7 ms·

I'd like to see more information on what to do if you are sick. Even younger people have gotten serious respiratory complications and it would be great to have

I'd like to see more information on what to do if you are sick. Even younger people have gotten serious respiratory complications and it would be great to have information on how to care for yourself or your family short of heading to the hospital and contributing to the overwhelming of their staff.

raphlinus 7y ago
The most authoritative source is (still) the WHO guidelines [1], though the audience for this is health care professionals, not patients. Your national and local public health departments may have more updated and tailored information. A popular article is "What Will You Do If You Start Coughing?" by James Hamblin [2], though this is heavier on public policy concerns than specific targeted advice. If anyone can find a really well-communicated set of advice on this, I'll gladly add it to my resource list. The need for such things is urgent, and I'm extremely frustrated about the poor quality and distribution of resources, which is why I'm putting time and energy into curating my own resource list. [1] https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts https://www.who.int/publications-detail/home-care-for-patien... [2] https://www.theatlantic.com/health/archive/2020/03/where-do-you-go-if-you-get-coronavirus/607759/ https://www.theatlantic.com/health/archive/2020/03/where-do-...
Leary 7y ago
Be careful with NSAIDs as they may exacerbate symptoms. [1] [1]: https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection https://www.theguardian.com/world/2020/mar/14/anti-inflammat...
- raphlinus 7y ago
  Is there an authoritative source for this other than the French public health authorities? I haven't seen references to it at all in epi Twitter.
  - throwaway_pdp09 7y ago
    Seems you're putting twitter above a country's health authority. That seems odd. Not necessarily wrong, just odd.
    - outworlder 7y ago
      Not necessarily wrong? I'm intrigued by the thought process.
      - raphlinus 7y ago
        I'm very happy to expand on my thought process. By "epi Twitter" I mean specifically experts I follow, over a wide range of specialties including disaster preparedness, epidemiology, public health, and related topics. These are among the best people in the field, and are kind enough to share with each other and the rest of us their expertise and thoughts through Twitter. It is awe-inspiring to see. At the same time on Twitter, and at much higher volume, is a torrent of bullshit, with apparently some seeding from active disinformation sources. I try to be very careful to filter this out, though it's not always easy (I find my curation much more effective on desktop web than mobile). Public health sources are sometimes wrong. For example, Ohio's chief public health doctor put out an estimate of 100k cases on 3/12, propagated through official channels including a tweet from the Governor [1], and which #epi Twitter very quickly criticized. Work out for yourself which to trust; among other things, with the CFR we're seeing, if the public health official is right we'd be seeing approximately 1k excess deaths in OH, with a timeframe that would certainly have started emerging by now. This particular thing (ibuprofen) is in the category of "emerging research which could be very important if and when it checks out." So basically I'm trying to be very careful to vet the information I transmit. The pipeline from that to actionable advice can sometimes be infuriatingly slow, which no doubt explains why certain things (especially with an easy-to-understand narrative) jump the queue. I will definitely put this in my resource list as soon as I see trustworthy confirmation. And I am confident that if it actually was valid and important, at least one of the experts I follow would have mentioned it by now. [1]: https://twitter.com/GovMikeDeWine/status/1238177953126604801 https://twitter.com/GovMikeDeWine/status/1238177953126604801
- searine 7y ago
  This isn't clear yet. It is a reasonable assumption based on the biology but not verified.
- yread 7y ago
  Especially ibuprofen as it can cause water retention exacerbating pneumonia
DoreenMichele 7y ago
1. Onions are good lung support. 2. Watermelon is good kidney support. This is helpful if you are experiencing bloating. 3. Hot peppers are antimicrobial, antiviral, antifungal and open a cell channel that helps you dump fluids. 4. Tea is an astringent. Drinking it can help reduce fluid in the lungs. 5. Spicy foods are medicinal. Some stuff that helps combat infection include: onions, garlic, hot peppers, black pepper, cinnamon, olives. Oregano and oil of oregano are especially helpful for lung infections. 6. Alkalinity helps combat viral infections. Look up alkaline food lists. 7. Stay hydrated and get enough salt. Water and salt are critical components of mucus, an important lung thing. 8. Lysine helps combat viral infections. 9. Lung clearance is a standard means to treat serious lung conditions and keep airways open. A simple means to do this is stand in the shower with your feet about shoulder width apart, bend over as far as you can and cough hard. 10. Caffeine is a stimulant that works very similarly to an inhaler drug. So you can drink coffee or eat very dark chocolate to open up the airways as a drug substitute. Most likely, this comment will be downvoted to hell and one or more people will promptly jump up to accuse me of nefarious behavior, delusions of grandeur, having no fucking clue what I'm talking about or similar. I get that a lot. I have a very deadly medical condition that involves the lungs. I'm off all drugs. The above are some of the things I rely upon. I'm not a doctor. I'm a former homemaker and formerly homeless person. Do whatever the hell you want with that info. Edit: if you have lung distress, avoid bacon.
- Alex3917 7y ago
  > Onions are good lung support. Out of curiosity, what in onions is good for the lungs? I know a lot of people have been talking about red onions due to their quercetin content, which in vitro works similarly to chloroquine in terms of helping cells absorb zinc.
  - deleted 7y ago
    [deleted]
- throwaway_pdp09 7y ago
  Have you any clinical evidence that any of this actually works?
robbiep 7y ago
Medical assistance is ‘supportive’ This means: If you come to hospital, we give you oxygen. Initially through nasal prongs, then progressively through mask and then straight to intubation - ventilator. If the lungs are completely unable to oxygenate, we will put you on ECMO which can work quite well whilst the lungs recover.... unfortunately not many of them. We will also take bloods and give IV fluids. If your blood pressure crashes, you may be given inotropes/vasopressors but the case reports about people who make it this far are not good to date (frankly, anyone who needs an ICU bed even today has a 30% mortality rate so there’s always the baseline comparison) Once ventilated, you will usually be in antibiotics to prevent opportunistic infections. We have no other ways of helping those who are otherwise able to breathe on their own, besides symptom control (ie fever/aches and pains) however if I were to get this I would ride the fever out (heightened temperature activated immune system, trial in ICU of permissive hyperthermia shows survival benefit, although this is in sepsis patients) If you have a productive cough (cough usually dry) then chest clearance, breathing exercises may be helpful, but should consider seeking antibiotics for secondary bacterial pneumonia
HashBasher 7y ago
Yes, we need more details about how to take care of yourself if you do exhibit those symptoms. Do we just address the symptoms? Anti-fever meds, cough drops?
wahern 7y ago
I've had pneumonia several times in my life (mostly as a kid--both my parents were chain smokers), and bronchitis more times than I remember. I'm not asthmatic, though it's possible I'm borderline. Respiratory illnesses are my achilles heel. One thing I always have on hand is Primatene. The guaifenesin loosens up mucus and the ephedrine opens up your respiratory tract so it's easier to breath--both improving nasal congestion, and also, AFAIU, helping with oxygen uptake in inflamed lungs. I have to be proactive because a simple cold can lead to bronchitis, and bronchitis can lead to pneumonia. Any doctors, please opine, but I believe that if you have pneumonia (obvious infection, shortness of breath, etc) and are unable to get medical treatment, having some ephedrine on hand might be worthwhile. A quick search through the medical literature shows that ephedrine is apparently used precisely to improve oxygenation for acute respiratory distress (not just for asthmatics, obviously, but sometimes in surgery and in other cases). The critical question would be counter-indications. The doctors I've run my cold treatment by always remind me that Guaifenesin and ephedrine both increase blood pressure, so that's something to keep in mind. (Fortunately, I don't have high-blood pressure.) But how that would figure into an acute distress situation, I dunno. I'm sure that in any particular context doctors probably know of many other counter-indications. Primatene, Bronkaid, and similar generics are the only way to get ephedrine OTC, and they always include guaifenesin, so be mindful of dosages for both drugs. I just picked up a box of Primatene just in case as I forgot how much I had left at home. They're usually on the front shelves behind the pharmacist; don't bother hunting for one of the placards in the store aisle.

raphlinus 7y ago

The most authoritative source is (still) the WHO guidelines [1], though the audience for this is health care professionals, not patients. Your national and local public health departments may have more updated and tailored information. A popular article is "What Will You Do If You Start Coughing?" by James Hamblin [2], though this is heavier on public policy concerns than specific targeted advice. If anyone can find a really well-communicated set of advice on this, I'll gladly add it to my resource list. The need for such things is urgent, and I'm extremely frustrated about the poor quality and distribution of resources, which is why I'm putting time and energy into curating my own resource list. [1] https://www.who.int/publications-detail/home-care-for-patients-with-suspected-novel-coronavirus-(ncov)-infection-presenting-with-mild-symptoms-and-management-of-contacts https://www.who.int/publications-detail/home-care-for-patien... [2] https://www.theatlantic.com/health/archive/2020/03/where-do-you-go-if-you-get-coronavirus/607759/ https://www.theatlantic.com/health/archive/2020/03/where-do-...

Leary 7y ago

Be careful with NSAIDs as they may exacerbate symptoms. [1] [1]: https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection https://www.theguardian.com/world/2020/mar/14/anti-inflammat...

raphlinus 7y ago
Is there an authoritative source for this other than the French public health authorities? I haven't seen references to it at all in epi Twitter.
- throwaway_pdp09 7y ago
  Seems you're putting twitter above a country's health authority. That seems odd. Not necessarily wrong, just odd.
  - outworlder 7y ago
    Not necessarily wrong? I'm intrigued by the thought process.
    - raphlinus 7y ago
      I'm very happy to expand on my thought process. By "epi Twitter" I mean specifically experts I follow, over a wide range of specialties including disaster preparedness, epidemiology, public health, and related topics. These are among the best people in the field, and are kind enough to share with each other and the rest of us their expertise and thoughts through Twitter. It is awe-inspiring to see. At the same time on Twitter, and at much higher volume, is a torrent of bullshit, with apparently some seeding from active disinformation sources. I try to be very careful to filter this out, though it's not always easy (I find my curation much more effective on desktop web than mobile). Public health sources are sometimes wrong. For example, Ohio's chief public health doctor put out an estimate of 100k cases on 3/12, propagated through official channels including a tweet from the Governor [1], and which #epi Twitter very quickly criticized. Work out for yourself which to trust; among other things, with the CFR we're seeing, if the public health official is right we'd be seeing approximately 1k excess deaths in OH, with a timeframe that would certainly have started emerging by now. This particular thing (ibuprofen) is in the category of "emerging research which could be very important if and when it checks out." So basically I'm trying to be very careful to vet the information I transmit. The pipeline from that to actionable advice can sometimes be infuriatingly slow, which no doubt explains why certain things (especially with an easy-to-understand narrative) jump the queue. I will definitely put this in my resource list as soon as I see trustworthy confirmation. And I am confident that if it actually was valid and important, at least one of the experts I follow would have mentioned it by now. [1]: https://twitter.com/GovMikeDeWine/status/1238177953126604801 https://twitter.com/GovMikeDeWine/status/1238177953126604801
searine 7y ago
This isn't clear yet. It is a reasonable assumption based on the biology but not verified.
yread 7y ago
Especially ibuprofen as it can cause water retention exacerbating pneumonia

DoreenMichele 7y ago

1. Onions are good lung support. 2. Watermelon is good kidney support. This is helpful if you are experiencing bloating. 3. Hot peppers are antimicrobial, antiviral, antifungal and open a cell channel that helps you dump fluids. 4. Tea is an astringent. Drinking it can help reduce fluid in the lungs. 5. Spicy foods are medicinal. Some stuff that helps combat infection include: onions, garlic, hot peppers, black pepper, cinnamon, olives. Oregano and oil of oregano are especially helpful for lung infections. 6. Alkalinity helps combat viral infections. Look up alkaline food lists. 7. Stay hydrated and get enough salt. Water and salt are critical components of mucus, an important lung thing. 8. Lysine helps combat viral infections. 9. Lung clearance is a standard means to treat serious lung conditions and keep airways open. A simple means to do this is stand in the shower with your feet about shoulder width apart, bend over as far as you can and cough hard. 10. Caffeine is a stimulant that works very similarly to an inhaler drug. So you can drink coffee or eat very dark chocolate to open up the airways as a drug substitute. Most likely, this comment will be downvoted to hell and one or more people will promptly jump up to accuse me of nefarious behavior, delusions of grandeur, having no fucking clue what I'm talking about or similar. I get that a lot. I have a very deadly medical condition that involves the lungs. I'm off all drugs. The above are some of the things I rely upon. I'm not a doctor. I'm a former homemaker and formerly homeless person. Do whatever the hell you want with that info. Edit: if you have lung distress, avoid bacon.

Alex3917 7y ago
> Onions are good lung support. Out of curiosity, what in onions is good for the lungs? I know a lot of people have been talking about red onions due to their quercetin content, which in vitro works similarly to chloroquine in terms of helping cells absorb zinc.
- deleted 7y ago
  [deleted]
throwaway_pdp09 7y ago
Have you any clinical evidence that any of this actually works?

robbiep 7y ago

Medical assistance is ‘supportive’ This means: If you come to hospital, we give you oxygen. Initially through nasal prongs, then progressively through mask and then straight to intubation - ventilator. If the lungs are completely unable to oxygenate, we will put you on ECMO which can work quite well whilst the lungs recover.... unfortunately not many of them. We will also take bloods and give IV fluids. If your blood pressure crashes, you may be given inotropes/vasopressors but the case reports about people who make it this far are not good to date (frankly, anyone who needs an ICU bed even today has a 30% mortality rate so there’s always the baseline comparison) Once ventilated, you will usually be in antibiotics to prevent opportunistic infections. We have no other ways of helping those who are otherwise able to breathe on their own, besides symptom control (ie fever/aches and pains) however if I were to get this I would ride the fever out (heightened temperature activated immune system, trial in ICU of permissive hyperthermia shows survival benefit, although this is in sepsis patients) If you have a productive cough (cough usually dry) then chest clearance, breathing exercises may be helpful, but should consider seeking antibiotics for secondary bacterial pneumonia

HashBasher 7y ago

Yes, we need more details about how to take care of yourself if you do exhibit those symptoms. Do we just address the symptoms? Anti-fever meds, cough drops?

wahern 7y ago

I've had pneumonia several times in my life (mostly as a kid--both my parents were chain smokers), and bronchitis more times than I remember. I'm not asthmatic, though it's possible I'm borderline. Respiratory illnesses are my achilles heel. One thing I always have on hand is Primatene. The guaifenesin loosens up mucus and the ephedrine opens up your respiratory tract so it's easier to breath--both improving nasal congestion, and also, AFAIU, helping with oxygen uptake in inflamed lungs. I have to be proactive because a simple cold can lead to bronchitis, and bronchitis can lead to pneumonia. Any doctors, please opine, but I believe that if you have pneumonia (obvious infection, shortness of breath, etc) and are unable to get medical treatment, having some ephedrine on hand might be worthwhile. A quick search through the medical literature shows that ephedrine is apparently used precisely to improve oxygenation for acute respiratory distress (not just for asthmatics, obviously, but sometimes in surgery and in other cases). The critical question would be counter-indications. The doctors I've run my cold treatment by always remind me that Guaifenesin and ephedrine both increase blood pressure, so that's something to keep in mind. (Fortunately, I don't have high-blood pressure.) But how that would figure into an acute distress situation, I dunno. I'm sure that in any particular context doctors probably know of many other counter-indications. Primatene, Bronkaid, and similar generics are the only way to get ephedrine OTC, and they always include guaifenesin, so be mindful of dosages for both drugs. I just picked up a box of Primatene just in case as I forgot how much I had left at home. They're usually on the front shelves behind the pharmacist; don't bother hunting for one of the placards in the store aisle.