NHS一线岗位。

英国医生待遇不错,但是不算最好,比美国差的很远。本国人少,NHS中三分之一医生是外国出生,因为医科教育系统接轨的缘故,大量来自前殖民地国家和欧洲其他国家。这次冲在前线死去的头九个医生都是外国来的。护士待遇差,本国人更不愿意做,外国人比例更高。我希望英国民众在为NHS鼓掌的时候,能够visualize 一下NHS的一张张脸孔,三分之一是他们要排出去,“抢了英国人工作”的“外国人”。

https://www.bbc.com/zhongwen/simp/uk-52249732
Image

Image
在任“英国小姐”说,疫情期间重返一线做医生是“天经地义”。
芭莎(Bhasha Mukherjee)今年24岁,现任“英国小姐”,但她也曾是英国的“新科”医生,而且专攻呼吸科!
英国疫情日益严峻,芭莎毅然结束她在印度的慈善之旅返回英国,预计下星期起重新加入“英国全国医保体系”NHS做一线医生。
芭莎告诉BBC,“能够在做英国小姐的同时为英国的骄傲-全国医保体系效力,我再自豪不过!”
芭莎拥有现任英国小姐头衔,此前在亚洲各地做慈善巡回。看到英国面临的危机,她说,真心希望能“分担重负”。
“我觉得,自己在安全的地方穿衣打扮、同事却在前线冲锋陷阵,太不公平了。”

英国疫情爆发以来,“英国全国医保”体系迅速调整,措施之一是调整人力分配、请新近“退役”的医护人员重返一线。
芭莎四月初从印度返回,开始自我隔离,她仍需要解决她重返一线的一些细节安排,包括需要住在哪里、值哪些班等等。
“我更关心NHS的压力”
2019年芭莎加冕“英国小姐”,当时她也是NHS新“入道”的医生。现在她很清楚,自己可能必须接受更多的培训、承担更多的责任。
芭莎也很明白重返病房可能面临的风险,但是她说:
“我可能在其他任何地方、任何时候染病,比如在印度的任何一个机场。我最担心的是NHS目前面临的压力。”

芭莎九岁时从印度加尔各答迁居英国德比郡, 2019年8月获“英国小姐”选美头衔。此前不久,她刚刚获得诺丁汉大学颁发的医学双学位。芭莎在医院实习期间专攻呼吸科。同期继续做业余模特、参加选美。去年10月芭莎请长假、参与在伦敦举办的世界小姐选美比赛,获胜后前往外国展开慈善之旅。
“别人一直劝我在娱乐、选美和行医之间做选择,现在我可以兼顾。”
“如此关头为国效力,‘英国小姐’还有比这更好的选择吗?”
Nevertheless, she persisted.

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-12 7:18

Knowing wrote:
2020-04-12 3:13

lucoco wrote:
2020-04-11 14:19
中国的一个腺病毒做载体的疫苗上二期临床了, 应该是疫苗领域最快的。
https://www.fiercepharma.com/vaccines/c ... afety-data
这是好消息啊!川皇有打电话来说要买这个公司吗?
:-D 这家公司的名字是CanSino... 疫苗candidates 是军科院的陈薇院士组出来的(据说疫情一开始他们就接管了武汉病毒所)。
川皇可以试试看?
这几天听了几个国内COVID-19 研发讲座,他们很多项目做的非常快,而且靠谱。 比欧美早了两个月的疫情的研发先机,加上先前SARS 的经验,还是非常impressive的, 美国这次方方面面得表现相比较而言真的差很多。。。
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-12 7:25

说实话军科院研制出了疫苗我倒是不意外,不过如果成功了不卖给美国,以川皇之道还其之身就有趣了。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-12 7:38

Jun wrote:
2020-04-12 7:25
说实话军科院研制出了疫苗我倒是不意外,不过如果成功了不卖给美国,以川皇之道还其之身就有趣了。
嗯,估计川皇也不知道,类似的疫苗 JNJ 也在开发, 不过很慢,听说起码要7-9月份才能上临床。
川皇估计是容不得别人比他快的。。。
Fujifilm 的 Avigan (favipiravir) 据说效果比人民的希望好。 这个中国的浙江海正正在大规模生产generic favipiravir.
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-12 14:31

CanSino 名字就起得好,听上去象 Casino,川皇一拍板“买了!” :roll:

英国小姐 :super:
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

CAVA
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Re: 2019 Novel Coronavirus 医学信息链接

Post by CAVA » 2020-04-12 14:45

下次英国保守党要削减NHS经费的时候,不知道会不会记得Boris Johnson今天说过的话。

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-12 16:09

希望民众记得。
Nevertheless, she persisted.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-13 11:39

最近收到几个关于消毒的问题,包括家里亲人,顺便公告一下也许对大家有帮助。

如果酒精和 disposable wipes 缺货,可以用稀释的洗衣粉或 liquid dish soap 来擦物体表面,如门把手,外包装,总之手接触的地方。

面罩可以用加热方法杀死病毒,例如把烤箱开到60摄氏度,即140华氏度,放进去几分钟即可。特好笑的是我一说起这个方法,我哥哥和婆婆分别惊骇地问会不会烧着了,60摄氏度连水都烧不开,手都不会烫到,当然很多细菌也是杀不死的,但是杀病毒足够了。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

vivi
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-04-13 12:26

很多烤箱最低知道170F。Food Dehydrator 可以。N95比较金贵,其他的面罩估计没太大所谓。
又没头脑又不高兴

CAVA
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Re: 2019 Novel Coronavirus 医学信息链接

Post by CAVA » 2020-04-13 12:32

感谢Jun同学。

关于消毒网上众说纷纭。肥皂和水洗手是各国都认可的最佳方法,宅在家里基本可以做到,比酒精啫喱有效。衣物放在洗衣机里洗,基本等同于肥皂和水,应该也能杀毒。英国政府网站说感染病毒的人与无感染的人衣服放在一起洗也没关系,我则尽量用60度机洗。物体表面消毒这里分歧比较大,一般都说日用品包装带有病毒的可能性虽然有,但并不最高。也许所谓消毒求得的更多是心理安慰。稀释漂白粉水普遍认为最有效,可操作起来不如disposable wipes方便,味道会不会也很大?Disposable wipes除了70%酒精以外哪些有效哪些无效,也有争议。

哎有时候甚至想干脆早点感染也罢,省得一年以内都提心吊胆。

lucoco
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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-13 13:34

CAVA wrote:
2020-04-13 12:32
感谢Jun同学。

关于消毒网上众说纷纭。肥皂和水洗手是各国都认可的最佳方法,宅在家里基本可以做到,比酒精啫喱有效。衣物放在洗衣机里洗,基本等同于肥皂和水,应该也能杀毒。英国政府网站说感染病毒的人与无感染的人衣服放在一起洗也没关系,我则尽量用60度机洗。物体表面消毒这里分歧比较大,一般都说日用品包装带有病毒的可能性虽然有,但并不最高。也许所谓消毒求得的更多是心理安慰。稀释漂白粉水普遍认为最有效,可操作起来不如disposable wipes方便,味道会不会也很大?Disposable wipes除了70%酒精以外哪些有效哪些无效,也有争议。

哎有时候甚至想干脆早点感染也罢,省得一年以内都提心吊胆。
10% freshly prepared bleach 肯定是最有效的。不过那个味道实在是太大了, 非常时期,我两周一次用来消毒浴室和马桶。
肥皂水/洗衣液/dish detergents 其实都可以用来消毒的。
酒精啫喱我一直觉得消毒能力最弱, 对病毒还好, 对很多细菌,霉菌,没啥用。
但是酒精啫喱一个是方便,另外一个就是最后都挥发了, 没啥毒性和副作用。
disinfectent wipes 应该不是alcohol based? 至少这边卖的lysol, clorox 系列应该不是。
我不担心衣服, 也不选热水洗衣服, 我觉得烘干机开到最热那一档,烘干衣服,没问题的。
groceries 我真的觉得没必要消毒, 但是迫于某人的压力, 进冰箱的东西,我拿酒精擦一下。 其他的堆在车库, 放几天。
一个人的性格决定他的命运。

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-13 13:42

CAVA wrote:
2020-04-13 12:32
哎有时候甚至想干脆早点感染也罢,省得一年以内都提心吊胆。
I know that feeling. I have the same thought a lot. 如果已经被暴露了不就可以大摇大摆到处晃荡了吗?

可惜目前不知道感染后重病的原因是啥,尤其是有些看似健壮的年轻人也会倒下,虽然比例颇低。我真觉得跟基因有关系,也许以后会研究出来。

我也觉得 package 塑料袋之类的表面是安全的,要不然阿玛桑之类的仓库工作人员早就大片倒下了。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-13 14:09

Jun wrote:
2020-04-13 13:42
CAVA wrote:
2020-04-13 12:32
哎有时候甚至想干脆早点感染也罢,省得一年以内都提心吊胆。
I know that feeling. I have the same thought a lot. 如果已经被暴露了不就可以大摇大摆到处晃荡了吗?
还是不要了。 目前一个是不知道重症有多严重, 还有一个就是就算暴露了之后有了抗体,不等于有了免疫力。 有二次感染的可能性。
我个人感觉,第一次感染,轻症恢复的那种估计免疫力最强; 如果第一次感染没有症状 (那免疫力肯定不够的),或者是第一次感染后中-重症活下来的 (有了irreversive damage) , 二次感染估计还是会很麻烦。
估计到最后就是拼基因了。。。
一个人的性格决定他的命运。

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Re: 2019 Novel Coronavirus 医学信息链接

Post by tiffany » 2020-04-13 14:50

不要吧,疫苗研制中,快出来了。坚持到疫苗出来了,打上了基本就比较安全了。
有酒有酒 闲饮东窗

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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-04-13 14:54

我妈和我们住,这种想法我都不敢想。
又没头脑又不高兴

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-13 15:25

想想而已,小豪不是已经用 coronavirus party 的实例吓唬过我们了嘛,6个进 ICU,两个死掉。

我觉得如果第一次感染后如果症状明显,并且后来确实好了,短时期应该不会二次感染了,体内的 memory B cells 和抗体也都够用了。有少量阴性诊断复阳的病例,造成了不少恐慌,但实际上是呼吸道取样+/-检测结果不准,以及 viral shedding 时间长的原因,换言之,就算症状消失了,呼吸道的 viral load 少到暂时测不出来,体内遗留的病毒不一定已经杀干净了,但目前看来是少数。
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

CAVA
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Re: 2019 Novel Coronavirus 医学信息链接

Post by CAVA » 2020-04-14 2:48

lucoco wrote:
2020-04-13 13:34
disinfectent wipes 应该不是alcohol based? 至少这边卖的lysol, clorox 系列应该不是。
跟lysol同一母公司的Dettol,在自家网站上声明有几种产品可用于新冠消毒(如下)。其中一种Surface Cleanser Wipes,成分:100 g of product contains 0.37g Benzalkonium Chloride, Disinfectant, Parfum。但有不少质疑说Benzalkonium Chloride对新冠无效果。
Given the structural similarities of the COVID-19 virus to the coronavirus strains tested previously (SARS-CoV, MERS-CoV, Human Coronavirus), and based on the evidence available to us, we would expect our Dettol products (listed above) to be effective against the new strain. Definitive scientific confirmation of this, as with all other commercially available virucides, can only be provided once testing against COVID-19 Coronavirus has been conducted, following release of the strain by relevant health authorities.

Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-14 3:03

英国的新增病例,入院人数和死亡人数都开始持平。希望是end of the beginning 的征兆。今天看见BBC的报道,官方报的新冠死亡人数只统计医院里的死亡,不统计老人院和在家死亡,所以低于实际数字。然而另一个说法是,有没有新冠,80岁以上的人每年都是死10%, 对高龄人士,新冠并没有增加死亡危险。
听了一篇卫报讲新冠疫苗开发的文章,说DNA or RNA vaccines是本世纪才有的新技术,从来没有真正使用于投产,所以虽然大大缩减开发疫苗第一阶段的时间,第二阶段临床试验快不了,还是要12-18个月。但是如果这个技术制造新冠疫苗成功,是分水岭,因为今后对付其他瘟疫多了利器。这就是你们说的Inovio 疫苗是DNA vaccine, moderna 的mRNA vaccine 新技术平台?报道里的科学家说她们是拿到病毒测序系列就开始在电脑上做,根本没见到病毒本身,这种事儿总是让我觉得很high...

https://www.theguardian.com/news/audio/ ... ne-podcast
Nevertheless, she persisted.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-14 7:17

还好各种疫苗都在研究中,传统的 inactivated 病毒本身或表面蛋白质也在研究,新技术也上,总之就是 we will have one, maybe several, successful vaccines, probably soon. 当然啦,如果新 platform 成功了,以后开发别的疫苗会更快。

-----------

最近只有时间看看本州的数据,十分幸运 Virginia 的情况相当稳定,死亡人数不是很多,也没有挤兑医疗资源。卫生部门很体贴地在网站上报道了 outbreak 的状况,说明做图表的是内行专业人士:人数多而且死亡率高的 outbreaks 在于 long-term care facilities,人口密集的公寓楼也有,但并不危险。

现在数据多了,形势比开头明朗很多,感觉渐渐可以开放一些公共场所了,同时重点控制高危的setting,如 long-term care 和医院诊所之类地区。目标不是完全清零而是把发病数控制在一定数目之内。

纽约也过了 peak,曙光在前头!
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

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Re: 2019 Novel Coronavirus 医学信息链接

Post by lucoco » 2020-04-14 8:09

Jun wrote:
2020-04-14 7:17
还好各种疫苗都在研究中,传统的 inactivated 病毒本身或表面蛋白质也在研究,新技术也上,总之就是 we will have one, maybe several, successful vaccines, probably soon. 当然啦,如果新 platform 成功了,以后开发别的疫苗会更快。

-----------

最近只有时间看看本州的数据,十分幸运 Virginia 的情况相当稳定,死亡人数不是很多,也没有挤兑医疗资源。卫生部门很体贴地在网站上报道了 outbreak 的状况,说明做图表的是内行专业人士:人数多而且死亡率高的 outbreaks 在于 long-term care facilities,人口密集的公寓楼也有,但并不危险。

现在数据多了,形势比开头明朗很多,感觉渐渐可以开放一些公共场所了,同时重点控制高危的setting,如 long-term care 和医院诊所之类地区。目标不是完全清零而是把发病数控制在一定数目之内。

纽约也过了 peak,曙光在前头!
太好了。 麻州刚刚进入peak, 看到别的州的曙光非常鼓舞。 这些消息要多多跟大家分享。

现在川普的briefing 根本没法看了都, 从一开始记者们看他回答问题的表情还是苦笑,不可思议,到现在更多的是一种horror, 讲真我觉得记者们应该联合起来, boycott 他的一切public apperance, 把他彻底逼疯算了。
一个人的性格决定他的命运。

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Re: 2019 Novel Coronavirus 医学信息链接

Post by CAVA » 2020-04-14 8:51

即使我们被逼对川普的无耻发展出了一定的承受力,昨晚的这场表演也太荒诞了。如果有植物人四年之前昏迷,今天醒过来一看,会认不出今天的美国政府罢。

BBC驻美国记者写的:
This has been the most dizzying, jaw-dropping, eyeball-popping, head-spinning news conference I have ever attended. And I was at Bill Clinton's news conference in 1998 when he faced the press for the first time over his relationship with Monica Lewinsky.

.........

There are more than 23,000 Americans dead because of coronavirus and more than half a million infected - and remember that, in early March, Donald Trump was saying there were a handful of cases, but that would soon be down to zero.

Yet Donald Trump walked into the briefing room with scores to settle with the media. This wasn't about the dead, the desperately sick, the people fearful of catching the virus. This was about him. And more particularly his profound sense of grievance that the media has been critical of his handling of Covid-19.

.........

Like so much in this divided country, I suspect it is entirely a question of where you stand. His supporters will probably have loved him sticking it to the media the moment he walked into the briefing room.

His opponents will have been appalled that he could put the coverage of his own handling of the crisis above the suffering of the American people.

Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-14 9:20

It's not just him. 所以外国的同学无法想象美国已经处于实质内战的状态。

Nearly half of Republicans think Trump should be able to close news outlets: poll
Christal Hayes
USA TODAY
Nearly half of Republicans surveyed — 44 percent — believe the president should be able to shutter news outlets for "bad behavior," according to a new poll released Tuesday.

The poll by Ipsos emphasizes the clear divide between party lines when it comes to the role of the media and its coverage of the Trump administration. Twenty-nine percent, nearly a third, of the more than 1,000 people polled said they believed the news media was the enemy of the American people, a phrase that was coined and popularized by President Donald Trump. That number jumps to 48 percent if you just examine Republicans surveyed.
他只不过是说出三分之一的美国人的心里话而已。有数据表明,过去几十年里,美国人民里的 hardcore racists 比例一直保持在30%-40%。

It so happens that racist leadership is fucking up public health right now. If they were doing well in public health, more people would be openly supporting the administration's racism.

Right wing Americans have been waging a civil war against "libtards" and minorities and (especially) immigrants, since ... I'd say Obama's second term, at least.
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-14 12:04

美国按人口ICU病床蛮多的,而且普通病床改成ICU也很容易很快。记得看到这个讨论的时候,有人感慨说,就算美国有3亿张ICU病床,我也不想去躺上一躺。

BJ住了三天ICU转普通病房,现在还在乡下疗养。进一趟ICU还真不是小事。COVID-19 的ICU 比例蛮高的, 接近确诊的10%,住院人数里的1/3-1/2这样。
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Jun
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Jun » 2020-04-14 12:42

Johns Hopkins 的医生叙述自己患病的经过,现已痊愈并回到工作岗位。提到了感染期间嗅觉失灵,以及 isolation。

https://www.medpagetoday.com/infectious ... id19/85886
"I thought I was going to be so productive, that I would be able to sit and write papers, but I couldn't bring myself to do anything," she said.

That wasn't just a result of the fatigue: the isolation from loved ones also fed into her lack of inertia, she said.

"By day 10, I was in a pretty dark place," she said. "Having human touch and contact is so important to the psyche. I know this from my ICU research, but personal experience is so different."
There was nothing to warn anyone about. The world went on, even as it fell apart, changed irrevocably, became something strange and different. --- "Acceptance" in The Southern Reach Trilogy by Jeff VanderMeer

豪情
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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-14 13:13

我记得支援武汉的医护比例是1:10.护士的需求量非常大。 这是个非常耗费护理资源的病。英国那个新改造的大型医院叫南丁格尔?
"In cyanotic heart disease, we see kids with pulse ox saturations in the 70s or 80s all the time, and we generally only intubate when we see increased work of breathing or poor perfusion," she said. "It can be alarming to see patients with sats in the 70s, just sitting there talking to you, looking fine, but we're used to that in PICU."
这个也是经常被提到的这个病很容易得不到及时治疗的一个缘故。肺和血氧已经很糟糕了,但是症状不明显。颠覆传统经验和标准操作。
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Knowing
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-14 13:41

我被各种故事吓得买了个血氧仪。
英国在几个城市改建了医院,都叫南丁格尔。伦敦这个目前有五百张ICU床,但是可以扩大到四千张。现在ICU没有过载,全英国还有二千五百张空床。
Nevertheless, she persisted.

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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-14 14:17

我一月底就买了,现在买不到。回国回来全家轮流感冒了一轮。除了呼吸症状,其他都很像,间歇性发烧,失去味觉嗅觉肠胃有症状,根本吃不下任何东西,掉了十磅以上。延绵很久都不好,咳嗽,人特别虚弱,最后忍不住疑神疑鬼买了个,寄到我也基本好了。

大概是二十号我带ETHAN去看了儿医,希望照个X光。他们如临大敌让我们从发热进口进去,医生戴着N95,拿了个google map让我们指认去了哪些地方。看了半天,说不管是啥, 现在已经基本好了应该测不到了,也没照。我自己的医生约不到,约到也好了。
Last edited by 豪情 on 2020-04-14 14:55, edited 1 time in total.
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Re: 2019 Novel Coronavirus 医学信息链接

Post by vivi » 2020-04-14 14:39

豪情 wrote:
2020-04-14 14:17
我一月底就买了,现在买不到。回国回来全家轮流感冒了一轮。除了呼吸症状,其他都很像,间歇性发烧,失去味觉嗅觉肠胃有症状,根本吃不下任何东西,掉了十磅以上。延绵很久都不好,人特别虚弱,最后忍不住疑神疑鬼买了个,寄到我也基本好了。

大概是二十号我带ETHAN去看了儿医,希望照个X光。他们如临大敌让我们从发热进口进去,医生戴着N95,拿了个google map让我们指认去了哪些地方。看了半天,说不管是啥, 现在已经基本好了应该测不到了,也没照。我自己的医生约不到,约到也好了。
能测个抗体吗?
又没头脑又不高兴

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Re: 2019 Novel Coronavirus 医学信息链接

Post by 豪情 » 2020-04-14 14:49

斯坦福两周前在南湾测了3200个志愿者,我事后才知道否则也想去测。刚报名全国的测试但是不知是否能抽上。斯坦福在给自己的医护和工作人员测。过一阵子估计南湾会放开测。

没有呼吸症状这点不像。感冒的病毒多了。当然我很希望全家都有抗体了,反正苦头也吃了, 现在省多少心。如果没有还是千万不要传染上。
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Re: 2019 Novel Coronavirus 医学信息链接

Post by Knowing » 2020-04-14 15:03

说道十分之一住院,我觉得有点奇怪。英国的数据里测试positive 和住院人数官方公布数字的确达到10:1. 我的邻居群里目测一下,至少有七八个房子,每个房子里三到五人不等,得了病,到现在为止,只有一个六十岁左右的男性进了医院,住了三周,险些要进ICU,但是最后熬过来,现在已经出院。所以绝对不到10%住院率。英国的guideline 是生病了就在家自我隔离,严重到一定程度才去医院。估计这些生病的邻居都觉得自己症状显然是而没有测试。
Nevertheless, she persisted.

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