Have 29 y/o teetering on vent sick as hell. Plus numerous 30-50 y/os. Community spread.

I've seen over 30 new COVID consults this week alone. I can recite my note template word for word by heart at this point.

Aggie95 said:

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any contract tracing to see where they may have picked it up?

Bars, protests, etc?

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I can't speak for Marcus (though my understanding is this is true across DFW and generally large urban centers as a whole based on discussions with colleagues) but the vast majority of my patients are/have been Hispanic and black from low to lower-middle class backgrounds. This is, for example, one reason why Parkland is overrun but CUH and the Dallas VA aren't TOO bad yet. These are groups both less able to socially distance and who have higher rates of obesity/diabetes/etc. thus making them more likely to be sick enough to get admitted.

I have noticed the average age of my patients has gone down a little since the protests broke out, maybe by 5 years or so.

DadHammer said:

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Infection_Ag11 said:

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I've seen over 30 new COVID consults this week alone. I can recite my note template word for word by heart at this point.

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How are you keeping yourself safe seeing that many sick people?

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Might be going out on a limb, but maybe masks?

I'm curious of the overall health and demographic of the people who are the most sick. At this point I'm trying to figure out how I might do when I catch this. Notice I said when because it seems like that's where we are headed. Don't take that as I'm not taking this seriously either. I'm doing the things I'm supposed to do but I'm still living my life by going to my sons baseball games, playing golf etc.

My question is I'm a 41 y/o white male in generally good health. By medical standards I'm considered obese but I think most people who see me would think I've just got a few extra lb's. I'm 5'11" and weight ~205lbs. I know there is no exact way to tell but statistically how at risk am I of having a major problem?

Also I'm curious if having 2 kids under the age of 8 is a good thing as I feel we are exposed to every germ known to man and our immune systems are in pretty good shape.

The CDC ethnicity data is shocking.

I would never have anticipated a multiplier of roughly 5x between whites and Hispanics and blacks. Even 2x would be considerable.

There have been a few scientific papers out that control for underlying conditions and socioeconomics and show that the mortality rate for whites and blacks is virtually identical. What you are seeing is not the impact of race per se but the many inequitable systemic factors that create poor health conditions in blacks and other minorities (poverty, food deserts, lack of health insurance, etc.)

DadHammer said:

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Infection_Ag11 said:

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I've seen over 30 new COVID consults this week alone. I can recite my note template word for word by heart at this point.

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How are you keeping yourself safe seeing that many sick people?

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The ones who aren't very sick and can communicate effectively I call using either the room phone or their cell. The sick ones, those who cannot effectively communicate for whatever reason and those who are intubated I just use gown/gloves/N95/face shield or trauma glasses and go see them. It's really not scary at all, I'm far safer in the COVID unit with all the precautions and knowing who has it than I am in a crowded public place.

Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

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BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

Keegan99 said:

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The CDC ethnicity data is shocking.

I would never have anticipated a multiplier of roughly 5x between whites and Hispanics and blacks. Even 2x would be considerable.

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It was entirely predictable from an epidemiology standpoint.

Goodbull_19 said:

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SnyderAg02 said:

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Are the younger patients ones you would consider metabolically healthy?

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That's my big question. Are any of these young people that are very sick at all metabolically healthy?

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This far, I've seen two patients <40 die, 5 get intubated and 15 sick enough to get monitored in the unit. Of those 15, six had no readily apparent risk factors (including one who died) and 9 did (usually obesity and/or diabetes).

To answer your question on a macro level though, your risk as a truly healthy young adult is very small. The caution I use there is about half of that group that perceives themselves as young and healthy actually have a health risk factor, either undiagnosed or ignored in their calculation. For instance, there's a TON of undiagnosed hypertension in the 35-40 age group.

Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

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BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

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Heck, just watch news footage from the 1970's. Pedestrians looked like rails.

Thanks to you, High Fructose Corn Syrup!

thanks Iowa caucuses

Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

---

BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

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I remember when they did that reboot of The Alamo near here, they had a hard time finding enough Hispanics to be extras in the movie, as soldiers...dudes who looked like they were skinny enough to have marched from Mexico City to San Antonio. They probably have the same issue with WW movies for today.

Just saw 29, 33, 33 y/os. Sick. No cormorbids. No one is immune.

Marcus, sorry you are going through this, and thank you for reminding people that you don't need to be old or have co-morbidities to get very sick with this.

Take care of your own mental and physical well being too please.

Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

---

BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

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The average American (male and female) has put on 30 lbs since 1960.

I am 6'1" and have weighed between 205-215 for most of my adult life. I considered myself "bigger built" but few would have described me as fat.

I have in the last 3 months lost 30 lbs. Now 6'1" and finally truly healthy.

All that to say, I totally agree, our perceptions of "slightly overweight" or "normal" are so skewed

KlinkerAg11 said:

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A blood type?

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One getting CVP so far. O+.

Goodbull_19 said:

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Infection_Ag11 said:

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Bonfired said:

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BMI needs to be used in conjunction with other measures...it is possible to be a very fit 5'11", 205# person, yet the BMI chart classifies that as very close to obese. The word itself implies slovenly and out of shape, even if it is a medical definition (kind of like idiot and moron used to be in psychology).

When I hear that obesity is a factor, I am guessing that it is probably referring to someone who is obviously not in good physical shape.

---

BMI is a reliable metric of medical risk related to excess weight in humans with anything resembling a normal body fat to muscle mass ratio. The kind of people who it doesn't work well for are those >2 standard deviations above or below average height, those with extremely high muscle mass and those with extremely low body fat. We're generally talking about elite level athletes and dedicated resistance training groups.

For the average American male, 5'11", 205 makes you about 30 pounds overweight. The issue is not so much with BMI but rather Americans have developed such a skewed idea of what a normal human body looks like. Nearly everyone under 6 feet and over 200 pounds was viewed as unusual and obviously overweight for all of human history prior to the mid-20th century western world. Go look at the average height/weight charts of American and Western European troops from WW1 and WW2 and prepare to be shocked.

---

The average American (male and female) has put on 30 lbs since 1960.

I am 6'1" and have weighed between 205-215 for most of my adult life. I considered myself "bigger built" but few would have described me as fat.

I have in the last 3 months lost 30 lbs. Now 6'1" and finally truly healthy.

All that to say, I totally agree, our perceptions of "slightly overweight" or "normal" are so skewed

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Exact same here. I've lost a considerable amount of weight since COVID started (intentionally) and have a normal bmi now (just barely). The majority of my friends who hear my stats or see me think i'm underweight, too skinny, "you need to stop running", etc.

It's wild, scary, and sad how twisted society's view of 'healthy' has become.

Ragoo said:

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Infection_Ag11 said:

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Keegan99 said:

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The CDC ethnicity data is shocking.

I would never have anticipated a multiplier of roughly 5x between whites and Hispanics and blacks. Even 2x would be considerable.

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It was entirely predictable from an epidemiology standpoint.

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why do you say that?

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Hispanics and blacks have higher rates of diabetes, hypertension and obesity compared to whites. Higher percentages of those populations come from lower socioeconomic backgrounds. Hispanics often live in multi generational homes with elders in constant contact with small children. Both groups have higher percentages of their populations living in low income housing and generally have less ability to social distance. Those groups are less likely to have health insurance and thus their chronic conditions are less well managed.