wild. thanks for sharing

Yes, I appreciate the info.

If you use a CPAP machine and test positive for COVID, should you be cleaning/disinfecting your machine after each use?

Out of how many total patients this week and over the past 2 weeks?

Marcus Aurelius said:

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I would advise no CPAP if you have active COVID. I see approx 12 sleep and 12 pulm pts a day. 4.5 days a week.

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Why? Because of the infected patient using CPAP making things worse or because of spreading droplets and infecting others in the same household?

Yes. It increases aerosolization of the virus. We use CPAP and BIPAP in the ICU but the rooms are equipped with negative pressure. The mask, tubing and humidity reservoir would be teeming with virus as well. I think it would be hard to completely disinfect. Plus, most COVID pts have cough, congestion, coryza, which makes it very hard to wear a CPAP mask.

Do you think New York has reached herd immunity and that why they are having so few cases now? Just to reinforce your point, we antibody tested our entire office of approx. 360 people in San Antonio a few weeks ago when the number of confirmed cases was very low, close to 50 people tested positive for antibodies and every report I've heard is that they were all either asymptomatic or had very mild symptoms that lasted for no more than a few days.

Also, there are reports out of Italy that the virus has mutated and the severity is much less than in the beginning, which I think is pretty obvious but American doctors don't seem to want to talk about.

1939 said:

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Do you think New York has reached her immunity and that why they are having so few cases now. Just to reinforce your point, we antibody tested our entire office of approx. 360 people in San Antonio a few weeks ago wen the number of confirmed cases was very low, close to 50 people tested positive for antibodies and every report I've heard is that they were all either asymptomatic or had very mild symptoms that lasted for no more than a few days.

Also, there are reports out of Italy that the virus has mutated and the severity is much less than in the beginning, which I think is pretty obvious but American doctors don't seem to want to talk about.

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Interesting to look at NY - change second dropdown to "(ALL)" to see how testing is up but total confirmed cases way down.


https://covid19tracker.health.ny.gov/views/NYS-COVID19-Tracker/NYSDOHCOVID-19Tracker-DailyTracker?%3Aembed=yes&%3Atoolbar=no&%3Atabs=n

I think mutations in different areas can stay pretty local, at least for a good period of time, so a mutation in Italy may not match what is happening in Texas. And severity and communicability are separate, if a mutation explains a drop in NY cases that might suggest it's less communicable - or that they have some immunity as a group. Whatever the case may be, definitely a large drop in new cases detected in NY and it does seem that in areas with a large amount of testing, the bulk of the rise/spread take 6-8 weeks to pass. We may see a rise in Texas until mid or late July, but it should taper off if it follows that pattern. I understand it isn't apples to apples when comparing different countries and areas within our country, but try to see the end of this with a positive light.

1939 said:

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Also, there are reports out of Italy that the virus has mutated and the severity is much less than in the beginning, which I think is pretty obvious but American doctors don't seem to want to talk about.

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Diseases do tend to get less deadly over time via natural selection. The viral strain that is less deadly and produces less symptoms is more likely to get spread around than the one that makes people sick enough to stay home, go into the hospital, or die. Additionally our understanding of the virus and how to treat it is probably helping.

I don't think any American doctors are denying that the virus may be getting less deadly or trying to ignore it. It's just that we can't bank on it.

I think we're going to see another run in NYC, once they open up like we did. It just won't be as deadly due to mutation, better nursing home orders, masks, etc. Little premature for their Gov to be spouting off at this point.