Covid Treatment Research, Toilet Plumes, and Increasing Cases 6-23-2020

by birtanpublished on August 4, 2020

Some of the latest coronavirus news has everyone talking and some of it isn't being talked about enough let's talk about all of it on this week's healthcare triage the item that seems to be generating the most chatter is the recent news out of the UK about

Dexamethasone a steroid used to treat inflammation before I talk about this I just want to make it clear that almost everything we know at the time of writing the script comes from a press release from Oxford University well

There's a pre-registered report on which methods and analyses the researchers intended to use we don't know what the final methods are discipline demographics modes of analyses or results actually look like so that

Disclaimer aside although it's a big one the current story is that dexamethasone significantly reduced mortality in patients critically ill with kovin 19 the press release states that there was no benefit of the drug to patients not

Requiring respiratory support in patients requiring oxygen deaths were reduced by 1/5 in a nose requiring ventilation deaths were reduced by 1/3 it does not appear that a placebo was used

We had healthcare triage we'll remain wary until we see the published study and until we see further confirmation with appropriate trials and while we would readily celebrate it all working out because dexamethasone is a low cost

Commonly used and widely available drug we also caution against the Magic Bullet illusion while we would be grateful for something to bring patients back from the brink of death we are still lacking solutions to avoid that brink altogether

The second item of business swirling up a media frenzy our toilet plumes it turns out fecal transmission is a Kovach concern and flushing the toilet creates a plume that rises into the surrounding air in a study published on June 16th

Researchers use computational fluid dynamics to model the trajectories of virus aerosol particles during flushing there's simulation estimated that 40 to 60% of viral particles rise above the toilet seat during flushes they

Recommend closing the lid before flushing cleaning the seat before using it and of course washing your hands when you're done will also point out that all these things were a good idea even before Cova 19 and then in public spaces

Where this is the most concerning toilets don't often Lidz it's important to note that we don't have data yet on the effects of flushing in real world spaces how much infectious virus might exist in toilet

Plumes or if public toilets are a major source of transmission for now these data are something to keep in mind particularly in settings with Kovac patients like shared bathrooms and hospitals and lastly information that

We'd like to see a little more chatter about the alarming rise of Kovac cases in states like Texas Arizona Florida Nevada and Oregon there's been messaging on this to the tune of we're just testing more but that completely ignores

The fact that the overall percentage of positive tests is increasing if you're interested in state-by-state data on where things are improving and where they're not ghovat exit strategy org is an excellent

Resource we'll include that link in the description there are also people who feel this is of no concern because the number of hospitalizations are not concurrently rising but hospitalization is a lagging indicator meaning it's an

Indicator that develops from past data which of course means that it becomes a clear sign only after the event it is signaling has taken place we should also note that in some of these states hospitalizations are already increasing

And that's even more of a reason to freak out we recognize that some states are doing better and that's great but we've got to respond to the signals coming from states that are not the consequences of becoming apathetic about

This virus will not be pretty agent Reyes episode you might enjoy this previous episode on how a study on hydroxychloroquine was retracted and what it all means it also appreciate if you like and subscribe down below

Consider going on over to patreon comm slash healthcare triage well you could help keep the show going even during a pandemic you'd like to especially thank our research associate James Glasgow Joe

Sevens Josh mr Michael Chen and of course our Surgeon Admiral Sam you

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