Pete W.

Apr 13, 2020 Dr. Mobeen discusses immunity and when lockdowns are lifted, different approaches to the management of the pandemic after an introduction describing how herd immunity works. Notably the locked down flattened curve approach is also a progression toward her immunity as well as future vaccines. He also discusses the use of prophylaxis to slow the the progression of the disease itself once contracted by an individual and if effective could enable the body to better develop stable immune response. Mobeen Syed M.D, MS graduated from King Edward Medical University (Pakistan) in 1994. After practicing clinical medicine for a few years, he continued his studies in Computer Science with the goal of merging innovative technologies and healthcare. Dr. Mobeen's dedication for teaching began at Horizon Medical Institute, where he and his world-renowned brother Dr. Najeeb, focused on teaching basic sciences to medical students.

3 nurses discuss how Intubation is routinely being used early instead of CPAP and hyflow options in certain NY hospitals, reason given because they are a closed system less likely to spread infection however therapeutic medications and other treatments are often not being employed. Majority of patients in unnamed hospital dying. Family members kept out of rooms reduces accountability. Poles being extended outside of rooms. Various problems discussed ( disregard the exaggerated click bait video title, couldn't find original source with proper title). You may or may not agree but this is a reasonable discussion In this earlier 10 minute video one of these nurses expresses a more urgent tone speaking of negligence in certain hospitals in NY Read in its entirety: New analysis recommends less reliance on ventilators to treat coronavirus patients Read in its entirety: Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings

Dr. Cameron Kyle-Sidell is an ED physician in New York. He tweeted a response at the end of March that challenged intubating COVID patients. The following is from the audio discussion. Listen to this very interesting audio discussion: ThinkingCriticalCare.com: COVID Clinical Discussion w/Cameron Kyle-Sidell NYC ED/ICU doc in the trenches. #FOAMed Another very interesting discussion about atypical acute respiratory distress syndrome from Italian physicians treating COVID patients. Read in its entirety and view graphics in the PDF: American Journal of Respiratory and Critical Care Medicine: Covid-19 Does Not Lead to a "Typical" Acute Respiratory Distress Syndrome

Also a face shield could have plastic bag material taped to the bottom edge and either hanging down far and loosely over the neck and upper chest or taped on to the upper chest pinned in the cap. Another piece of such loose plastic taped to the top possibly. At the end of the shift these attached pieces are discarded. Before using motion tested to make sure it's not too tight restricting and has some looseness

IF YOU CAN'T GET AN N95 AND MUST USE A SURGICAL MASK ALSO USE A PLASTIC FACE SHIELD, although not equivalent that will be a significant improvement over the surgical mask alone and there are even some Youtube videos on how to make one hour of soda bottled plastic. This is a very simple device

There should be no shortage of face shields since those are easy to make, even homemade versions. There are several videos on Youtube on making homemade versions using plastic waters bottles cat and stretched out or other plastic sources and other simple materials for the headband. If someone can't get an N95, a face shield in addition to a surgical mask is surely better than a surgical mask alone

(PPE)

1) New Wuhan Doctor Speaks Out From Ground Zero (Covid-19 - Coronavirus Mar 21, 2020 (Youtube channel Daniel Dumbrill) This Doctor form Wuhan discusses how the ICU for Covid-19 in Wuhan is managed. One thing not described here but the terms are mentioned "red zone" and "green zone" is that they divided the hospitals into these two zones. Medical staff and patients of the Red Zone (Covid-19) are completely separate and don't cross into the green zone. Doctors are assigned one of these zones exclusively. Many other finer details also discussed on masks, PPD, shift structure, staff meals, etc. Please spread this video as widely and to as many higher ups as possible if you think there is anything of value here. They have learned a lot through trial and error probably Youtube channel Daniel Dumbrill's facebook: https://www.facebook.com/shenzhen.kong ______________________________________________________________________ World's cheapest ventilator | Diwakar Vaish | TEDxDYPatilUniversity 7,587 views •Mar 20, 2018 TEDx Talks n 2017, Diwakar Vaish, alongside All India Institute of Medical Sciences, Delhi co-created the world's cheapest and smallest ventilator, the ventilator does not require an artificial oxygen supply and can process atmospheric air, the ventilator, currently in trials, will cost $250 US Dollars Redefining the current complexity and high-priced medical devices, he has designed a portable ventilator that uses a cell phone interface, artificial intelligence and is as big as an adult human palm. In this talk, Prof. Vaish gestures how we can make technology and medical resources affordable and available to those who need it the most. Born in 1992, Diwakar Vaish is an Indian roboticist, Head of Robotics & Research at A- SET Training and Research Institute. ________________________________ However as for India there is a materials problem with this device now https://tech.economictimes.indiatimes.com/news/technology/parts-shortage-may-pull-the-plug-on-ventilator-making/74784443 Parts shortage may pull the plug on ventilator-making Flight ban hits supply of sensors, chips and micro controllers from China, critical for manufacturing Raghu Krishnan | ETtech | March 24, 2020, 07:22 IST India’s efforts to shore up manufacturing of ventilators to deal with the rapid spread of Covid-19 infections may unravel in the absence of a local electronics components industry. The ban on international flights has made worse the issue, with manufacturers struggling to lift sensors, chips and controllers from suppliers in China. AgVa Healthcare, which makes ventilators at one-fifth the cost of imported ones, says the flight ban has hit supply of sensors, chips and micro controllers from China, critical to building ventilators in large numbers. The company is looking to scale up production to 20,000 units to meet the growing demand. “The electronic components are ready at Shenzhen. They are unable to ship it to us because of the flight ban,” said Prof Diwakar Vaish, cofounder of AgVa. “If we don’t get it, our production will be hit.” (more at link) ______________________________________________ linkedin https://in.linkedin.com/in/diwakarvaish Prof. Diwakar Vaish Co-Founder at AgVa Healthcare

YES IT ALL DEPENDS ON ICU VENTILATOR CAPACITY.

There are conflicting reports. The CDC doesn't say it's airborne yet there was some Chinese research that says it is. Bill DiBlasio in his latest update said that if someone infected is in a room and leaves the virus is not going to be in the air. But I noticed how he said an hour. What about 2 minutes? What about 10 minutes. Can the droplets be semi-airborne. Somebody gets on a small elevator whose infected and is coughing. Then they leave. A minute later you walk in and there's no one in there. Could you get it from the air? It seems to be unknown. Yes most of those cough droplets fell to the floor (or wall) but are there some tinier ones still in the air for a minuter or two?

Somebody is asking me about a worst case scenario. Do they stay in the city or is leaving to upstate safer because of much less population density? In the last DiBlasio update he said he thought the shut down of Italy was too extreme and it is going to have economic repercussions for years. He says he really doesn't want to do it but we know there is a point wher he may have to like all these cities in china. He says avoid crowds but the big problem is subways and buses and people with no masks. With 8 million people ICU could fill to capacity quickly. If they lock down and weeks go by getting food to all the people in these big buildings could be very challenging. She is wondering with all this population density that if we turn into Italy is it going to be a lot safer upstate? I'm guessing it's safer but it's also hard to estimate in some given place upstate like Ithica, Syracuse or a smaller place like Hudson their healthcare capacities relative to the population size but it seems like other things, food supply, law and order would be much easier to manage outside of NYC. Withe the density here they will have to bring in National guard like in New Rochelle. This is a highly international city there has got to be dozens or hundreds of carriers, some asymptomatic exponentially spreading it as the days go by to get the testing together