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For an entire ER shift, I saw a total of one non #COVID19 patient (TIA, prior strokes, 95yr). Only able to discharge 2 #COVID19 home, rest too sick to convalesce at home. There is a Tsunami coming. The public needs to understand:
- there is no cure,no quick fix, 2 wk of suffering
- sick contact & travel history matters little now
- a LOT of household transmission. This is a BIG problem
- all "flu"s should be treated as #COVID19| isolate, quarantine
- even sick should stay home.Only if short of breath need to be seen.Still may be sent home.
Spread the word
Almost forgot: the data from US could prove very different from Wuhan experience. Young patients become severely ill relatively fast. Multiple patients in their 20-30 in severe #ARDS and two on #ECMO
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Josh Swihart
@jswihart
This thread is my story battling symptoms this last week. They started differently than what has been reported, which caused some confusion and later fear, and might have led to other's exposure. I believe there are a things we (collectively) can do to better combat #COVID
My wife (Melody) and I were exposed to someone that was sick and in our home a few days before we started seeing symptoms. Melody developed a mild fever, headache and was nauseous a little over a week ago. She also had digestive issues.
The next day, I started having the same issues and developed a rash on my biceps that lasted for a few hours. We didn’t think much of it, because these aren’t symptoms commonly described as being related to COVID-19 and we likely exposed other people.
Read 21 tweets
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Aptulla GONBULPİŞİK
@islakmeseodunu
Bu doktoru takip etmeye başladım. Bu zincirinde COVID-19'la ilgili yanlış bilinen 10 hususu açıklıyor. Daha çok insan görsün diye her bir tivitin capsini alıp çevirisini yapacağım. Yapayım mı, lüzumsuz yere akışı işgal etme diyorsanız yapmam.
#COVID-19'la ilgili pek çok söylenti duyuyorum ve yanlış bilgileri hızlıca düzeltmek istiyorum.

Coronavirüs yaz aylarında silinecek.

Yanlış. Önceki pandemiler mevsimsel düzenlilik göstermemiştir, kaldı ki biz yaza girerken GYK kışı yaşayacak. Virüs küresel (dağılımlı)
Mit #2: Yaz aylarında virüs, sivrisinekler aracılığıyla daha fazla yayılacak.

Yanlış. Bu enfeksiyon kan yoluyla değil solunum damlacıklarıyla yayılıyor. Sivrisinekler yayılmayı (bulaşımı) artırmayacak.
Read 12 tweets
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Alex Wellstead
@AlexWellstead
This is an incredibly inaccurate headline and article.

Bottom line: the Canadian government - led by Prime Minister @JustinTrudeau - has been acting to protect Canadians since the very beginning of #COVIDー19.

Here's a bit of a timeline... 1/
When the disease became a real concern for Canadians abroad, the government acted to get hundreds of Canadians home safely. 2/
rcinet.ca/en/2020/01/29/…
During that time, Canada's top public health official, Dr. Tam, (@CPHO_Canada) and the Minister of Health, @PattyHajdu, began sharing with Canadians the best public health practices and measures to follow.

And they still are. 3/
theprogress.com/news/heres-wha…
Read 11 tweets
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Trisha Greenhalgh
@trishgreenhalgh
1/n
Thread for healthcare providers on video consultations (VCs) as a partial solution to #COVID pandemic. I’ll cover RESEARCH, CLINICAL, TECHNICAL, STRATEGIC and OPERATIONAL issues.

Mute this thread if not interested – it’s quite long.
2/n
 RESEARCH - RCTs
In trials, VCs appear to be safe, effective & popular but almost all RCTs were confided to highly selected patients with chronic stable conditions. Most RCT evidence is irrelevant to the current acute, escalating situation.
3/n
 RESEARCH – QUALITATIVE CASE STUDIES
Introducing VC in real-world settings is a complex change that disrupts roles, relationships and routines. It is more resource-intensive and takes longer than most people anticipate, and failure is common.
Read 20 tweets
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François Heisbourg
@FHeisbourg
A back-of-the-enveloppe thread on the spread of #COVIDー19:

1) HUBEI province (ca 60 million people) has had close to 3000 deaths. It still has an active caseload of ca 20 K patients & some 130 new cases a day, & ca 30 daily deaths. So I expect up to 3500 deaths, assuming...1/9
...a winding down of the epidemic there by end March. If,stress IF, the rest of the world became like Hubei (0.8%of world population), the death toll could be of ca 400 K with a cumulative number of cases of ca 8 million.This possibly sets the outer bounds of a Covid pandemic 2/n
Of course, active measures in the world may prevent Hubei-scale outbreaks so this is unlikely to happen (conversely, late but tough measures in Hubei have also limited Covid's spread in that province).

2) GOOD NEWS though in rest of mainland China ( minus Hubei, HK,Macau): 3/n
Read 9 tweets
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Medical Axioms
@medicalaxioms
Lessons Learned from H1N1 October 2009:

I was there as a hospitalist doing a month of nights. What follows is my experience and what I learned.
You know how people say “my dad was in the war but he never talked about it?” These memories are like those. They have been sort of locked away for 10 years.
We didn’t have the forewarning like we do now. We just heard there was an early flu season and the flu was worse. I feel like the beginning of the month was normal. Chest pain. Pneumonia. Pyelonephritis. Asthma exacerbation.
Read 16 tweets

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