Doing a coding refresher while my kids were watching a movie, resulted in an epic crossover: Home Alone ICD10
First the title. 3 options:
Z62.29 Other upbringing away from parents
Z60.2 Problems related to living alone
T76.02XA Child neglect or abandonment, initial encounter 1/
The movies opens with household chaos. The protagonist (Kevin) is bullied by his older Brother “Buzz”.
Don’t worry there’s not one but two ICD10 codes for this:
1️⃣Y07.41 Sibling, perpetrator of maltreatment
2️⃣F93.9 Childhood emotional disorder, unspecified 2/
Kevin fears that Fuller (played by his real life brother Kieran) will wet the bed.
You can code this concern from Fuller’s perspective or from Kevin’s:
1️⃣N39.44 Nocturnal enuresis
2️⃣W55. contact with urine of unspecified mammal
Molnupiravir is a pro-drug that is converted to the ribonucleoside analog N4-hydroxycytidine (NHC).
Phosphorylated NHC is incorporated into SARS-CoV-2 RNA by the viral RNA polymerase. This causes many mutations in the virus (“viral error catastrophe”), preventing replication. 2/
But wait aren’t mutations bad? Isn’t Omicron a bunch of mutations that make it more infectious?
The distinction is the *number* of mutations.
RNA viruses are error prone - accumulating on average 1-5 mutations with every copy.
Google says AH-MUH-KRAN is 🇺🇸 & OH-MU-KRON is 🇬🇧
Oversimplified..
In ancient Greek, there were 2 letters pronounced similarly:
Ω made a long Oooo - it was called big O or O Mega
Ο made a short Oo - it was called little O or O Micron
Thus, OH-MI-KRON is probably more accurate 2/
To understand Omicron, we need to understand pandemic surveillance:
A sick person 🤒 gets COVID tested.
The (+) results get sequenced (depending on where in the 🌎 ) & published to @GISAID (or other platform).
Sequences are used by researchers globally, such as @nextstrain. 3/
There’s a new SARS-CoV-2 variant of concern: Omicron (aka B.1.1.529) #OmicronVariant
What is this Omicron COVID variant & is the panic of it justified? (spoiler alert: no)
A short #OmicronExplainer 🧵 about what we actually know, what we suspect, & what’s still unknown. 1/
4 reasons Omicron is worrisome:
1️⃣ it is spreading rapidly in South Africa (known)
2️⃣ it is highly mutated (known)
3️⃣some mutations likely increase transmissibility (suspected)
4️⃣others *may* allow it to evade existing immunity or vaccines (unknown)
We’ll talk about all 4...
2/
First some nomenclature:
B.1.1.529 (its Pango lineage) is the same as “Omicron" (WHO declared it a variant of concern & assigned a Greek letter) #OmicronVariant
It’s also known as K21 (Nextstrain clade)
It’s erroneously been called the #NuVariant ... yeah that’s not a thing 3/