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Posted on 4/6/20 at 10:09 pm to pngtiger
*a lot of outlets are downplaying the risk, though.
Wanted to add something:
What we are seeing is different than what’s going on in Europe. I’m not sure about New York, but there have been many that go on to multisystem organ failure. It’s not just the lungs that are the issue. Almost like there’s a more virulent strain that we’re dealing with.
With that knowledge, it’s possible the reason HCQ isn’t working in these places is because of the strain.
Wanted to add something:
What we are seeing is different than what’s going on in Europe. I’m not sure about New York, but there have been many that go on to multisystem organ failure. It’s not just the lungs that are the issue. Almost like there’s a more virulent strain that we’re dealing with.
With that knowledge, it’s possible the reason HCQ isn’t working in these places is because of the strain.
Posted on 4/6/20 at 10:15 pm to pngtiger
quote:
With that knowledge, it’s possible the reason HCQ isn’t working in these places is because of the strain.
Or even just the type of people here vs there, down to the level of the conceptually-important gut/lung microbiome, amount of obesity and sedentary lifestyle and other underlying factors that exist here that are fairly immeasurable.
Posted on 4/6/20 at 10:24 pm to Hopeful Doc
quote:.
Or even just the type of people here vs there
Absolutely!
I don’t know if y’all have done this, but we have gone back and looked at CT-Chest on weird cases we’ve had over the past several months. I think this virus has been here since at least the new year.
Posted on 4/6/20 at 10:26 pm to pngtiger
I think it was definitely at UAB in early January...
Posted on 4/6/20 at 10:26 pm to DMAN1968
quote:
Wow...You have better numbers than pretty much anywhere...up to this point.
Where I am, it’s 1.6%. Add in that tests are still at least 4 days behind, and that many have no or mild symptoms, and are not seeking testing or treatment.
Posted on 4/6/20 at 10:27 pm to auggie
Isn't a z-pac a steriod?
Posted on 4/6/20 at 10:28 pm to russellvillehog
quote:
Steroids are bad for all viruses. It literally feeds them and makes them stronger.
Not really. What it does is hamper your immune system response to the infection, which leads to the infection getting worse.
To answer your question OP, no, they definitely wouldnt help.
SIDE NOTE: Corticosteroids are not similar to Anabolic steroids. In fact, corticosteroids will actually lead to muscle wasting (along with bone depletion) with long term use.
Posted on 4/6/20 at 10:28 pm to Tigahs24Seven
Are you at UAB? If so, I feel for you. Y’all have been hit hard.
Posted on 4/6/20 at 10:30 pm to Barstools
Z-pac is azithromycin, in a dose pack form. It’s an antibiotic.
And the reason they are giving it is to prevent community acquired pneumonia that people taking HCQ would be susceptible to.
And the reason they are giving it is to prevent community acquired pneumonia that people taking HCQ would be susceptible to.
Posted on 4/6/20 at 10:34 pm to Barstools
quote:\
Isn't a z-pac a steriod?
No. A Z-Pack is an antibiotic called Azithromycin. It is a macrolide antibiotic that acutally used to be very effective against many types of bacteria. Sadly, the over-prescribing of it everytime any Nancy goes to the doctor demanding an antibiotic for their "head cold" has rendered it virtually ineffective against most bacteria.
What's worse, is that it is still a first-line drug against many types of bacterial infections, including some bacterial pneumonia. But because new antibiotics are rarely being created, these drugs that are becoming less useful arent being replaced. Thats bad news for you and me.
Posted on 4/6/20 at 10:39 pm to pngtiger
quote:
I think this virus has been here since at least the new year.
I've got one from February that I'm highly suspicious of, though I do have other cause (influenza was positive)
Our vent days from this January vs the past 3-4 were way up as well, but I'm not at a large center, so averages skew very easily.
I go back and forth as to whether I think it's been here vs not. Namely, even at my small center, we are seeing more and sicker people, and we don't really think it's just awareness of the presence, because the severe (hospitalized resp cases without a cause) are really spiking now. I want it to have been community spread and present for 3 months instead of just 3 weeks, but (despite the little evidence of our vent days being high), it just feels different now. The patients are different and sicker.
That said, flu this season was odd with 3 decent peaks in my area. The January one included a weird group of patients that were young, healthy, got tamiflu within 48h, and on the 2 days after finishing tamiflu, ran 1-2 more days of fever (after having stopped running fever while on the meds). It wasn't just one or two of them. In fact, just prior to confirmation of the spread of COVID19 to the US with community spread, I was telling my wife (also MD) that I was thinking about extending tamiflu to 7d and writing a small case series on it (I'm not particularly into clinical research).
We've either got a few weird bugs, or this one had a weird wave or two.
Another point I'm curious about is CDC influenza data. We experienced near-epidemic ILI this season, and a fair amount of that could be related to this as well. Again, perhaps it really is just awareness, but these people just 'feel' different, and I don't understand how it could have been here and slow burned to culminate in a spike of severe cases now, because at least my I'll influenza patients were- for the most part- influenza positive on swab.
This post was edited on 4/6/20 at 10:50 pm
Posted on 4/6/20 at 10:43 pm to CFB_Fanatic
quote:
Sadly, the over-prescribing of it everytime any Nancy goes to the doctor demanding an antibiotic for their "head cold" has rendered it virtually ineffective against most bacteria.
If I ever get admitted for pneumonia, I still want it
Posted on 4/6/20 at 10:59 pm to Hopeful Doc
I got bronchitis in December,Zithromax didn’t touch it.Had to get second script of amoxicillin.
Posted on 4/6/20 at 11:11 pm to Hopeful Doc
quote:
f I ever get admitted for pneumonia, I still want it
Oh certainly. I would rather have Levaquin, but wouldnt turn down the Zithromax either.
Posted on 4/7/20 at 12:17 am to CFB_Fanatic
Interesting, when we were in college if we went to UGAHC with basically any cold/flu symptoms they would just give out zpacks and I thought they said it was a steroid. In retrospect they were prescribing zpacks with steroids and I conflated the two in my memory leading me to believe zpak was a steroid.
ETA: This was circa 2000. It was actually kind of a meme, broken leg- zpack and steroids.
ETA: This was circa 2000. It was actually kind of a meme, broken leg- zpack and steroids.
This post was edited on 4/7/20 at 12:20 am
Posted on 4/7/20 at 12:21 am to auggie
quote:You'd think so considering the pulmonary cytokine storm thesis. But steroid does not help.
Would steroids, along with the Hydroxychloroquinine/zpac help at all?
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