Coronavirus Sars-CoV-2/Covid-19 Megathread

[Sheilbh]

Is a ventilator and intubation the same thing?

For the lay press they're probably trying to say the same thing. Intubation is the act of placing an endotracheal tube through the mouth into the trachea. Ventilator is the machine that pumps air through the tube into the lungs. In order to be ventilated you have to be intubated.

I thought there was also ventilation without intubation? Or is that just not relevant with this disease.

[Fate]

I wouldn't phrase it so grimly - ventilators save 50% of patients. 100% of these patients would die without the intervention. It's reasonable for the press to focus on the number of ventilators as it's the best tool we have to save severe COVID-19 cases.

100%?

Isn't a BVM a potential stop gap in any event, assuming ventilators are unavailable? People like me would be happy to spend their days pumping away right now.

For everyone  - BVM is a bag valve mask. You squeeze a balloon manually to pump air into the lungs through an endotracheal tube.

Yes, that's an option in the third world on any normal day in the hospital. In India families will have to manually pump air into the lungs of their love ones for days at a time because there are not enough ventilators.

If you have COVID-19 you are not allowed to have visitors in the US. There's no one to do prolonged bag valve masks because that'd just spread COVID-19 to the whole family. You either get ventilated or have a natural death.

[Fate]

Is a ventilator and intubation the same thing?

For the lay press they're probably trying to say the same thing. Intubation is the act of placing an endotracheal tube through the mouth into the trachea. Ventilator is the machine that pumps air through the tube into the lungs. In order to be ventilated you have to be intubated.

I thought there was also ventilation without intubation? Or is that just not relevant with this disease.

I mean the generic term "ventilation" can be just the exchange of air in the lungs with air outside the body. But in this specific context we're using it to refer to a machine which pumps air into the lungs through a breathing tube. It could be an endotracheal tube (intubation) or it could be a tracheostomy. A tracheostomy is an incision through the throat into the trachea, a permanent solution to those who need prolonged ventilation because oral intubation can only be done for 10-14 days since  the airway and mouth start to ulcerate and cause problems.

[alfred russel]

For everyone  - BVM is a bag valve mask. You squeeze a balloon manually to pump air into the lungs through an endotracheal tube.

Yes, that's an option in the third world on any normal day in the hospital. In India families will have to manually pump air into the lungs of their love ones for days at a time because there are not enough ventilators.

If you have COVID-19 you are not allowed to have visitors in the US. There's no one to do prolonged bag valve masks because that'd just spread COVID-19 to the whole family. You either get ventilated or have a natural death.

What do you mean there is no one? I just said I'd volunteer - and I've asked doctors I know if there is any way I can help (this isn't me just randomly saying it on the internet). I'm sure there are 10s of thousands of others that would do the same.

[Fate]

For everyone  - BVM is a bag valve mask. You squeeze a balloon manually to pump air into the lungs through an endotracheal tube.

Yes, that's an option in the third world on any normal day in the hospital. In India families will have to manually pump air into the lungs of their love ones for days at a time because there are not enough ventilators.

If you have COVID-19 you are not allowed to have visitors in the US. There's no one to do prolonged bag valve masks because that'd just spread COVID-19 to the whole family. You either get ventilated or have a natural death.

What do you mean there is no one? I just said I'd volunteer - and I've asked doctors I know if there is any way I can help (this isn't me just randomly saying it on the internet). I'm sure there are 10s of thousands of others that would do the same.

And then you all are guaranteed to get COVID-19. Then 14% of you end up needing to be in the hospital yourself and 2% will require intubation.

Maybe there'd be a placed for antibody proven COVID-19 immune people to do that in a desperate situation. But there's no system to even see if healthcare workers are immune, let alone volunteers from the lay public. Hopefully we don't get to that point.

[Sheilbh]

I mean the generic term "ventilation" can be just the exchange of air in the lungs with air outside the body. But in this specific context we're using it to refer to a machine which pumps air into the lungs through a breathing tube. It could be an endotracheal tube (intubation) or it could be a tracheostomy. A tracheostomy is an incision through the throat into the trachea, a permanent solution to those who need prolonged ventilation because oral intubation can only be done for 10-14 days since  the airway and mouth start to ulcerate and cause problems.

Okay - interesting. So presumably it is distinct from the pressure on ICU, because I'm thinking of the pictures of face masks for breathing in Italian hospitals which in this context probably isn't the ventilation we mean. So there'll be hospitalisation, then a proportion will need ICU and then a proportion will need ventilation but others might be okay with face masks but have other critical care needs? And I assume the capacity issue is across the board so there aren't enough ICU beds, staff or ventilators rather than one bit causing these issues.

I think it's a bit annoying that the NHS isn't releasing data on patients and demographics because I feel that would be helpful - and is something other countries have done.

[crazy canuck]

Just received a general email from my bank saying that they will defer all mortgage payments for six months upon request and an offer of further personal and business loans for those who want them.  I assume the federal government has told the banks they will underwrite the loans.

[derspiess]

Good time to get financing, I s'pose.

[Legbiter]

What's the situation in Canada? I've not seen anyone here report any major lockdowns.

[mongers]

What's the situation in Canada? I've not seen anyone here report any major lockdowns.

Languish IS the Canadian lockdown.


Though thinking about it, Malthus has gone a bit quiet these last few days,  hope he's alright.

[alfred russel]

And then you all are guaranteed to get COVID-19. Then 14% of you end up needing to be in the hospital yourself and 2% will require intubation.

Maybe there'd be a placed for antibody proven COVID-19 immune people to do that in a desperate situation. But there's no system to even see if healthcare workers are immune, let alone volunteers from the lay public. Hopefully we don't get to that point.

First, there isn't a guarantee to get covid 19. Second, that sounds to me like, if there are a shortage of ventilators, you would trade 100 people that go without ventilators that need them for 2 new patients down the road...seems like a quality tradeoff. Not to mention the 2% is likely high considering the factors previously discussed.

[viper37]

What's the situation in Canada? I've not seen anyone here report any major lockdowns.

it varies mostly by province.

Quebec is on near lockdown, only essential businesses are open, the others, for emergencies only (like construction, and since there's no emergencies right now, I am shut down).  Ontario is in the same situation, but their construction sites are still open, apparently.  Lots of Quebec workers in the border areas working in Ontario.

The Premier has asked us to avoid unnecessary travels from region to region, and most people seem to comply.  Anyway, bars, restaurants, theaters, etc,it's all been closed for 2 weeks now.  Even if I wanted to go to Quebec city, there'd be nothing to do.

There were talks about shutting down the provincial borders, but I haven't heard anything new about it.

The Canadian border is closed for non essential travelers.  Merchandises are still coming true, obviously.

14 days quarantine is mandatory for all travelers now, used to be voluntary except for health&eduction workers.

About 3500 infected people (I think I saw 197 recovered), 35 deaths.

In the western provinces, spring break was just 2 weeks ago, Quebec & Ontario (I think) was 4 weeks ago.  Naturally, we're seeing a spike in infected people.  All our snowbirds are coming back to the country, isolating themselves, but there were some spreaders, unfortunately in the beginning, and they haven't all been identified.  Plus some morons who totally ignore the directives.

Quebec has predicted 18 000 infected by mid-April, it seems we'll be below that due to our earlier confinement. Crossing fingers.  We have 1339 confirmed & possible cases, 6 deaths, 1 recovered.

[Fate]

And then you all are guaranteed to get COVID-19. Then 14% of you end up needing to be in the hospital yourself and 2% will require intubation.

Maybe there'd be a placed for antibody proven COVID-19 immune people to do that in a desperate situation. But there's no system to even see if healthcare workers are immune, let alone volunteers from the lay public. Hopefully we don't get to that point.

First, there isn't a guarantee to get covid 19. Second, that sounds to me like, if there are a shortage of ventilators, you would trade 100 people that go without ventilators that need them for 2 new patients down the road...seems like a quality tradeoff. Not to mention the 2% is likely high considering the factors previously discussed.

Yes, you are 100% going to get COVID-19 if you sit next to a very ill and highly contagous person using a bag valve mask for 24 hours a day 7 days a week. 10-15% of all Italian COVID-19 cases are healthcare workers and they're not even sitting next to a patient BVM'ing all day long.

Who is going to BVM for a mean of 14 days and up to 20+ days? It's not realistic. The best outcome in this situation is to triage current ventilators based on likelihood to leave the hospital alive and let those who don't meet that threshold to have the best natural death possible.

Stay home. Slow the spread.

[Tamas]

Fate, there is no point in arguing with edgelords.

[Legbiter]

I get AR's willingness to help. I feel it too. My part consists in doing my elderly neighbor's shopping, donating blood, talking to grandfather every day. Oh and obessive handwashing... 

It's weird though, it's not a killer snowstorm nor a volcanic eruption or an earthquake. Those are old hat.

But this, 100% will be me after a month of this.