Coronavirus

[Econoline]

From Bloomberg:

Neurologic Symptoms Found in 4 of 5 Hospitalized Covid Patients
By Reg Gale
October 5, 2020, 2:26 PM CDT
● Headaches, confusion, dizziness among symptoms cited in study
● U.S. study on neurology symptoms offers sobering picture

About 4 out of 5 patients hospitalized with Covid-19 suffer neurologic symptoms such as muscle pain, headaches, confusion, dizziness and the loss of smell or taste, new research shows.

The most severe condition listed was encephalopathy, “characterized by altered mental function ranging from mild confusion to coma,” said Igor Koralnik, the chief of neuro-infectious disease at Northwestern Medicine in Chicago and one of the study’s authors. The study outlined the frequency and severity of neurologic symptoms in 509 patients hospitalized for Covid-19 in the Chicago-based health system at the start of the pandemic.

Koralnik, who also leads Northwestern’s neurology-focused Covid clinic, declined to discuss the paper’s relevance to the condition of U.S. President Donald Trump, who has been diagnosed with the disease. He said doctors generally should be on the lookout for any signs of neurologic distress in Covid-19 patients.

“Even people who have mild respiratory problems that don’t last long are still at risk of long-haul symptoms” that can affect some Covid patients for months, he said by telephone.

Assessing Symptoms

The average age for those in the study with encephalopathy was 65, he said, compared with 55 years old for patients who didn’t have it. Patients with brain ailments were more likely to be male and have a shorter time from disease onset to hospitalization, according to the study. Patients with the condition also tended to have a history of other disorders, including high blood pressure.

The study was published today in the Annals of Clinical and Translational Neurology. It is one of the first published on the frequency of neurological symptoms tied to Covid-19 in a large population of patients, Koralnik said. A study published in China found 36% of patients there had neurological symptoms, while one in Spain put the rate at 57%.

The difference in the Chicago study may be that hospitals there were never overwhelmed, like they might have been in other parts of the world. That may have made it easier for researchers to assess patients’ neurological symptoms.

Of the 509 patients studied, 42% had neurological problems when they first became aware they were infected, 63% at the time of hospitalization and 82% at any time during the course of the disease. The most frequent symptoms were muscle pain, headaches and encephalopathy.

Next Step

The next step, Koralnik said, is to determine what triggers these conditions. He said the group is continuing to study patients “who are discharged from the hospital, as well as in Covid-19 long-haulers, who have never been hospitalized but also suffer from a similar range of neurological problems, including brain fog.”

The phenomenon, involving thousands of patients with symptoms lasting months at a time, complicates the Trump administration’s argument that most illness is mild so the U.S. can quickly reopen the economy.

These frightening long-term cases aren’t captured in official statistics that show that the vast majority of younger adults survive the virus.

“What we’d like to know is if the virus somehow infects the brain itself or the wrapping of the brain in patients with encephalopathy,” Koralnik said. His group will be studying that in the future, along with possible immunological factors.

[ex-khobar Andy]

Re Trump's 'hospitalization' and the actions of his doctor:

I don't normally copy and paste such a long piece but it's behind the Atlantic's paywall and I have a subscription. Basically the good doctor is doing what most Trump minions do: padding the narrative to fit his boss's wants. He's no different than Harold Bornstein although, I'll grant you, better looking. (So am I.) He proudly wears his 'Doctor to the President' white coat. Sending a COVID-positive patient back 'home' - even though that home has a 20 person medical unit on 24/7 standby. - when you know he will not obey the most basic rules of infection prevention is just plain irresponsible. I'd like to see the AMA take a good look at his actions.

For the past several days, President Donald Trump has had COVID-19. It’s unclear for how many days, because the president’s physician, Sean Conley, refuses to share that information. When asked again yesterday, Conley told reporters, “I don’t want to move backwards.” In fact, Conley has shared very little about the course of the president’s illness. On Friday, the same day Trump informed Americans that he had tested positive, he was taken to the hospital “out of an abundance of caution,” according to his press secretary. By the next morning, the narrative had shifted. Conley said that Trump was “doing much better,” but relative to what, exactly? Then, on Monday, Conley told reporters that the president was to be discharged to the White House. “He’s back,” Conley said with a smile.

To hear Conley tell it, Trump was also never gone. The story of his illness jumped from “nothing to see here” to “mission accomplished.” Trump reportedly worked out of the presidential suite at the military hospital as the White House reassured Americans that his job could be done well from there. It released images of him in a suit at a desk, next to a telephone. Now, according to Conley, the president is back at the White House, where he can get “world-class medical care, 24/7.” (Conley could not be reached directly, and the White House did not immediately respond to a request for comment.)

Last night, Trump was helicoptered back to the White House, crossing the lawn and removing his mask to salute Marine One in a spectacle that quickly was turned into a gauzy campaign-style video. The president is declaring victory. “Don’t be afraid of COVID,” he tweeted earlier in the day. “Don’t let it dominate your life.”

This is a dangerous narrative, and Trump’s doctor has helped to shape it. Conley has served as Trump’s publicist in a white coat, reassuring Americans at every turn that Trump is doing well, while leaving out conspicuous details. His vaguery and obfuscation have repeatedly undermined these reassurances. His ethical obligation to his patient is in direct conflict with the basic moral imperative not to lie, by omission or otherwise. Any physician has a duty to the public as well, specifically when dealing with a patient who poses a direct threat to others. Conley is seemingly intent on informing the country how strong the president is, making him complicit in the downplaying of this disease when what the country needs is the bare truth.

The American people still do not know when the president was infected with the coronavirus. We know little more than Trump’s age, his current vital signs, and some of the medications he is taking. Just since Saturday, Conley has declined to answer the most basic questions: Does the president have pneumonia? Why did he start taking dexamethasone? What blood tests have been abnormal? When asked by reporters for discrete data such as the president’s oxygen-saturation levels, Conley said, “Less than 94.” If there is one value that a doctor should know precisely about a patient who is being monitored for respiratory failure—for which the low 90s constitute an unstable zone—it’s this number.

Conley has changed the story. In a press conference on Saturday, he said that Trump was not on supplemental oxygen, and then conspicuously avoided three direct questions as to whether he ever had been. But then, on Sunday, he claimed that the president had received supplemental oxygen in two instances during his illness. Conley said that he had concealed the fact before because he “was trying to reflect the upbeat attitude that the team, the president, [and] his course of illness has had … In doing so, you know, it came off that we were trying to hide something, which wasn’t necessarily true.”

Maybe the biggest lingering question surrounding Conley’s statements is the decision to start Trump on dexamethasone, even while Conley has repeatedly denied that the president has had significant respiratory issues. Dexamethasone is a commonly used steroid, sometimes prescribed for COVID-19 patients in an attempt to tamp down the immune response that can cause them to crash after an initial phase of mild symptoms. But the Infectious Disease Society of America does not recommend the drug for patients who are not in “severe” or “critical” stages of COVID-19. When reporters asked Conley to explain this treatment decision on Monday, he expressed indignation at the question: “I’m not going to go into specifics of what he is and is not on.”

Conley has also referenced “expected” findings in Trump’s chest-imaging tests, but that’s different from “normal,” the term doctors use to denote that nothing is wrong. “Expected” findings are not necessarily good. Conley repeatedly declined to elaborate. He also mentioned abnormal blood tests, but would not say more. On Monday, he alluded to abnormalities in Trump’s kidney functioning, saying that blood tests showed the president had been “dehydrated,” but that this test had returned to normal.

For dehydration to temporarily impair the kidneys is not uncommon. It’s not typically concerning. What is concerning is Conley’s unwillingness to just say that, instead resorting to dodges like “I’m not going to get into operations” and invoking HIPAA when asked about abnormal findings. Every patient has a right to privacy, and there are some issues that the president may not want to go into extreme detail about. It’s possible that Trump directed his doctor not to talk about certain findings. As the president’s physician, Conley is not an elected official: His primary duty is to Trump. He may consider himself to be a responsible citizen and doctor as long as he is leaving the American people with a basic feeling that the president is doing fine.

But a doctor who is at liberty to discuss only normal and positive findings should not be holding a press conference. The job of a physician is not to reflect an upbeat attitude. It is not to conflate optimism with obfuscation. The job of a physician is to deal in reality—to neither minimize threats nor overemphasize them.

The unique bioethical dilemma of the moment is that we are in the middle of a pandemic. Accepting reality, and a shared set of facts, is vital. And there is one crucial exception to a doctor’s obligation to protect a patient’s privacy: when that patient is a threat to others.

On Monday, when Conley told reporters that he had given Trump the go-ahead to return to the White House, he could not say whether or how Trump would isolate himself for the rest of his illness. He is presumably still contagious (unless he has already had the virus for 10 days). That is: The president, in the throes of COVID-19, was being discharged back to the very site of a major coronavirus cluster. Why send a contagious person back to the place where an outbreak is still unfolding, if he is able to quarantine and execute his duties in his presidential suite at Walter Reed?

Conley even defended the president’s decision on Sunday to break quarantine and go on a car ride with Secret Service agents, which an attending physician at Walter Reed called “insanity.” At the very least, the appropriate response from Conley would have been to say “I advised against that.”

Statistically, Trump is most likely to continue recovering uneventfully. This decision to return home is not clearly medically unwise for him. But the declaration of victory and the overall downplaying of Trump’s medical status do a grave disservice to the public. And though it is within Trump’s purview, going back home is, at the very least, inconsiderate of the staff at the White House. That creates risk not just for those who work there, but everyone who has contact with those people, and then everyone who has contact with those people. As the current cluster at the White House has made abundantly clear, a single negligent act can end up leading to multiple cases.

Such acts are preventable. Most happen because of failures to take basic precautionary measures. Since the beginning of the pandemic, Trump has repeatedly failed to take such measures, and he continues to dismiss the threat, denying simple facts and implying that some form of exceptionalism will exempt Americans from suffering. Meanwhile, more than 200,000 Americans have died from COVID-19. Conley has had ample opportunities to do what Trump hasn’t done—speak objectively about the medical facts. Simply doing so would emphasize the importance of wearing masks and taking the virus seriously.

Instead, Conley has opted for complicity, becoming a mouthpiece for Trump’s show of personal strength. Americans are left to speculate about Trump’s health based on what they see in curated videos and press photos—none of which show him in a hospital gown or even in a medical setting. In another time and place, it may be fine to respect a president’s privacy regarding medical issues that have no bearing on ability to govern. But downplaying Trump’s case of COVID-19 in this unique moment has widespread consequences. The hundreds of millions of Americans who are still at risk of contracting this disease could have seen the realities of what it is like, and better understood the value of stopping the virus. Instead, they have been shown that the consequences of negligence are cinematic helicopter rides and a weekend spent wearing a suit in the hospital.

[ex-khobar Andy]

And now Stephen Miller has it. I am finding tears are hard to shed.

[Gob]

God will save his chosen ones....

About 80 people took to the streets Tuesday night in Brooklyn to protest Gov Andrew Cuomo's restrictions on nine New York City neighborhoods where COVID-19 rates are surging.



The group of Orthodox Jews gathered in Borough Park Brooklyn for the demonstration against the closure of schools and the banning of large religious gatherings.

Footage from the protest showed members of the group setting fire to a pile of masks in the middle of the street as others cheered.
Firefighters from a local department arrived to the scene a short time later to extinguish the flames.

The group of mostly men were also seen gathering closely together as they heard from Councilman Kalman Yeger.

Yeger is heard telling the men: 'We're going to be safe. We're going to be smart. We're going to wear masks.

'But we are not going to be deprived the right that we have in America, like everybody else in America, the right to observe our religion, the right to do it freely, the right to do it without government interference.'

'I don't care who in government thinks that they can stop us. They're wrong. Let them try,' Yeger added.

In addition to his appearance at the protest, Yeger also released a statement with other local leaders that called Cuomo's actions a disgrace.

'We are appalled by Governor Cuomo's actions today. He has chosen to pursue a scientifically and constitutionally questionable shutdown of our communities,' the statement reads.

'His administration's utter lack of coordination and communication with local officials has been an ongoing issue since the start of the pandemic and particularly recently as we face this uptick... What occurred today can only be described as a duplicitous bait-and-switch.'

The local leaders called it 'disgraceful' that Cuomo would impose restrictions 'targeting our community in the midst of our Jewish holidays'.

The statement said the communities impacted by the restrictions have been left 'shocked, angered and highly frustrated'.

Gov Cuomo forces non-essential businesses to close, bans...

Happy to wear daft hats and ringlets, but not masks? Religion is truly for the stupid.

[Jarlaxle]

Nothing Cuomo says means anything after what that mass-murderer did to the nursing homes.

[Gob]

[ex-khobar Andy]

I don't know where that graph comes from Gob but that very steep UK spike is alarming. Is that perhaps due to the recount because someone forgot that Excel only has a limited number of rows, and 16,000 cases just were never counted? They had gone past the bottom line of the spreadsheet and no-one noticed.

https://www.theguardian.com/politics/20 ... in-england

[Jarlaxle]

How much of it is simply more testing?

[Gob]

I don't know where that graph comes from Gob but that very steep UK spike is alarming.

Spain, France, and the Dutch have all experienced similar spikes too, people are getting too blase about it

[Bicycle Bill]

-"BB"-

[Gob]

[Econoline]

[Econoline]

[BoSoxGal]

[Scooter]

Alexis Lee Crumbley

So I might just delete this post.
Anyways, here goes.
Today is my six month anniversary of coming down with Covid. I’ve been dealing with the repercussions for SIX MONTHS.

I didn’t want to share on Facebook before, but I have shared privately with friends. Today I decided I was tired of hiding and hoping my story will be a warning to others.

In the past six months:
I landed in the hospital because my chest pain was so bad that it required iV pain killers and my fever required iv fluids.
I’ve had pneumonia twice. My lung capacity has been reduced because of lung fibrosis (damage)
I’ve had pleurisy
I’ve had inflammation of the cartlidge in my rib cage
I’ve had so much brain fog. I haven’t thought straight for 6 months. I constantly have to go back and do things twice.
I can’t drink alcohol because my liver is inflamed and the alcohol makes me feel bad now.
I have had chest pain and shortness of breath every single day.
I can only walk for exercise. Anything more and I cannot breathe normally. Before March 16 I used to do spin classes 3/week.
My resting heart rate is 101. It used to be 55.
Fast forward to today. I just left the cardiologist because I’m going to have to have two different echocardiograms and a MRI to determine the severity of my heart damage.
Covid is scary. Covid can cause an inflammatory response that doesn’t land you on a vent but can be life changing. I would be characterized as having a “mild to moderate” case of coronavirus.
My cardiologist is hopeful but doesn’t know what to do about me. It’s not in my head he says! I’m his tenth patient in September who has come to him with these long term symptoms. Average stats of “long haulers” as we are called is 44 (me!) a woman (me!) and previously fit/healthy and no preexisting conditions (me!)

I go on with daily life, baking bread, helping the kids, wiping down counters bc that’s what you do. You can’t lay in bed forever. Doctor tells me I’m full of antibodies (I hope I still am) and I’m not contagious. I have to live the life I’m dealing with now.

Anyways I share not to get any sympathy. I share because I feel people are getting fatigued of hearing about Covid and have moved on. I get it. It’s exhausting. But I want people to still continue to take this monster seriously.

Here’s a picture of the heart monitor I have to wear now. Stay healthy.

(Edited to add: feel free to share. The support shown below has made it clear that it may be helpful for someone else not on my fb page)
Edited to add (9/19). The response to this has been amazing. Honestly I thought 50 people would like this post. I’m getting messages from all over the planet and so many people are getting the message. Thank you so much
Editing one last time (10/28) THANK YOU so much to every single one of you who have reached out to me via PM. I’m so sorry I can’t respond to everyone but it means so much that you took the time to do so.

[Econoline]

Too bad the one person on the planet who most needs to read that, won't (he doesn't/can't read)...and if by chance someone should happen to read it to him, he'd just dismiss it as "fake".

[Econoline]

[Econoline]

[Econoline]

HUD Secretary (and member of Trump's coronavirus task force) Ben Carson and Trump adviser David Bossie (president of Citizens United and head of Trump's quote-unquote "legal" team for challenging the election results) have both tested positive for COVID-19.

[BoSoxGal]

They were both at the White House election night party; I suspect there is another WH outbreak occurring and we will likely not be told the extent.