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Since #California is #shelteringinplace for #COVID19 here tips for how to survive based on my 21 day quarantine after returning from W. Africa

1. Develop a daily routine/schedule
2. Limit time on TV/Internet dedicated to COVID-19
- Check news 1-2x/day
- Follow a few sources
3. Exercise
- Go for a walk/run, try an online yoga class or video
4. Schedule FaceTime or Skype calls with friends/loved ones (particularly the elderly)
5. Pick up a new hobby
-Cooking, painting, take an online course in something you always wanted to learn (@coursera)
6. If nervous/anxious try to meditate.
- You can use apps like @Headspace or @calm
7. Have virtual "dates" via @Zoom or @Skype
- coffee, drinks, dinner, movie nights
8. Organize that room/closet you have always wanted to
9. Play online games with friends (i.e. @wordsproblems)
10. Journal or blog about your experience
11. Make a #COVIDComfortKit which includes things like your favorite movies, podcasts, books, playlists, games, comfort foods, and other things to pass time

@KindrachukJason @MackayIM @Crof @GeopoliticalJD @svqjournalist @RebeccaKatz5
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#California #shelteringinplace #COVID19 #COVIDComfortKit

More from @KrutikaKuppalli see all

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Dr. Krutika Kuppalli
@KrutikaKuppalli
Ppl ask, why not try #Hydroxychlorquine and #Azithromycin for #SARSCov2 #COVID19. Here is some important info to know about the study sciencedirect.com/science/articl…

1. 20 HCQ pts (200 mg TID) & 16 controls with SARSCoV2
2. Pts w/ URTI, LRTI, or asx
3. 6 HCQ pts received Azithro x 5 d
4. Pts received Azithro to prevent bacterial superinfxn
5. At day 6 post-inclusion 70% of HCQ pts were virologically cured vs 12.5% in control
6. At day 6 100% (6 pts ) with HCQ+Azithro were virologically cured vs 57.1% of HCQ only (14 pts) vs 12.5% in control (16 pts)
Although this data is potentially promising there are a few things to consider
1. This study is not powered for efficacy
2. Small sample size
3. No long term follow-up (although virologically cured unknown if it returned)
4. Unclear info on pt co-morbidities who received drugs
Read 5 tweets
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Dr. Krutika Kuppalli
@KrutikaKuppalli
New @CDCMMWR describing Outcomes in pts with #COVID19 from 2/12/20-3/16/20. Info below

1. 4,226 cases by 3/16/20
2. 31% of cases, 45% hospitalizations, 53% of ICU admissions and 80% deaths in pts > 65 yo
3. Highest % severe outcomes >85 yo
4. No ICU admits or deaths <19 yo
5. No data on co-morbidities available

6. Of 2,449 pts with known age
- 6% >85 yo
- 25% 65-84 yo
-18% 55-64 yo
-18% 45-54 yo
-29% 20-44 yo
-5% 0-19 yo

7. Of 508 pts hospitalized
-9% >85 yo
-36% 65-84 yo
-17% 55-64 yo
-18% 45-54 yo
-20% 20-44 yo
*Hospitalization Rate 20.7-31.4
8. Of 121 pts admitted to ICU
-7% >85 yo
-46% 65-84 yo
-36% 45-64 yo
-12% 20-44yo
*ICU Admit Rate 4.9-11.5

9. Outcomes in 44 cases
-15 Deaths in >85 yo
-20 Deaths in 65-84 yo
-9 Deaths in 20-64 yo
*Fatality 1.8-3.4

cdc.gov/mmwr/volumes/6…
Read 3 tweets
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Dr. Krutika Kuppalli
@KrutikaKuppalli
On 3/3/20 Chinese NHC issued version 7 of "Diagnosis and Treatment of Novel Coronavirus PNA" Info below
1. In confirmed cases (PCR) had serology with IgG/IgM
2. Most new have IgM + 3-5 days after onset
3. Recovery of IgG is 4 times or more higher than acute phase
4. ECMO indications for Fi02 >90% and O2 index <80 mmHg for > 3 hrs, airway plateau pressure >35
5. CRRT for significantly ill patients
6. For severe and critically ill patients with elevated IL-6 and extensive lung disease recommend tocilizumab (ongoing trial in China)
7. #Tocilizumab does NOT prevent infix with #COVID19 it helps mediate the cytokine storm from IL-6
Some exclusion are ALT/AST > 5x ULN, active TB, or certain fungal infections
8. Children with severe or critical cases consider IVIG
translate.google.com/translate?sl=a…
Read 3 tweets

Related threads

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Lawrence Gostin
@LawrenceGostin
Language re #covid law, ethics, policy is wooly/confusing. What is #SocialDistancing Mass #Quarantine #Lockdown? We can't possibly balance PH & HRs w/o knowing exactly the intervention. This thread explains what policies are ethical & lawful, & those that are troublesome.
I've worked in PH Law since #AIDS

amazon.com/Public-Health-…

Following is lawful/ethical w/ individualized risk assess based on sci:
❖ Isolation: positive #SARSCoV2 test
❖ Quarantine: known exposed
❖ Close venues posing sig risk of spread (schools, businesses, mass gatherings)
These actions stretch law/ethics, no clear precedent in modern con law:
❖Cordon sanitaire of large area (incorrectly termed "lockdown")
❖So-called "Mass Quarantine" of large venue (nursing home, cruise ship, apartment block)
❖Draconian enforcement: armed guards, intrusive surv
Read 8 tweets
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Ralph Napolitano
@DrRalphNap
How To Develop Old School Mental Toughness:

1. Resist Impulses
2. Get uncomfortable
3. Workout
4. Eat healthy
5. Sleep
6. Set goals
7. Get organized
8. Meditate
9. Manage time
10. Live in gratitude
11. Relentless determination
1. Resist Impulses

•Don’t reach for the snack foods or energy drinks.

•Don’t buy crap you don’t need.

•Stop checking social media and email every 2 minutes.

•Don’t watch main stream news or porn.
2. Get Uncomfortable

Do something difficult everyday.

Something you hate to do that you’ve been avoiding.

This conditions you to attack obstacles instead of running from them.
Read 13 tweets
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Kera «« Listen to Disabled People »» O’Regan
@KeraSauR
For lots of people navigating working from home for a bit, I know it’s tricky!

I don’t always follow my own advice, but here are a few practices I try to implement myself and with my wee team of remote workers to help us keep things rolling smoothly:
1) Do not, I repeat, do not work from bed. Not even to check emails on your phone in the morning (guilty). Keeping a separate work space helps to not only prevent the overwhelm of work bleeding into personal space, but also helps you get in the zone for doing productive mahi.
2) If you don’t have a separate space to work from, or need to work from bed for any reason, try to establish a separate ritual for getting into work mode - it might be only to work once you’ve had your morning coffee or brushed your teeth, and to put the laptop away at X time.
Read 32 tweets
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Tom Jesson
@thomas_jesson
Fantastic podcast on coronavirus #COVID - here are my notes, if helpful to anyone
Comparisons to other diseases:

Compared to SARS, MERS, coronavirus is "more transmissible... really unforgiving".

Compared to the flu - "I hear a lot of this, 'it's just like the flu' - it's 20x more deadly, from what we know right now"
The flu is, comparatively, "not that transmissible"... "for the flu you need close contact", which is defined as being within 6 feet for 10-15 mins.
Read 22 tweets
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Sam Parker 🇺🇲
@SamParkerSenate
1. Wuhan Coronavirus is an engineered offensive bioweapon.

You're not being told this by the Mockingbird media here because the US Gov is directly responsible for the global bioweapons arms race. We've spent somewhere in the neighborhood of $100-200 Billion since 9/11.

(cont)
2. The swine flu, hoof & mouth and western Africa ebola outbreaks, etc, were all bioweapon development accidents.

This kind of research is happening here, on US soil, & the last thing our police-state rulers want is for us to be aware of this domestic WMD research.

(cont)
3. The WHO, CDC, Fort Detrick, NIH & Big Pharma all know what's going on. Their corporate media allies are not going to spill the beans.

We're being lied to, and not just by China.

#WuhanPneumonia #WuFlu #WuhanCoronavirus

(cont)
Read 64 tweets
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DocRock1007 🇺🇸
@DocRock1007
...to San Francisco. apnews.com/cc77e92054c495…
2. Roads in and out of #Wuhan (even small side roads) being barricaded with piles of dirt/rocks to block all traffic in or out.
3. "Ye shall not eat any thing with the blood: neither shall ye use enchantment, nor observe times. Ye shall not .. print any marks upon you: I am the LORD. Do not prostitute thy daughter, to cause her to be a whore; lest the land fall to whoredom"..."apnews.com/d59f43a911996a…
Read 279 tweets

Trending hashtags

#Dubai #terrorism #WestBank #coronavirus #Spain #COVID #LaPaz #UnitedArabEmirates #Twitter #NYC #Assange #Israel #WorldHypocrisy #American #NBC #冠状病毒 #Gulen #France #CoronaVirusUpdate #ConfrontingHolocaustDenial #BinLadenDeath #Oil #NewZealand #Hospital #Shanghai

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