80% of NYC's coronavirus patients who are put on ventilators

Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

 

[Jeff Liebermann]

On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
<https://youtu.be/7vLPefHYWpY>

--
Jeff Liebermann jeffl@cruzio.com
150 Felker St #D http://www.LearnByDestroying.com
Santa Cruz CA 95060 http://802.11junk.com
Skype: JeffLiebermann AE6KS 831-336-2558

 

[TTman]

On 10/04/2020 04:37, Jeff Liebermann wrote:

On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

But isn't a ventilator part of a closed loop system, the feedback being
saturated O2 levels in the blood ? If the O2 levels drop, don't they
wind up the ventilator ? Just guessing here as I don't know.....

--
This email has been checked for viruses by Avast antivirus software.
https://www.avast.com/antivirus

 

[Martin Brown]

On 10/04/2020 09:49, TTman wrote:

On 10/04/2020 04:37, Jeff Liebermann wrote:
On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

The Lancet seems to back up that 80% failure rate for Covid-19 treatment
based on a cohort study in China:

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30633-4/fulltext

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

But isn't a ventilator part of a closed loop system, the feedback being
saturated O2 levels in the blood ? If the O2 levels drop, don't they
wind up the ventilator ? Just guessing here as I don't know.....

It is really quite tricky since giving people pure oxygen itself can
also lead to cellular damage. It is a very fine line and in people with
already badly inflamed lungs it may well be almost impossible.

UK says it has a 50:50 survival rate of those who end up on ventilators
because of Covid-19. I thought that was pretty bad. It worsens to 66%
dying if you count those that later die of damage inflicted by Covid-19.
Half get out of ICU but then a third of those succumb to something else.

https://metro.co.uk/2020/04/07/65-people-put-ventilators-will-die-nhs-data-shows-12521335/

OTOH the Scripals who were poisoned by the nerve agent Novichok almost
certainly owe their lives to ICU ventilators since they had fully
working lung structures but no muscle control to operate them.


--
Regards,
Martin Brown

 

On Thursday, April 9, 2020 at 11:37:09 PM UTC-4, Jeff Liebermann wrote:

On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

Okay, that's the engineering end of it. The clinical end is much more complex, with doctors constantly running blood panels looking for enzyme levels which tell them a lot about the status of the patient and their trajectory. They're considering taking it one step further and, based upon the blood chemistry testing, maybe not even staring them on the ventilator because it's too hopeless. The consensus within the medical profession treating these people is that intervention needs to be started at the earliest possible time. This would imply hospitalizing the at risk people much sooner than they're doing, which may require moving the hopeless people out of the way to make room for people with a much greater chance of surviving.

--
Jeff Liebermann jeffl@cruzio.com
150 Felker St #D http://www.LearnByDestroying.com
Santa Cruz CA 95060 http://802.11junk.com
Skype: JeffLiebermann AE6KS 831-336-2558

 

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970

Cheers,
James Arthur

 

On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:
Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970

Cheers,
James Arthur

Have you seen any data on infection rates of people who had known,
serious exposure?

Some things, like measles, will infect everyone who is not vaccinated.
Some things, less so.



--

John Larkin Highland Technology, Inc

Science teaches us to doubt.

Claude Bernard

 

On Friday, April 10, 2020 at 1:05:32 PM UTC-4, jla...@highlandsniptechnology.com wrote:

On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970


Have you seen any data on infection rates of people who had known,
serious exposure?

Only anecdotes so far. But we know, for example, that only a small
fraction were infected on the Corona Princess, and that families
living with Kung Pao Lung patients are generally not affected. One
of my pals is an example of that.

> Some things, like measles, will infect everyone who is not vaccinated.

That is plainly not the case -- it's not that easy to spread, otherwise
we'd see much higher transmission.

Of tuberculosis, Dad said one guy's cough can infect everyone in the
room. Chi-Commie Virus ain't that.

> Some things, less so.

Cheers,
James

 

[George Herold]

On Friday, April 10, 2020 at 12:26:47 PM UTC-4, dagmarg...@yahoo.com wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:
Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of..

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970

Cheers,
James Arthur

OK, That checks the 'why are face masks good?' box. I went food shopping
with my bandanna on yesterday. ~20% of people had some sort of mask on.
Here's a million dollar idea. Trump bandanna's! "Make America Safe Again"

George H.

 

[George Herold]

On Friday, April 10, 2020 at 12:26:47 PM UTC-4, dagmarg...@yahoo.com wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:
Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of..

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.
Ahh I don't see a link?

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970

Cheers,
James Arthur

 

[George Herold]

On Friday, April 10, 2020 at 1:59:27 PM UTC-4, dagmarg...@yahoo.com wrote:

On Friday, April 10, 2020 at 1:05:32 PM UTC-4, jla...@highlandsniptechnology.com wrote:
On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970


Have you seen any data on infection rates of people who had known,
serious exposure?

Only anecdotes so far. But we know, for example, that only a small
fraction were infected on the Corona Princess, and that families
living with Kung Pao Lung patients are generally not affected. One
of my pals is an example of that.

Some things, like measles, will infect everyone who is not vaccinated.

That is plainly not the case -- it's not that easy to spread, otherwise
we'd see much higher transmission.

Of tuberculosis, Dad said one guy's cough can infect everyone in the
room. Chi-Commie Virus ain't that.

Some things, less so.

Cheers,
James

I was listening to biologist podcast who said we missed a bet
with the infected air craft carrier. If we had asked the crew to
record what they'd done for the last few weeks we might have gotten some
decent data on how it spread.

George h.

 

[John Larkin]

On Fri, 10 Apr 2020 10:59:21 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Friday, April 10, 2020 at 1:05:32 PM UTC-4, jla...@highlandsniptechnology.com wrote:
On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970


Have you seen any data on infection rates of people who had known,
serious exposure?

Only anecdotes so far. But we know, for example, that only a small
fraction were infected on the Corona Princess, and that families
living with Kung Pao Lung patients are generally not affected. One
of my pals is an example of that.

Some things, like measles, will infect everyone who is not vaccinated.

That is plainly not the case -- it's not that easy to spread, otherwise
we'd see much higher transmission.

Of tuberculosis, Dad said one guy's cough can infect everyone in the
room. Chi-Commie Virus ain't that.

Luckily, most exposed people will not develop active tuberculosis
disease.

https://en.wikipedia.org/wiki/Tuberculosis#Epidemiology

C19 is similar, most exposed people don't get noticeably sick.

--

John Larkin Highland Technology, Inc
picosecond timing precision measurement

jlarkin att highlandtechnology dott com
http://www.highlandtechnology.com

 

On Friday, April 10, 2020 at 5:19:46 PM UTC-4, Lasse Langwadt Christensen wrote:

fredag den 10. april 2020 kl. 23.05.49 UTC+2 skrev Jeff Liebermann:
On Fri, 10 Apr 2020 09:49:28 +0100, TTman <kraken.sankey@gmail.com
wrote:

On 10/04/2020 04:37, Jeff Liebermann wrote:
On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

But isn't a ventilator part of a closed loop system, the feedback being
saturated O2 levels in the blood ? If the O2 levels drop, don't they
wind up the ventilator ? Just guessing here as I don't know.....

I can't answer that. All I know is what I read. Low blood oxygen
saturation levels indicated on a pulse oximeter is just one indication
of a problem. Excessive CO2 in the blood is another. As I understand
it, getting rid of the carbon dioxide is as much a problem as getting
enough oxygen. It helps to how the virus works:

How Coronavirus Kills:
Acute Respiratory Distress Syndrome (ARDS) & COVID-19 Treatment
https://www.youtube.com/watch?v=okg7uq_HrhQ

I think we can safely assume that oxygen concentration, pressure, and
flow rate are controlled by some kind of control system. It's
obviously automatic, but with plenty of manual tweaks and adjustments.
When fighting a massive lung infection and the resultant pneumonia,
one can't just plug a magic ventilator, punch the "fix everything"
button, and walk away. The situation is dynamic, with the patient's
condition varying constantly. An automatic control system can do its
best, but it's going to need some expert attention to the indicators
and manual adjustments to the machine settings. That requires
qualified people, training, experience, and time, all of which tend to
be lacking during a pandemic.

The ventilator also doesn't kill the virus. It's still doing its
thing and growing. When all the alveoli in the lung are trashed and
full of fluids, it's over. Without sufficiently functional alveoli,
we can pump the lungs full of pure oxygen and none of it will end up
in the blood stream. What keeps some lucky patients alive, is that
some alveoli are still functional. These try to take over the job of
the alveoli that are gone. Increasing the oxygen concentration partly
compensates for the loss of some alveoli. Unfortunately, this makes
the remaining functional alveoli work really hard. A slight bit of
overpressure and the alveoli burst. When that happens, all the
sophisticated ventilator control systems isn't going to be of much
use.


so they should use an ECMO machine instead?

Yes, but they're rare. Long-term results? Dunno.

Cheers,
James Arthur

 

On Friday, April 10, 2020 at 3:05:59 PM UTC-4, George Herold wrote:

On Friday, April 10, 2020 at 12:26:47 PM UTC-4, dagmarg...@yahoo.com wrote:
On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:
Dr. Tiffany Osborn, a critical-care specialist at the Washington University School of Medicine, told NPR on April 1 that ventilators could actually damage a patient's lungs.

"The ventilator itself can do damage to the lung tissue based on how much pressure is required to help oxygen get processed by the lungs," she said.


"We know that mechanical ventilation is not benign," Dr. Eddy Fan, an expert on respiratory treatment at Toronto General Hospital, told the AP.

"One of the most important findings in the last few decades is that medical ventilation can worsen lung injury — so we have to be careful how we use it."


Dr. Joseph Habboushe, an emergency-medicine doctor in Manhattan, told the AP that until a few weeks ago, it was routine in the city to place particularly ill coronavirus patients on ventilators. Now doctors are increasingly trying other treatments.

"If we're able to make them better without intubating them," Habboushe said, "they are more likely to have a better outcome — we think."


Dr. Howard Zucker, the New York state health commissioner, said on Wednesday that officials were examining other treatments to use before ventilation but that it was "all experimental," the AP reported.

https://www.businessinsider.com/coronavirus-ventilators-some-doctors-try-reduce-use-new-york-death-rate-2020-4

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.
Ahh I don't see a link?

Twitter, below...

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970

Cheers,
James

 

[Lasse Langwadt Christense]

fredag den 10. april 2020 kl. 23.05.49 UTC+2 skrev Jeff Liebermann:

On Fri, 10 Apr 2020 09:49:28 +0100, TTman <kraken.sankey@gmail.com
wrote:

On 10/04/2020 04:37, Jeff Liebermann wrote:
On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

But isn't a ventilator part of a closed loop system, the feedback being
saturated O2 levels in the blood ? If the O2 levels drop, don't they
wind up the ventilator ? Just guessing here as I don't know.....

I can't answer that. All I know is what I read. Low blood oxygen
saturation levels indicated on a pulse oximeter is just one indication
of a problem. Excessive CO2 in the blood is another. As I understand
it, getting rid of the carbon dioxide is as much a problem as getting
enough oxygen. It helps to how the virus works:

How Coronavirus Kills:
Acute Respiratory Distress Syndrome (ARDS) & COVID-19 Treatment
https://www.youtube.com/watch?v=okg7uq_HrhQ

I think we can safely assume that oxygen concentration, pressure, and
flow rate are controlled by some kind of control system. It's
obviously automatic, but with plenty of manual tweaks and adjustments.
When fighting a massive lung infection and the resultant pneumonia,
one can't just plug a magic ventilator, punch the "fix everything"
button, and walk away. The situation is dynamic, with the patient's
condition varying constantly. An automatic control system can do its
best, but it's going to need some expert attention to the indicators
and manual adjustments to the machine settings. That requires
qualified people, training, experience, and time, all of which tend to
be lacking during a pandemic.

The ventilator also doesn't kill the virus. It's still doing its
thing and growing. When all the alveoli in the lung are trashed and
full of fluids, it's over. Without sufficiently functional alveoli,
we can pump the lungs full of pure oxygen and none of it will end up
in the blood stream. What keeps some lucky patients alive, is that
some alveoli are still functional. These try to take over the job of
the alveoli that are gone. Increasing the oxygen concentration partly
compensates for the loss of some alveoli. Unfortunately, this makes
the remaining functional alveoli work really hard. A slight bit of
overpressure and the alveoli burst. When that happens, all the
sophisticated ventilator control systems isn't going to be of much
use.

so they should use an ECMO machine instead?

 

On Friday, April 10, 2020 at 4:22:38 PM UTC-4, John Larkin wrote:

On Fri, 10 Apr 2020 10:59:21 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Friday, April 10, 2020 at 1:05:32 PM UTC-4, jla...@highlandsniptechnology.com wrote:
On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970


Have you seen any data on infection rates of people who had known,
serious exposure?

Only anecdotes so far. But we know, for example, that only a small
fraction were infected on the Corona Princess, and that families
living with Kung Pao Lung patients are generally not affected. One
of my pals is an example of that.

Some things, like measles, will infect everyone who is not vaccinated.

That is plainly not the case -- it's not that easy to spread, otherwise
we'd see much higher transmission.

Of tuberculosis, Dad said one guy's cough can infect everyone in the
room. Chi-Commie Virus ain't that.

Luckily, most exposed people will not develop active tuberculosis
disease.

https://en.wikipedia.org/wiki/Tuberculosis#Epidemiology

That's good and bad. It's good not to be sick, of course. But any
number of life-saving drugs can light up a dormant TB infection.

It's a terrible dilemma that may, in the final analysis, have cost
me my dear brother Jeffrey, who did not have TB, but could not be
treated until after a dreadful delay to be sure he did not. In those
many days spent waiting he suffered a frightful decline, from
"feeling under the weather" to "not expected to survive the night".

> C19 is similar, most exposed people don't get noticeably sick.

Cheers,
James

 

On Friday, April 10, 2020 at 3:04:38 PM UTC-4, George Herold wrote:

On Friday, April 10, 2020 at 1:59:27 PM UTC-4, dagmarg...@yahoo.com wrote:
On Friday, April 10, 2020 at 1:05:32 PM UTC-4, jla...@highlandsniptechnology.com wrote:
On Fri, 10 Apr 2020 09:26:39 -0700 (PDT), dagmargoodboat@yahoo.com
wrote:

On Thursday, April 9, 2020 at 8:16:57 PM UTC-4, bloggs.fre...@gmail.com wrote:

Spending another gazillion bucks on something that's a death machine, and the people who survive it have seriously damaged lungs.

This is an even bigger fiasco than the chloroquine which is killing people with cardiac arrhythmia, another treatment doctors are becoming wary of.

Here's a _very_ useful 10-minute video by a physician on NY's
front lines. All his patients are COVID-19er's.

He says they've learned a lot about transmission, explains who
needs to go to the hospital and when. He says transmission seems
to be overwhelmingly to people who spent 20-30 minutes in physical
contact, then touched their eyes, nose, or mouth.

He says it's safe for ordinary-risk people to share a house with
a COVID patient, with basic sanitation precautions. High-risk people
need more drastic protections, or alternate living arrangements.

He says it's safe to shop as long as you don't touch your face
until after you wash your hands.

Other good, useful stuff...

https://twitter.com/bennyjohnson/status/1246849319694675970


Have you seen any data on infection rates of people who had known,
serious exposure?

Only anecdotes so far. But we know, for example, that only a small
fraction were infected on the Corona Princess, and that families
living with Kung Pao Lung patients are generally not affected. One
of my pals is an example of that.

Some things, like measles, will infect everyone who is not vaccinated.

That is plainly not the case -- it's not that easy to spread, otherwise
we'd see much higher transmission.

Of tuberculosis, Dad said one guy's cough can infect everyone in the
room. Chi-Commie Virus ain't that.

Some things, less so.

Cheers,
James

I was listening to biologist podcast who said we missed a bet
with the infected air craft carrier. If we had asked the crew to
record what they'd done for the last few weeks we might have gotten some
decent data on how it spread.

That carrier's an example worth looking at -- thousands of guys on a
ship, many contagious, and how many ultimately got it? About 1-of-10,
so far.
https://www.sfchronicle.com/bayarea/article/First-sailor-with-coronavirus-hospitalized-in-15189830.php

Cheers,
James

 

[Jeff Liebermann]

On Fri, 10 Apr 2020 09:49:28 +0100, TTman <kraken.sankey@gmail.com>
wrote:

On 10/04/2020 04:37, Jeff Liebermann wrote:
On Thu, 9 Apr 2020 17:16:52 -0700 (PDT),
bloggs.fredbloggs.fred@gmail.com wrote:

"The ventilator itself can do damage to the lung tissue based
on how much pressure is required to help oxygen get
processed by the lungs," she said.

Here's a video on the design requirements for a proper ventilator
which includes some comments on over-pressure and breathing
synchronization problems:

"A Guide To Designing Low-Cost Ventilators for COVID-19"
https://youtu.be/7vLPefHYWpY

But isn't a ventilator part of a closed loop system, the feedback being
saturated O2 levels in the blood ? If the O2 levels drop, don't they
wind up the ventilator ? Just guessing here as I don't know.....

I can't answer that. All I know is what I read. Low blood oxygen
saturation levels indicated on a pulse oximeter is just one indication
of a problem. Excessive CO2 in the blood is another. As I understand
it, getting rid of the carbon dioxide is as much a problem as getting
enough oxygen. It helps to how the virus works:

How Coronavirus Kills:
Acute Respiratory Distress Syndrome (ARDS) & COVID-19 Treatment
<https://www.youtube.com/watch?v=okg7uq_HrhQ>

I think we can safely assume that oxygen concentration, pressure, and
flow rate are controlled by some kind of control system. It's
obviously automatic, but with plenty of manual tweaks and adjustments.
When fighting a massive lung infection and the resultant pneumonia,
one can't just plug a magic ventilator, punch the "fix everything"
button, and walk away. The situation is dynamic, with the patient's
condition varying constantly. An automatic control system can do its
best, but it's going to need some expert attention to the indicators
and manual adjustments to the machine settings. That requires
qualified people, training, experience, and time, all of which tend to
be lacking during a pandemic.

The ventilator also doesn't kill the virus. It's still doing its
thing and growing. When all the alveoli in the lung are trashed and
full of fluids, it's over. Without sufficiently functional alveoli,
we can pump the lungs full of pure oxygen and none of it will end up
in the blood stream. What keeps some lucky patients alive, is that
some alveoli are still functional. These try to take over the job of
the alveoli that are gone. Increasing the oxygen concentration partly
compensates for the loss of some alveoli. Unfortunately, this makes
the remaining functional alveoli work really hard. A slight bit of
overpressure and the alveoli burst. When that happens, all the
sophisticated ventilator control systems isn't going to be of much
use.



--
Jeff Liebermann jeffl@cruzio.com
150 Felker St #D http://www.LearnByDestroying.com
Santa Cruz CA 95060 http://802.11junk.com
Skype: JeffLiebermann AE6KS 831-336-2558

 

[Jeff Liebermann]

On Fri, 10 Apr 2020 12:00:26 -0700 (PDT), George Herold
<ggherold@gmail.com> wrote:

OK, That checks the 'why are face masks good?' box. I went food shopping
with my bandanna on yesterday. ~20% of people had some sort of mask on.
Here's a million dollar idea. Trump bandanna's! "Make America Safe Again"
George H.

Done. Here's me modeling my red Republican bandana:
<http://www.learnbydestroying.com/jeffl/pics/jeffl/slides/cloth%20PPE.html>
I also have a matching blue bandana for when it's expedient to act
like Democrat.

Make America Late.



--
Jeff Liebermann jeffl@cruzio.com
150 Felker St #D http://www.LearnByDestroying.com
Santa Cruz CA 95060 http://802.11junk.com
Skype: JeffLiebermann AE6KS 831-336-2558

 

[Jeff Liebermann]

On Fri, 10 Apr 2020 14:19:41 -0700 (PDT), Lasse Langwadt Christensen
<langwadt@fonz.dk> wrote:

>so they should use an ECMO machine instead?

"FDA Approves ECMO to Treat COVID-19 Patients"
<https://www.dicardiology.com/article/fda-approves-ecmo-treat-covid-19-patients>

Personally, I don't think it's going to work. With the entire surface
area of the lungs infected and inflamed, an ECMO machine might keep
the patient alive for a while. Eventually, they will need to go back
to normal breathing. If the aveoli recover sufficiently, then it's
possible. However, if it's like what I've been reading about
"recovered" patients having permanent fibrosis (scaring) of the lungs,
the patient will not be unable to breath normally.

--
Jeff Liebermann jeffl@cruzio.com
150 Felker St #D http://www.LearnByDestroying.com
Santa Cruz CA 95060 http://802.11junk.com
Skype: JeffLiebermann AE6KS 831-336-2558