Corona Virus Feb 2020

[jcgtok17]

Tokyo, my base of operation, is in proper freak out mode over COVID-19 a total of 621 cases aboard DP (Diamond Princess) and 84 cases elsewhere (tie with SG); Coronavirus Update (Live): 75,316 Cases and 2,012 Deaths from COVID-19 Wuhan China Virus Outbreak - Worldometer The Tokyo marathon was cancelled (for all but elites, ie, 38,000 cut) and some think the olympics could be in peril. Limited number of expats bugging out yet, but a few. Glad I have no flights until May and will never board a cruise ship, ever. Stay safe all. Wash hands like you are a surgeon prepping. Mask best purpose is keeping you from touching your face most likely. JCG

 

[rich01]

I'm seeing more and more articles talking about supply chain and drugs. That if there is a problem with supply chain, there is enough drugs in pipeline for only a few months. The thing is, at least in US, some pharmaceutical companies have sole sourced some critical ingredients to China.

There appears to be no government regulation that forces drug companies to release this information, so there is no easy way to predict which drugs might become in short supply.

What I am doing is getting doctors to write renewable prescriptions that allow me to get 3 months supply at a time. I have also discovered that as long as there are refills available, I can buy another 1 month supply out of pocket. (I have only done 1 month, but I don't see any reason I couldn't do 3 months).

 

[LondonAndy]

There is a dilemma here of course, which we in the UK had a little experience of in October last year when Brexit was supposed to have happened (on 31 October) and there were claims of long delays to be expected at ports whilst new customs arrangements came into place that would put the supply chain at risk. My pharmacy had some delays in obtaining supplies of some medication due to the fact that demand had increased by some patients 'stockpiling' supplies. So the act of taking a precautionary approach caused a shortage, which was thankfully brief. If nothing else it highlights the interdependence of countries and the fragility of a just-in-time delivery network that otherwise apparently delivers cheap products in so many sectors of the economy. I don't know if additional stockpiling by our NHS apparently implemented at the time still continues, but we may be shooting ourselves in the foot if we all try to rush out and stockpile our meds, understandable though that desire is.

 

[Protimenow]

That makes sense, Andy. A year or two ago, there was a big fire in Wine Country (Northern California). My wife asked me to hurry and get a case of the wine we occasionally have with dinner. Supplies quickly sold out. I don't think we've ever opened that case.

The wine came back on the shelves after a few months. It's now readily available, for $1 less per bottle than I paid.

I may wind up stockpiling my Warfarin because my new PCP is afraid to prescribe Warfarin, and I still have a few refills left from another physician -- I'll refill before they expire.

As regards the international nature of prescription drugs - I've seen a few suppliers of Warfarin in Israel. If you go onto some of the 'foreign' sites (AllDayChemist is one of them), you can see many medications offered - the interesting information for the generics is the country of origin for these generic drugs. I used this company a LONG time ago, befoer I had prescription coverage, and I had no problems with what they sold me. (I'm not recommending any foreign company as a provider for medications - just pointing out a location where you can see the many sources of common generics located all around the world).

 

[jcgtok17]

Patients with heart issues are showing to be at elevated risk as CODID-19 roils on. Versus the generic 2% mortality rate, those with heart issues are now thought to be upwards of 10%.
· If you have respiratory symptoms such as a cough, nasal discharge, or sore throat, be sure to use cough etiquette (covering nose and mouth with a mask, or coughing or sneezing into your elbow).
· Wash your hands frequently (alcohol disinfection, soap, running water).
· Try to avoid touching your face with your hands, as eyes, nose and mouth.
· Avoid unnecessary crowds and gatherings.
· Sleep well, and eat well.

 

[jcgtok17]

One of my friends used to work for Roche and as an employee benefit they all got a lifetime supply of Tamiflu, worth $100,000 in the peak of previous pandemics. He used some for a recent illness to get his immune system ready for USA case expansion (COVID-19) as this is not a case reporting issue it is a testing issue. More tests = more cases as Korea is bearing out. After my current teaching term is done in Tokyo I'm bound for rural Canada where I'd need to try to find a group larger than 12. Stay safe, try not to get boxed travel wise and get some meds in inventory. #JCG

 

[d333gs]

coronavirus is now in France which has me a bit worried and I expect to be told I will need a new aortic valve today ......... I dont like the idea of being operated on in this atmosphere even though I would like to get it done.......this thing is getting really creepy

 

[AmyBL]

Patients with heart issues are showing to be at elevated risk as CODID-19 roils on. Versus the generic 2% mortality rate, those with heart issues are now thought to be upwards of 10%.”

I wish “heart issues” was defined. My aortic valve is mechanical and functioning very well but it seems possible that hearts with devices maybe vulnerable. I will call my doc and follow up.

 

[AmyBL]

coronavirus is now in France which has me a bit worried and I expect to be told I will need a new aortic valve today ......... I dont like the idea of being operated on in this atmosphere even though I would like to get it done.......this thing is getting really creepy

I can understand your concern. It would be beneficial if scientists and physicians understood the virus more than they seem to now. On the other hand, perhaps they will be extra cautious now.

 

[jcgtok17]

The financial markets have lost $3.5tln in 7 trading days. There is talk of an emergency co-ordinated rate cute before the market open Monday, but it may be like pushing a string. 1st death in USA and big growth in #'s in Italy and S. Korea. Japan #'s steady it seems, but not a lot of testing being done. Kids home from school for a month and my university has gone to "distance" learning, what a drag. #JCG

 

[Paleowoman]

Good blog post by Dr Mary Dan Eades on the importance of vitamin D to help our immune system fight this virus if we're exposed to it: Sunshine - Vitamin D and Immune Health - The official website of Drs. Michael & Mary Dan Eades

 

[Art O Ceitinn]

When the corona virus becomes an issue in America will the medical care services take care of the people without medical insurance. If all victims are not treated I can see it will become a game changer in the election.

 

[rich01]

When the corona virus becomes an issue in America will the medical care services take care of the people without medical insurance. If all victims are not treated I can see it will become a game changer in the election.

Everyone will get care, but people without insurance will be charged. Probably they will be billed and the hospital will eat the cost. Somewhere between 10% and 15% don't have health insurance.

Another problem is the deductibles are so high that many people with have to pay out of pocket for any health care services they need.

It would probably be cheaper for Congress to appropriate money to guarantee everyone needing treatment for the virus gets it.

 

[Protimenow]

Yes, it would be great for Congress to appropriate enough so that tests and treatment can be given to anyone who needs it. I don't want to get political here, because it would be zapped, but this may turn into a public health emergency. Without proper efforts - from the White House down - this can be a catastrophe.

Art - you mentioned that a possible epidemic can be a game changer in the election. Add to that the issue of how our leader handles the economic crisis that will probably get even worse - and it could REALLY force some change, if the electorate knows who to blame.

 

[Suckyvalvegurl]

Of course, most people will not even have any symptoms or ever know they have/had it.

 

[Art O Ceitinn]

Of course, most people will not even have any symptoms or ever know they have/had it.

That is what makes this virus so dangerous.
21% of patients are serious or critical.
6% to 7% die.
We could be part of the 21%.
Before my heartvalve replacement my doctor informed me that I had a 99% chance of surviving.
I didn't like the odds then.
21% scares the bejesus out of me.

 

[rich01]

That is what makes this virus so dangerous.
21% of patients are serious or critical.
6% to 7% die.
We could be part of the 21%.
Before my heartvalve replacement my doctor informed me that I had a 99% chance of surviving.
I didn't like the odds then.
21% scares the bejesus out of me.

I heard a few days ago that the virus will likely not infect more than 30% of the population. Population wasn't defined. That makes your odds much better. Don't get it.

 

[Suckyvalvegurl]

I just wonder how they are calculating those percentages not knowing how many people have had it without any symptoms. I am very suspicious of those calculations. I had my AVR replaced 1 year ago and I am just not very worried at all. I do not feel it really increases my risk much at all.

 

[rich01]

I just wonder how they are calculating those percentages not knowing how many people have had it without any symptoms. I am very suspicious of those calculations. I had my AVR replaced 1 year ago and I am just not very worried at all. I do not feel it really increases my risk much at all.

I wonder if people with artificial heart valves are more prone to infections?

I think having an artificial heart valve qualifies as having heart disease.

 

[Protimenow]

Suckyvalvegurl - you make a great point. At this point, we don't have any idea how many people who get it are completely asymptomatic, or just think its the flu. They don't seek medical care, they don't go to hospitals, they're a shadow part of a smaller problem.

The percentages that they quote seem to be for people who already present with advanced symptoms (or are part of a small group - like those who were isolated on a cruise ship, then in a military base).

So - of those who got really sick, the percentage of those who die from the virus are part of a potentially small group who are most affected by it.

This makes me think about the 'success' of anticoagulation clinics that tout great results - even with testing every month or two. What they're not counting is the people who 'drop out.' It hardly makes sense to 'drop out' of a program that is essential for valve recipients - unless they self test and self manage, or go somewhere else for anticoagulation monitoring. They don't count those who 'drop out' because they've had strokes or other problems because they're not tested often enough.

If they did adequate follow up - contacting the patients who dropped out to find out the reasons, and their health status, I wouldn't be too surprised to see that their success rates drop. (I used to run a Tumor Registry at a major medical center, and follow-up was one of the most important things that we did).