Doctors at the University of Chicago Medicine are seeing “truly remarkable” results using high-flow nasal cannulas rather than ventilators and intubation to treat some COVID-19 patients.
High-flow nasal cannulas are non-invasive nasal prongs that sit below the nostrils and blow large volumes of warm, humidified oxygen into the nose and lungs.
A team from UChicago Medicine’s emergency room took dozens of COVID-19 patients who were in respiratory distress and gave them the cannula treatments instead of putting them on ventilators. The patients all fared extremely well, and only one of them required intubation after 10 days.
High flow nasal cannulas are a special technology that can deliver up to 60 L/min of oxygen, whereas a regular cannula maxes out at ~6L/min. At UChicago, they combined the high-flow cannula with prone positioning (laying on the stomach instead of the back). Unfortunately, the high flow cannula and blows a fine spray over the patients’ room, so negative pressure rooms and anterooms (changing rooms) need to be created.
In the video accompanying the article linked above, Dr. Michael O’Connor, who heads up the UChicago critical care response, explains how they are able to segregate COVID-19 patients at their hospital. There’s some footage from within the hospital showing the massive amount of equipment and PPE devoted to the treatment of just one patient. Dr. Thomas Spiegel, of the Emergency Medcine department, also expresses how relieved he is that the curve has been flattened.
Every day that we flatten the curve gives research hospitals like UChicago time to figure out he best way to treat COVID-19. Unfortunately some people need tattoos and haircuts, so in those states, the hospitals and medical examiners will be slammed.
satby
My friend is a nurse there, and she said that it had been (probably still is, haven’t talked to her in 10 days) really bad with the covid patients. They didn’t have enough ventilators for them all anyway, so this was probably a Hail Mary that worked out well.
Dorothy A. Winsor
That does seem hopeful. It sounds like one of those things a sanely run country might be able to act on between now and fall, when the virus strikes hard again. Of course, to do that, we’d need leaders who don’t deny it will return.
dmsilev
This is really the only short-term way out while we wait for a vaccine. Find treatments, be they mechanical, drug regimens, etc., that reduce the mortality and long-term damage rates. Flatten the curve to reduce the infection rate. Hopefully find some fast test that can be deployed at large scale to identify local hot spots (for instance, there have been suggestions to use blood oxygen levels as a preliminary screening criteria; if your SpO2 reads below 90 or whatever, the restaurant doesn’t let you in and maybe it’s a good idea to call your doctor and and get in the queue for the more specific viral tests).
Le Comte de Monte Cristo, fka Edmund Dantes
I’ve been wondering if those who have more developed immune systems (people who have had a lot of life exposure to infectious diseases and the ability to fight them off – means older people, experienced medical professionals, people who are at risk because of other factors) aren’t being betrayed by their own immune responses into going into the cytokine storm which causes death.
Maybe the trick is to turn off the immune response in moderately impacted patients through steroids and simply treat the other symptoms as they arise.
I’m not a doc, but I am recalling the simplicity that finally got discovered about stomach ulcers and antibiotics.
Capri
60 l/min is crazy high. But so much better than a ventilator. Hope it can help more people. And honestly, who needs a tatoo that badly?
Marvin
Terms like “truly remarkable” set off my b.s. detector; perhaps this is my fault, but those kinds of words are clearly in the lexicon of flacks more than of scientists. If they have a good idea, there are peer literature outlets.
Frankensteinbeck
Every day we can buy gets us closer not just to a vaccine, but to figuring out what medicines and techniques inhibit the disease or reduce mortality. This, of course, is one reason why Trump’s wasting a month going ‘What virus? Hoax hoax hoax!’ was such a terrible response.
Chief Oshkosh
So, open up the oxygen bars!!!
/s
SFAW
When can we expect the Murderer-in-Chief to suggest to Dr. Birx — when he’s being “sarcastic,” of course — that doctors mix disinfectant and/or bleach with the oxygen?
Random Poster
I deal with people who made a cheap vent, pioneered new vent techniques for fragile lungs, worked to develop surfactant to protect lungs’ inner membranes (the stuff is difficult to make and even harder to stockpile), and know a ton about lung injury. No commercial development for lack of commercial interest and institutional support for low-cost replacements that needed a lot of help to get through regulatory trials.
It has made the emails interesting though. The primary attacks seem to be on the inner membrane of the lungs, preventing oxygen saturation and then screwing with anticoagulant functions surrounding the lungs, leading to micro-clotting problems throughout the body. Very scary, since the former kills the weak, the latter kills the strong.
PsiFighter37
@SFAW: I do wonder how long Jared’s advice (presuming it was him, because Trump probably won’t listen to anyone else) that Trump should not get in front of the camera for a while will stick. The man’s narcissism requires a steady diet of attention.
Le Comte de Monte Cristo, fka Edmund Dantes
@SFAW:
Bleach and ammonia should do the trick.
On that topic, many years ago, I made the rookie mistake of using a bleach solution to clean dog pee in the garage. I saw the bubbles and got a strong whiff, swooning as I realized my stupidity before running from the garage.
CliosFanBoy
@Le Comte de Monte Cristo, fka Edmund Dantes: It’s bene decades since chemistry class, and I got a C. What does it create? Ammonia??
NeenerNeener
@CliosFanBoy: Mustard gas, I think. Think WWI
debbie
Hope this helps, but it does seem odd that such a passive delivery would work better than a ventilator.
Every time I think about Trump and his “sarcasm,” I think even if it really were sarcasm, it was wildly inappropriate. I also think that when Trump is presented with the news that people have been sickened because they ingested Lysol or whatever, he’s enough of a sick fuck to think it proves he is greatly loved.
Shalimar
@PsiFighter37: I hope he is planning rallies in re-opened states like Georgia instead of attending press conferences again. Arguing with reporters isn’t the same fix as cheering crowds, and better that just his fans have to listen to his bullshit anyway.
WaterGirl
Absolutely not picking on you at all, Dorothy, but I worry that we are a little bit picking up on the rhetoric used by the people who are pushing for the country to reopen. “When it gets bad again” and other phrases I have seen – even here on Balloon Juice – imply that we aren’t smack in the middle of the first wave.
There are plenty of places in the US that haven’t peaked yet, and even when they have peaked, thousands of people are still dying every day because that plateau can be a really long one.
I’m tired of letting the Rs set the narrative with language, the first of which was “right to life”.
Dorothy A. Winsor
@WaterGirl: You’re right, of course. I was thinking about things easing up by the end of summer and then getting bad again, the way they did in 2018.
Jinchi
@debbie: Right. The president doesn’t get to be sarcastic when he’s giving an official news conference on the topic of a pandemic that’s killed tens of thousands of people.
I don’t know why he thinks that’s a legitimate excuse.
Haydnseek
@NeenerNeener:One of my duties while working for a city water dept was changing out the chlorine tanks at a pumping plant. I was always very careful, but once while tightening up the main fitting I got a tiny puff from the tank right in the face. A very small puff, but enough to shut my system down entirely. I lay there on the concrete on my back trying to get a breath. I was there all alone on swing shift and I really thought I was going to die. I finally managed to get my breath but I was shaking for hours. I’ve never experienced anything like that again and I hope I never do.
Chlorine gas was used during WW1. The things we do to each other…….
WaterGirl
@Marvin: I suspect that what we’re seeing with that is a cross between two things:
“we saw dramatic results, let’s get this information out there ASAP so it can save lives in other places without enough ventilators”
AND
the desire to get the credit if your thing does indeed make a huge difference, which means you have to get it out there ASAP.
Ruckus
@debbie:
There may be something to what else has to be done to the patient to intubate them in the first place, I believe they have to be sedated or will remain unconscious because the tube down your throat is rather unpleasant. If you are conscious it causes one to gag. It is a last resort for breathing. I’d bet anything that gets oxygen in the lungs without fighting the tube would be better.
WereBear
Evidence of a possible common factor.
How Blood Sugar Can Trigger a Deadly Immune Response in the Flu and Possibly COVID-19
Glucose metabolism plays a key role in the cytokine storm seen in influenza, and the link could have potential implications for novel coronavirus infections
Eunicecycle
My daughter is an NP at a hospital that treats Covid-19 patients, and she mentioned proning the other day. She thought it made a huge difference. She may have mentioned the oxygen too but it wouldn’t have meant anything to me. She said keeping people off vents if possible helps because the vents cause their own problems.
ETA: Anecdotal evidence only, I know
SFAW
@debbie: @Jinchi:
The whole “sarcasm” excuse/lie would never be uttered by anyone with a microgram of shame.
Were Joseph Welch alive today, and questioning the Murderer-in-Chief, he’d probably either shoot himself, or choke the living shit out of the Murderer-in-Chief.
WaterGirl
@Jinchi: Why?
“I don’t want people to know that I am stupid enough to do what I have just done, so a lame excuse is better than that, even if all it does is give (not so) plausible deniability.”
And it partially worked! People are adopting the “sarcasm” language as they discuss this. Including us! Even when discussing it in a dismissive way, it still cedes the language to the people who do not want what is best for this country
We use it to mock him, but when everyone uses his desired language, he still wins – because it amplifies his talking point.
MoCA Ace
I have read and seen a few stories where doctors are having success using CPAP machines with supplemental oxygen as well. Much less invasive than ventilators and can be used earlier.
Brachiator
@WaterGirl:
In the UK there are strong indications that the response to the pandemic is being driven by political and ideological decisions, not science. There are calls for the government to outline an exit strategy for opening up the country again, which wrongly implies that the government has a handle on what is happening and also understands all possible outcomes.
Turns out that Boris Johnson’s chief political advisor and a colleague have been attending the SAGE scientific advisory meetings, even though these men have no science background at all.
The press has been compliant, especially the supposedly neutral BBC, and have been hailing the return of Boris Johnson and neatly avoiding discussion of failures of policy.
Cummings was also apparently a big believer in herd immunity.
And while I don’t ascribe to the idea of vast right wing conspiracies, UK diffidence does dovetail with efforts by Trump and his stupid plutocrat friends to rush ending lockdowns here.
Kristine
@Random Poster:
I’m guessing that’s why they’re seeing strokes in 20-30 year olds.
Damn, this is a scary virus.
Ruckus
@Jinchi:
To him it’s always a legitimate excuse because he, in his mind, can do no wrong. Despite all the proof of his entire life that he’s never right, he still believes he is. Think of the perspective this way, to us, he’s always wrong, always. To him, he’s always right, no matter the outcome.People didn’t listen, didn’t understand, are just wrong.
A narcissist can do no wrong. Everything that doesn’t work, be it tasks accomplished/not accomplished, everything misunderstood, is all the fault of the other person(s). The level of narcissism is basically the degree of fault that the individual can accept about themselves. That’s why shit for brains is the poster child for narcissism. It’s never about him, it is always the other person(s) fault.
Gravenstone
@NeenerNeener: Chloramine, not mustard gas. Still, highly toxic and quite dangerous to inhale.
Tokyokie
@dmsilev:
I’m a nurse, and the problem with a pulse oximeter is that the initial reading will be dreadfully low, but you know it’s not accurate because the pulse rate will be impossibly high (like 140+). Basically, it’ll take a bit of time, like about a minute or so, for the fingertip to warm sufficiently to provide an accurate reading, and although that may be OK in a clinical setting, for screening at a restaurant or other public place, it’ll piss folks off. Also, pulse oximeters don’t work well, if at all, on painted or false nails.
Brachiator
@debbie:
The claim of sarcasm is nonsense and no one should be fooled by this.
From every of his briefing appearances, it is clear that Trump is an idiot who does not understand science at even the grade school level, and who lacks the intellectual capacity to understand the information given to him by his science advisors.
Even some right wingers with medical and science backgrounds are at least holding their tongues, leaving only dedicated right wing pundits to try to defend or to justify Trump’s most recent remarks.
Trump claimed that he aimed his “sarcastic remarks” at a reporter. This is clearly a lie. And throughout he was stumbling and incoherent.
And the claim of sarcasm is insufficient when we consider the fortunately small number of foolish people who believed the president.
It’s pretty clear to see why Trump’s people now want to hide him away. But there is no reason for anyone to give any credence to this weak cover story.
sxjames
@CliosFanBoy: It’s bene decades since chemistry class, and I got a C. What does it create? Ammonia??
Actually, mixing ammonia (present in urine) and bleach creates (among other nasty things) chloramine, which was used as a poison gas in WW1.
Not fun….
MattF
@debbie: It wasn’t sarcasm, he’s just lying about that. I know that people still have trouble with the fact that Trump always defaults to lying when he gets into trouble, but that’s where we are.
ETA: As Brachiator said.
Betty Cracker
@WaterGirl: The ridiculous sarcasm cover story is a positive development in my view because it signals Trump is at least dimly aware that he said something humiliatingly stupid on live TV. So is this whiny tweet:
I saw Dr. Birx interviewed by Jake Tapper a little while ago. As Tapper was setting up the question about Trump’s humiliatingly stupid comments, you could see Birx’s soul attempting to leave her body, just as it did when Trump originally said those astoundingly dumb comments.
Birx did an able job tap-dancing around Tapper’s questions. I have some sympathy for her despite the occasional praise for Dear Leader’s leaderly leadership. It can’t be easy to manage a pandemic response and an egomaniacal lunatic who might replace you with Dr. Oz at any moment.
Capri
@Kristine: One of my daughter’s bridesmaids – a very healthy 33-year-old, died suddenly of a stroke 2 weeks ago. It was devastating.
At the time nobody saw a link to Corona, I’m sure they do now.
RepubAnon
@SFAW: Kommander Klorox is more likely to suggest that, as France is studying whether smoking reduces the risk of COVID19 infection, doctors test the effect of smoking cigarettes while on this therapy. None of the people in the immediate area are likely to die of COVID19…
(Given the high volumes of oxygen, one would want a spark-free environment…)
MattF
@Betty Cracker: Also, that he’s (reportedly) curbing the ‘news’ conferences… So now he’ll watch TV all day long, I guess.
RepubAnon
@Betty Cracker: So Drooling Donald considers live broadcasts of what he actually says “fake news.” Kind of says it all, doesn’t it?
debbie
Did anyone watch SNL? It was another “at home” show. I thought Brad Pitt did a decent Fauci.
StringOnAStick
I’ve been reading for awhile now that the issue with using ventilators is long term use has its own issues with lung tissue damage, so finding something less damaging and more readily available is important. The rush to make as many of these units as possible may turn out to be a dry hole, but based on the info we had at the time it was the right decision. How our for profit medical system deals with any over supply will be instructive, as usual.
As far as using steroids to tamp down immune system over response, that was something tried in the early stages in China, Italy and some other countries but it apparently increased mortality and the medical system s that tried this made sure that info got out there. tRump was hyping that malaria drug because billionaire Larry Ellison caught the shit gibbon’s ear and told him it would work. A rich guy with zero medical knowledge said it to him, so it simply must be true! Jesus, tRump is so easily led, no wonder Putin and Xi want him in office.
davecb
I googled “high flow nasal cannulas” for more information, and was instantly served an ad from a cpap store in Toronto (;-))
debbie
@MattF:
He won’t last. He cannot resist cameras and a national stage.
Fair Economist
@debbie: Not that passive. Normal breathing is 5 to 8 liters per minute, only 20% of that oxygen, so this is 50 times the oxygen that a person normally breathes. Like having a firehose up your nose. There was an experimental technique to force oxygen into the lungs under mild pressure; under suitable conditions blood even without hemoglobin can carry enough oxygen. Clearing CO2 becomes a problem but if the patients can exhale that should be OK.
At the same time boy that flow has to generate a LOT of aerosol. The Chinese tried this and went to direct intubation because it was making so many HCW sick.
L85NJGT
That’s says maybe. It could easily be some triage bias, or limited sample size, or whatever.
I wonder if partial cross-strain immunity with existing human corona strain(s), might help to fill in some of the bigger picture.
MattF
@debbie: I agree. No matter what Jarvanka says.
debbie
@StringOnAStick:
Some other conservative (Gerson or something like that, I think) is who gave Trump the idea about injecting disinfectant.
This is why even Birx needs to stay put. If all Trump has are the RWNJ loonies, we will all die.
SFAW
@MattF:
Not sure if, by “people still have trouble,” you mean that people are bothered by his unending lying, or that people can’t/don’t believe he lies as much as he does.
If the former, it’s because it still upsets most rational/sane/non-evil people that anyone lies that much; if the latter, then I think you’re misreading your audience.
Another Scott
@debbie: I only saw the Fauci bit, via a link here last night. His voice was just about perfect – impressive!
It was too late for me to catch the rest of the “show”. Maybe this week.
Anything that you noted?
Thanks.
Cheers,
Scott.
Jim, Foolish Literalist
@debbie: I say by Thursday at the latest he’s back out there. My guess: He’ll try to read a prepared statement and not take questions, but he won’t be able to resists
Ramalama
@NeenerNeener: Mustard gas in my kitchen sink last month (no dog pee) but bleach + some thing like hydrogen peroxide and or vinegar and or baking soda. As soon as I sprayed chlorox I had to run out of the house. I’m an idiot. No Dunning Kruger chart needed for me.
Jim, Foolish Literalist
@debbie: I watched most of it– a couple of good sketches. I liked the grocery store one best.
Lorne Michaels seems to really like Pete Davidson
ETA: also, the Brad Pitt thing is so high profile that The Beast is probably screaming at Obama’s portrait right now.
SFAW
@debbie:
Mark Grenon, whack job out of — surprise, surprise — Florida. No a pundit, speechwriter, or anything like that.
The Moar You Know
@WaterGirl: I would go further. It hasn’t gotten bad yet. Its just starting.
MattF
@SFAW: I think Trump’s lying is sometimes regarded as an issue rather than just a fact, and that’s an error, IMO.
Brachiator
@Betty Cracker:
What you said. Also, Trump again reveals himself to be a small minded, petty man child who can not put aside his silly obsessions with markers of celebrity in order to provide leadership in dealing with the pandemic.
His incompetence is clear. Just out there. And yet neither the liberal nor conservative pundits will call it for what it is.
PST
@Betty Cracker:
This is a great time to dig into the Wolf Hall trilogy. See what lengths a smart person who thinks he’s serving the public interest (as well as himself) will go in service to an omnipotent sociopath.
Uncle Cosmo
@davecb: Yeah, well, I read that as “nasal cannolis” & wondered why I should be interested in Italian deserts filled with the boogers we all stopped eating at age 6. /barf
(I myself never indulged; YMMV.) :^D
cain
@Brachiator:
A friend of mine wanted a take on a show called “Truth in Media” which is one of those conspiracy shows and of course it attacks the Bill and Melinda Gates foundation for funding models that are omg… changing and ascribing it to a personal agenda. But they point to Sweden policy of herd agenda with their lead response team person saying they will have herd immunity by May.
The show never talks to the person, but I did read up on politifact who did reach out and they said that using infection rate is a poor indicator, and two seniors are still dying and so yeah, you have herd immunity (which isn’t guarantee to save you from a 2nd infection) but at the expense of seniors and the immune-deficient.
debbie
@Another Scott:
I liked the news segment, but then I always do.
Ramalama
@PST: Wolf Hall was terrific (I listened on the audiobook version).
Mnemosyne
@MoCA Ace:
Fun fact: there are websites that can show you how to turn a CPAP machine into a makeshift emergency ventilator. I wouldn’t be surprised if that’s what the doctors are doing.
debbie
@Jim, Foolish Literalist:
Michaels has given him all kinds of breaks he never gave others. Maybe he’s learned from his mistakes with them.
leeleeFL
@PsiFighter37: The day he rode the escalator down to announce he was running, my table of well-off tennis guys just chattered like mad about tRump. I said” Stop talking about him, he’ll go away. He’s a fame junkie.” One of them said, ” but I like him!” Answered. “Stop doing that, it’s bad for the Country!” Kept my job, never knew how. Wonder how some of them feel now
debbie
@SFAW:
Thanks. I was kinda close. //
I had assumed he was a golfing buddy or Trump tenant, but he’s the “archbishop” of a quasi-religious group.
I know there are a million ideas about the first thing to do once we’re rid of this troublesome bastard, but I think it needs to be the reestablishment of separation of church and state. Enough with these idiots.
Brachiator
@debbie:
Yep. Problem is Trump is stupid. And he is naturally attracted to pseudoscience and all manner of woo.
Can you imagine any other president ever putting crap he heard from a crackpot buddy over expert advice?
Problem is, Young Jared, Pence and other loonies are also pushing Trump to make decisions not based on science.
You are right. We need Birx and Fauci. But we also have to hope that Trump and his worst people don’t sideline them.
Another Scott
@debbie: Too disinterested to look, but there was some woman on the cast – for years – who was (practically) never in a skit or anything else – just the opening and closing credits. SO of another cast member or something?
Michaels has a strange management style, but it seems to work more than half the time.
Davidson’s funny in the clueless-dude-that-women-swoon-over videos, but (as with almost everything on SNL), the joke wears off sooner than the sketch.
Cheers,
Scott.
Jim, Foolish Literalist
@PST: I listened to the first two volumes on my walks over the last couple of weeks. Very well done and the prose translates well to the audio format. So many times the descriptions of Henry sounded like trump I laughed out loud, with tremendous rue.
I read the books when they came out, but especially with Bring Up The Bodies, I got much more of a grasp of the change in, or revelation of, Cromwell as the second book played out.
cain
Nobody is going to listen to the president except our media and Trump supporters. If he goes off and starts talking about all these home remedies and people take them that is on them and the media who covers it.
If Trump supporters want to kill themselves – that’s fine with me. It sucks for their family members – but perhaps it might break the chain of the cult of personality. I’m not sure if these people are willing to die, and then have their family members cover for Trump to continue to make him look good. If they do, I guess that is their faith.
I rather focus on the ones that can be saved and saving ourselves.
Jinchi
Maybe.
I agree we should avoid using his language and almost added “He absolutely was not being sarcastic” to that post, but it seemed transparently obvious that he was BS-ing on that point.
The fact that he’s decided to run away from press conferences now shows even he thinks he lost this round.
Jim, Foolish Literalist
@Another Scott: Melissa VIllasenor? She gets almost no air time. They’ve also cut way back on Cecily Strong in the last couple of seasons. I think she’s great.
Brachiator
@cain:
Sweden has 16,000 cases and 1,900 deaths and the same problems with nursing homes as other countries.
Whether the Swedish approach has accomplished much is perhaps a matter of emphasis. Even their chief medical expert is somewhat diffident.
So, he thinks things will be better in May. We should be able to test whether these claims have any merit. Meanwhile, despite claims of herd immunity, Sweden is looking into ways of better protecting elderly and vulnerable people.
Again, this calls into question whether they really accomplished anything.
Also, they did not simply go on living life as usual. Social distancing was strongly encouraged if not made official policy.
Mnemosyne
@debbie:
As Adam alluded to the other day, injecting bleach and/or other disinfectants is one of the ways that anti-vaxxers torture their autistic kids to try and “cure” them. So it’s even worse than you thought. ?
Jinchi
@RepubAnon: Reminds me of the classic Newt Gingrich quote:
That sounds like something Captain Kirk would’ve said to send an alien android into melt-down.
Brachiator
The “sarcasm” factor:
debbie
@Jim, Foolish Literalist:
Her Jeanine Pirro needs to be on every week, dammit!
Barbara
@Le Comte de Monte Cristo, fka Edmund Dantes: It is a good thought, and if you read the article, it seems that Italian and Chinese doctors tried it, but without really seeing any mitigation in symptoms or death rates. UC concluded that it didn’t work.
debbie
@Mnemosyne:
Jesus. I did not know that. What sick fucks.
EthylEster
@RepubAnon: (Given the high volumes of oxygen, one would want a spark-free environment…)
Yeah, several remarks: 60 L/min is a lot of O2. It needs to be vented correctly. Otherwise others might experience hypoxia and/or explosions. And this O2 must be delivered from high-pressure tanks. I am not aware of a commercial concentrator producing that high a flow. In a hospital they probably have a central O2 supply. But can it deliver that high rate to many patients? And (really important) how does the O2 get vented?
Prepare for the upcoming shortage of high-pressure O2. Airco stock, anyone?
Barbara
@Haydnseek: I have a swimming pool, and when I open the bucket of chlorine tabs I always stand in the open outside, and even then I have learned to hold my breath while reaching in, and then putting the lid back on. And that is a relatively common domestic use. Powerful stuff.
Jim, Foolish Literalist
If you’re wondering why Land-O-Lakes is trending on twitter, it’s because people are mocking right wingers who are outraged that the company has removed the image of a Native American woman from its packaging, and MAGAt types are vowing a boycott.
To paraphrase Lily Tomin, no matter how you might want to mock some people, you can’t keep up.
Another Scott
@Jim, Foolish Literalist: No, it was some blonde woman.
I can’t find her at the moment. :-)
Cheers,
Scott.
Mnemosyne
@Another Scott:
Most likely she was a writer/performer who concentrated on writing. ?♀️
Brachiator
@Jim, Foolish Literalist:
These people are dopes on so many levels. infinite degrees of doptitude.
No, they cannot be mocked enough.
Kent
Here’s the problem. You are a world-renowned scientist who has dedicated your long career to viruses and fighting pandemics and you have risen to the top of the agency responsible for pandemic and infectious disease response in this country. You are a non-partisan civilian civil servant with a staff of thousands who look to you for leadership Your country needs you now more than at any time in the past 100 years.
And YOU are the one who is supposed to resign on principal because a minority of horrible old white racists voted Trump into our lives?
Would that make the agency he leads run better or worse? Would that save lives or cost them?
Much as I’d like to see Fauci give the finger to Trump and get his own 2-hour a day show on CNN to speak directly to the public on this crisis. Which would likely have HUGE ratings and make Trump’s head explode. That would probably not help things on balance. It is not Fauci’s job to fix Trump. That is our job in November. Until then we are all stuck with him.
Snarki, child of Loki
Quote from the Medical Examiner doing an autopsy on Gov. Kemp:
“There’s the problem! The brain is missing!”
chopper
@SFAW:
i dunno, but i expect trump to start confiscating all the cannula tubes and equipment the states try to buy over the next couple months.
ziggy
Very interesting article. I’ll have to dive further into this. I’ve been quite curious as to why those who are obese or have diabetes seem particularly prone to severe complications.
Brachiator
@Kent:
Here is the problem. Trump leads, or fails to lead, the effort to deal with the pandemic. It’s not just about speaking to the public.
But I obviously agree with you big time that we need Fauci to remain until we can dump Trump.
ETA: Another sign that Trump has abdicated the role of “leader of the free world.”
BR
I want to leave this here as a regular reminder that there are some herbal responses that may have benefit and are worth considering. Nothing is a cure, but we know that already. University of Arizona prepared a list that aligns with other herbal responses that were found for SARS back in 2003. Here’s their document:
https://integrativemedicine.arizona.edu/file/72354/Integrative+Considerations+during+the+COVID+3.18.20.pdf
Baikal skullcap, licorice root, quercetin, zinc, turmeric, ginger, astragalus, and boneset all appear to be useful, along with several others.
And the nicotine thing that people are discovering now — yes, it’s something that was found to be true for SARS as well, but not smoked (because that makes lung function worse, as expected). But nicotine was not as useful as the less harmful herbal responses above.
Pete Mack
So long as the hospital doesntburn down. 60L O2 per patient per minute is a whole lot of oxygen. It sounds hella expensive too, between the massive O2 use and the negative pressure room for a single patient. Better outdoors in a very well ventilated tent, I suspect.
Gin & Tonic
@Jim, Foolish Literalist: Funny thing is, they removed her from the packaging months ago and nobody noticed.
patrick II
@debbie:
I thought the highlight was weekend update, which was mostly about bleachgate. However, their “at home” shows they finish with taking turns daring each other to tell a joke written by the other from email not seen until the show. It’s a funny bit.
patrick II
@debbie:
Nor can his policies without him out there to shill them to the rubes.
Mandalay
@MisterMix
And people need to eat I guess; the Daily Mail was kind enough to show photos of social distancing in action when a restaurant reopened in Fort Worth reopened on Friday.
Call me crazy, but I’m convinced this is a carefully crafted plan by the Deep State to thin the herd in Texas.
PAM Dirac
@Kent:
This is the the key question. Part of the deal going into public service is recognizing that the public has elected the officials that determine your funding, overall mission, etc. and it is the public’s job to vote them out if they are making lousy decisions. Of course there are always going to be some elected officials that are idiots, but you can’t just call them idiots and ignore them. A big part of the director’s job is to insulate all the people doing the work in your institute from the idiots. The real questions is not whether Fauci should confront drumpft, but is he able to let all the NIAID folks do good and important work insulated from the idiots. If he can do that, he is performing a very important public service.
Betty Cracker
@PST: it really is. We received the third book in the mail just before the plague shut down our area.
trollhattan
This would seem like a good time to ban smoking in hospitals. Sounds risky!
PST
I found an interesting write-up in an emergency medicine blog on the subject of high flow nasal cannula (HFNC) treatment. One reason I find it credible is that it is from 2018 and therefore not special pleading by someone who thinks he has the miracle cure for COVID-19. This is meant for other doctors, but with Google at hand to look up abbreviations I found I could get the gist. My takeaway is that for some time emergency physicians (and presumably intensivists) have recognized that ventilator support is not always the best way to treat severe respiratory distress, even though sometimes it is indispensable. There is a search for signs and symptoms to help decide when HFNC or CPAP with oxygen might be better and how best to apply each. So it may be that the University of Chicago data is consistent with a general trend toward alternatives to ventilator support depending on circumstances. It correlates with bits of similar information from doctors around the world treating COVID-19.
joel hanes
@MattF:
now he’ll watch TV all day long
I think he’ll find a way to golf.
I kind of expect him to leverage DeSantis’s “re-opening” in Florida to “re-open” Mar A Lago, because he hates living in the White House.
joel hanes
@StringOnAStick:
Larry Ellison caught the shit gibbon’s ear and told him [hydroxychloroquine] would work.
This only adds to the pile of evidence that Larry Ellison is an evil egotistical jackass. Not that any more was needed.
joel hanes
@Fair Economist:
I’ve been wondering for a while if hyperbaric chambers with elevated oxygen levels would work. You could do a whole ward … if you could seal it. Wrong pressure direction for purposes of quarantine isolation, though … probably have to purpose-build them standalone in hospital parking lots. And build them of non-flammable materials.
Another Scott
@Mnemosyne: It looks like I was thinking of Abby Elliot. Who apparently was dating Fred, and apparently they had a falling-out.
https://variety.com/2012/tv/news/saturday-night-live-snl-squandered-abby-elliott-9185/
As usual, more was likely going on than it appeared to the audience, but it’s quite likely that my memory was faulty also too.
Cheers,
Scott.
joel hanes
@cain:
it attacks the Bill and Melinda Gates foundation for funding models
To be scrupulously fair, Bill Gates himself has publicly stated that the Gates Foundation poured a billion dollars into educational “reform” and accomplished nothing measurable. IMHO that’s because Gates, in techbro fashion, listened to the “disruptive” “reformers” rather than to teachers.
I welcome Gates’s money contributions to the fight. He and Melinda should have nothing whatsoever to do with choosing the research direction, because they have no qualifications to do so. Their intentions are good … and it turns out that good intentions are not sufficient.
Fair Economist
@Brachiator: That Land ‘o Lakes Native America woman was always a weird image. Awkward and vaguely submissive posture and it’s not like butter is a traditional Native American food. It was also out of scale with the landscape. The packaging looks far better with it gone, even aside from political correctness issues.
germy
did they take his phone away?
germy
@Fair Economist:
“They got rid of the Native American woman but they kept her land”
JoyceH
@joel hanes:
“I think he’ll find a way to golf.
I kind of expect him to leverage DeSantis’s “re-opening” in Florida to “re-open” Mar A Lago, because he hates living in the White House.”
He doesn’t have to go to Mar A Lago, his Virginia course is still open and only a motorcade drive away. I can only guess that someone with intense influence over him has convinced him that golfing in a pandemic is just a bad look. Either that or he’s physically unable to golf now. But come to think of it, if he can stand for a couple hours for those marathon ‘press briefings’, he should certainly be able to tool around in a little cart.
trollhattan
@germy:
Didn’t they technically keep the lakes?
Doug R
@Brachiator: Sweden has almost as many covid deaths as Canada, which has over 3X the population.
JoyceH
@Fair Economist: ” That Land ‘o Lakes Native America woman was always a weird image. Awkward and vaguely submissive posture and it’s not like butter is a traditional Native American food.”
I know! When they talked about removing the image, it dawned on me, I don’t recall ever hearing about tribal dairy herds.
trollhattan
Next time some Republican tells you “the cure is worse than the disease” i.e., “I want NASCAR and I want it now” ask him how this sounds, compared to staying in the house.
And may I add, holy shitballs!
Gin & Tonic
@joel hanes: I thought that was established a couple of decades ago.
ziggy
@germy: Dang he got his phone back and is at it again. Going bonkers about “Fake News”. He’s cuckoo.
Gin & Tonic
@ziggy: And tweeting about journalists who got Noble Prizes for the Russia conspiracy, and should return those prizes
p.s. I know how to spell, he doesn’t.
Robert Sneddon
@EthylEster: British hospitals ran into oxygen supply problems a few weeks back. The demand for oxygen in intensive care wards exceeded the supply system’s capabilities since they were not designed to face the extraordinary situation where every bed in every ICU ward needed large amounts of supplementary oxygen, not just some of them.
It’s one of those “nobody could have ever foreseen” situations and I expect revamping the oxygen supply systems in hospitals to meet unexpectedly high demands will be a priority, once this emergency is under control.
As for the high-flow-rate oxygen cannula treatment, the brief article I read on it mentioned some of the workarounds required to implement it safely, like isolation barriers between individual patients and extra breathing protection needed for healthcare workers since the high rate of gas flow disperses a lot of coronavirus-laden droplets around the working areas.
PJ
@WaterGirl
@The Moar You Know: New York is taking weeks to slowly come down off the “plateau” of deaths. Florida and other states with lackadaisical shutdowns or none at all are just ramping up. I would bet that we will be at 100,000 deaths by early June, and if some states really do open up, 200,000 by the end of the summer, if not before. That is with people mostly staying at home, mostly distancing, mostly wearing masks. And this is just the first wave. There will be a second wave in the fall, and maybe a third in the winter.
I was speaking with a friend who works at NIAID, and he thinks that, based on previous attempts to come up with vaccines, Covid-19 will burn its way through the population before a vaccine will be ready (if ever.) The only “solution” will be through aggressive public health measures.
ziggy
@Gin & Tonic: No “Noble” prize for journalism (it’s Pulitzer), besides the fact it is Nobel. Where is this coming from–there’s always a trigger….
Jim, Foolish Literalist
@Gin & Tonic:
man, I bet the committee for the bigly famous and prestigeful Noble Prizes in Journamalism is bigly scared. Also, it looks like he’s spending Melania’s birthday alone in his room.
Jim, Foolish Literalist
here’s the trigger:
so…. “many months”, inviting scrutiny of every move he’s made since the beginning of the year, every rally, every golf match, every weekend at Mar-a-Lago
germy
catclub
I had the same thought. If Fauci gets too much coverage, Trump has to get in front, AND fire Fauci.
Kay
Ohio just started distributing the 600 a week federal bump in unemployment – a lot of them are due retroactive if they’ve been on unemployment for the last couple of weeks so they’ll get a big bump all at once.
The extended eligibility (whether you’re covered under unemployment at all) still hasn’t kicked in however (gig workers, those who don’t ordinarily qualify for UI, etc.) but rumor mill has it as starting next week. They’ll be due $ from two sources- state unemployment and the federal bump. It doesn’t count towards employer unemployment rating- the amount an employer pays in unemployment “tax” based upon their risk rating with the state, so employers are held harmless. Anyway. Whew. Things were looking very bad for a while there – I just had no idea how these people were going to eat.
It’s not bad for everyone. A LOT of “production” type jobs are “essential” so they are not now and were never laid off. We have a huge Campbell’s facility in this area – I went by there yesterday and the parking lot was full on a Saturday- overtime. Canned food- no mystery there.
trollhattan
@Jim, Foolish Literalist:
How many months in a “many”? When’s the last time fat bastard golfed–would that count as getting out of the house?
trollhattan
@catclub:
Does Fauci technically “have ratings” that are measurable? If he does, and they’re good, watch out doc.
ziggy
At first I thought that said “attrition”, then realized that works also.
debbie
@patrick II:
Yes, and they’re doing it for charity this time. I can’t remember the actual terms of the contest, but I think people are supposed to submit jokes and a donation, and the winner’s joke will be read cold on air.
Robert Sneddon
@ziggy: I seem to recall that some group of journalists won a Nobel Peace prize some time back.
catclub
He claims he has been locked in the White house for months, plural, but he had a rally around march 11, and it is not even the end of April.
He has the patience of a flea.
debbie
@Kay:
They have done such a piss poor job on getting the call center and phone lines up and running. I don’t care how many calls are coming in, it’s shameful and it’s third-worldish that it’s still not fixed. This makes the ACA website look a piker.
P.S. I heard on a local news report that people were concerned about being asked to return to work before getting any checks and whether going back would cost them those checks.
catclub
VeniceRiley
@ziggy: Now I’m wondering if being keto diet helps.
Brachiator
@Jim, Foolish Literalist:
Do you know which other political figure had a list?
Trump is shadow boxing with himself, and losing badly. His guy’s should throw in the towel.
ziggy
I’m sure it doesn’t hurt. Anyone without stellar blood sugar control would be better off with a low carb diet, from what I’m reading. (Of course diabetics have to balance that with their medications).
Of course, in Coronavirus Days, I’ve been on a carb fest (comfort foods!), baking like crazy. Just finished a marionberry pie. 6 pounds up so far.
VeniceRiley
I have read those stories and I think we need an entire rethink of vaccine policies. Yes it would be nice to have stage 4 double blind ongoing data of whether 1 injection vs 2 injections at X strength is more effective than or the same as 3 at Y strength. People are dying and if they have a candidate the is more easily scable and works in at least the short term in initial human trials and is based on already established vaccine designs, they sould just effin roll that sucker out. It’s a moral argument vs a science data argument.
Brachiator
@Fair Economist:
The image was meant to be respectful. The indigenous woman even had a name, Mia. In the 1950s Red Lake Ojibwe artist Patrick Desjarlait updated the image and his work was considered to be respectful of indigenous culture. But time passes and later generations reconsidered how they viewed the image.
Kay
@debbie:
I have to say, I’ve been working on this for weeks now, for both small employers and employees, and it’s working. It’s moving. It was really an unprecendented hit and it’s unrealistic to think it would go smoothly immediately. The Ohio unemployment people have been great- hard to reach! Admittedly! They’re swamped, but they are busting ass.
The 600 federal bump is big. It’s a good, solid subsidy. At the end of this I think it will end up being the single most important thing Congress did (economically) to avoid real pain for people while they’re furloughed.
I’m not an economist but it’s big enough that I hope it helps avoid some of the national downturn. They will spend it. Immediately. It’s 600 a week extra, in their hands, to spend. I wish we had done it in ’09. It would have made all the diffference.
Another Scott
ICYMI, Charles Duhigg at the NewYorker – What WA got right and what NY got wrong about COVID-19:
There are a lot of lessons that need to be learned, quickly.
(via nycsouthpaw)
Cheers,
Scott.
Kay
@debbie:
I just think if you can get them some money perhaps we can avoid the kind of “cascade” we saw in 2009/10, where not paying one bill leads to the next 7 problems, and they get knocked down and can’t get back up. Admiitedly this is my half ass economic theory: get them some money= avoid ‘cascade of horrible events’ but 600 per person per week is enough to do that :)The small business subsidy is nice and all, but it’s not getting the money to masses of people, and unemployment subsidy does that. Much appreciated. Good job, Congress. For once :)
J R in WV
@trollhattan:
You obviously haven’t been around a hospital lately. There hasn’t been smoking allowed in or near WV hospitals in many years now. Nor e-cigarettes, nor snuff, nor chew, no tobacco use at all.
I guess there may be blighted areas that allow smoking in totally inappropriate places, perhaps Missouri, AL, LA, MS, etc? But not here!
Geminid
@Kay: Your comments regarding the efficacy of the $600 “bump” in unemployment compensation reminded me of an April 14 Washington Post article about Herbert Hoover’s veto of a 1932 unemployment relief act, and Will Rodgers’ assessment of Hoover: “Mister Hoover was an engineer. He knew that water trickles down…but he did not know that money trickled up. Give it to the people on the bottom and the people at the top will have it before night anyhow. But it will at least have passed through the poor fellows’ hands.”
debbie
@Kay:
Oh, I totally agree that the idea was genius. One of my nieces is out of work, as is her husband. They have a toddler. The money and the unemployment is their life line. But listening to Husted day after day in the DeWine press conferences saying they had no idea the response would be so huge and they are ramping up the call center, I feel he’s up to his same old B.S. By now, you should have an idea, dude, so fix it.
I also worry that the genuinely small businesses who have been getting shoved aside by big businesses for loans will not get those loans no matter how many CARES bills are passed.
Next up will be the homeowners. The banks are giving 90-day forbearances with a lump sum due at the end. What a dick move. I can understand they don’t want to forgive the payments, but why not just move them to the end of the loan? You’ll still get your money, guys.
I like your ideas, Kay! They don’t seem half-assed to me.
J R in WV
Regarding Trump’s claim that he was being “sarcastic” when he told people that disinfectants might be good for them regarding infectious virus SARS-Covid-19 — lying is not sarcasm, and what Trump did is no sarcasm at all.
He just displays his stunning level of ignorance about everything and anything. Over and over! He is not only killing people through his total inability to manage a true crisis, he’s committing depraved indifference to greivious physical harm to thousands of MAGAts all over the country. The only worse instances of mismanagement are in Great Britain and the ‘Stans where ignorant dictators absurdly claim “There is no virus in ‘country-name’ “! Or that it can e treated via saunas and vodka!!
Kay
@debbie:
I think it was hard for conservatives because they know it works but they’re ideologically forbidden to admit that it works. It was just so nice not to have a subsidy loaded up with a bunch of bullshit, qualifiers and targeting and so many hoops to jump thru it ends up hollow. THIS we can do- we can get them 600 a week when they need it, and they’ll spend it and we’ll all be better off.
If I were a Democrat in Congress I’d be shouting it from the rooftops. They don’t have to apologize for this- it is a simple good thing and it got done.
Sister Golden Bear
@VeniceRiley: Following a “lazy keto”* diet, combined with no snacking and intermittent fasting, brought my blood sugars back to an almost normal range after being scarily high.
*Technically it’s a very low carb (50-100g max/day), healthy fat diet, but not as extreme as formal keto diets, which are difficult to maintain long-term.
Unfortunately stress eating over the past weeks, has thrown me way off my diet, so I really need to get back to eating healthily again.
Sister Golden Bear
@Kay: I’m in a far, far better situation than folks in your neck of the woods, but if I can grouse some #firstworldproblems it’s really annoying that I’m not eligible for the extra $600 because I got laid-off as part of a corporate downsizing, nor am I getting the one time $1,200 payment because I made too much last year.
If it were a question of having to prioritize a limited pie, then I’d happily give them up to those in greater need, but the Bay Area is a fucking expensive place to live and that extra money would definitely help make sure I can pay my mortgage.
It’s the damn arbitrariness that’s infuriating. Even if you’re now unemployed for other reasons, it’s both a lousy time to be looking for a job, and you may be looking for a job that we don’t want reopened right now. Wishing we did the European-style shutdown benefits across the board. But socialism, right?
debbie
@Kay:
Pelosi did just that about an hour ago on NPR.
SFAW
@Kay:
I don’t know how late I am to the party, but I just wanted that I’m really glad to see you back here.