We Are Working Hard To Gather The Most Up-To-Date Information And Guidelines For You
Current Florida Update and The Curve
Lets see if our strategies have decreased or flattened the curve in Florida as the virus is spreading. Florida has 22 Million people so lets track the number of cases (yes, we still don’t have enough testing yet, so this stat may be not accurate and lower than what is truly out there) and the number of Florida resident deaths
Estimated ICU beds in FL = roughly 7000
Estimated % of US hospitalizations from COVID-19 (US study reference HERE) = patients known to have been hospitalized, 9% were aged ≥85 years, 36%end highlight were aged 65–84 years, 17% were aged 55–64 years, 18% were 45–54 years, and 20% were aged 20–44 years. Less than 1% of hospitalizations were among persons aged ≤19 years
Estimated % of US ICU cases (US study reference HERE) = patients known to have been admitted to an ICU, 7% of cases were reported among adults ≥85 years, 46% among adults aged 65–84 years, 36% among adults aged 45–64 years, and 12% among adults aged 20–44 years. No ICU admissions were reported among persons aged ≤19 years.
Estimated % of US deaths (US study reference HERE) = highest in persons aged ≥85, ranging from 10% to 27%, followed by 3% to 11% among persons aged 65–84 years, 1% to 3% among persons aged 55-64 years, <1% among persons aged 20–54 years, and no fatalities among persons aged ≤19 years.
Current Estimated COVID-19 FL Cases = 2355 (3/26/20)
Current FL Deaths = 28 (6 out of state) (3/26/20)
What Is The Coronavirus and COVID-19?
Coronavirus Resource Center (great resource!!!!) = http://www.cidrap.umn.edu/covid-19
Current CDC Recommendations For COVID-19 (3/16/2020)
CDC website on COVID-19 = https://www.cdc.gov/coronavirus/2019-ncov/index.html
Click Here for current events-gatherings guidelines https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/index.html
15 Day “To Slow The Spread” Plan Download HERE
Current Best Practice
- Social Isolation – 15 Day “slow the spread” plan to help prevent overflow into hospital system
- social distancing to decrease the spread of virus
- increase medical capacity – increase # of ICU beds, increase # of masks, increase # of ventilators, increase the capacity of the hospital to treat
- cancel all major events, social gathering, and meetings of 10 or more people
- identify those that are high risk (age 70+ or those with co-morbidities) and positive for COVID-19 with testing and quarantine
- continue with standard hand washing and cleaning
This was written by Dr. Porter McRoberts – Fmr. Medical Director, Interventional Spine and Pain Medicine at Holy Cross Hospital, Fort Lauderdale, FL
“Social isolation, business closure and border closure was the right response, about 6 weeks ago, but only then, prior to spring break, early in the numbers, when a short term, but complete, shutdown could have made a major deviation in the trajectory today. That approach no longer is appropriate. Now we know more, we understand our enemy better. At present an incredible 28,800 academic COVID papers have been published, which represents a deep and growing level of understanding regarding the virus and associated disease. Just as you can’t treat all patients the same you can’t treat everyone’s COVID morbidity, or “disease experience” the same. The disease manifests extremely differently, individual to individual. It turns out both seemingly competitive arguments are correct: This is just like the flu, so stop freaking out! And… this is way more lethal than the flu, we should be freaking out. The blunt and unrefined “lockdown” approach, while it works in state controlled economies, has far more serious unintended consequences in our free market, “just in time” economy. This heavy-handed, crude approach will kill our economy, which, unlike China, is intrinsically linked to our own health and wellbeing!
There are essentially three patient-groups, at present. As our science evolves, however, and we increasingly are able to weight how co-variables like age, but also blood type, current medication usage, and other co-morbidities influence the lethality, and course of the disease process, we understand the emergence of other sub-groups and individual risk becomes quite predictable.
The three groups exist as below.
1. Those who will be affected mildly or not at all by COVID, and who will impact the healthcare system minimally. These are the robustly healthy folks. They are generally folks under 60 with no comorbidities. These folks should get the green light to participate fully in society, with the moderate, nuanced social distancing we see in South Korea and Hong Kong, but not social isolation. They will get infected with minimal impact on themselves and can ride out the infection safely at home, or with minimal support. We WANT them infected and once recovered, right back out in society to provide herd immunity, to the following 2 groups. They continue to drive the economy before and after infection.
2. Those who have moderate risk of severe disease from COVID. these are folks generally in their sixties and under who also have co-morbidities, are on ACE inhibitors or other ACE enzyme drugs/ ARB blockers, NSAIDS or are immunocompromised in some fashion. Some of these persons may be younger, have the potential to cytokines storm. These folks would be expected to significantly impact the health care system once infected. These folks should participate minimally. Social isolation and significant social distancing should apply, even distancing from others within different categories in their own homes. These are yellow lighters until infected-recovered or immunized then green.
3. Those with high risk of severe disease, and health care utilization, much older folks and those with obvious risk factors of disease. These folks maintain high levels of sequestration, others do their shopping etc. They do not interact with groups 2 and especially not group one. These are red lighters until infected or vaccinated and then green again.
In summary, the only rational response, since a vaccine is still far off, is to develop herd immunity quickly without sacrificing fidelity to the economy, and with minimal impact to our vulnerable subgroups and precious and finite health care system. Hopefully we come to our senses.
The Best Interviews With Physicians And Infectious Disease Specialists About The Coronavirus:
Infectious Disease Specialist
Physician Discussion (This is more medical and in-depth content…)
John Hopkins Physician Interview
Symptoms And What Happens If You Are Infected With COVID-19
(Here is information on the symptoms as there is a good chance many of us will experience these. This was written from a physician friend of mine Dr. James Saunders of the University of Central Florida Medical School….)
In 80% of known cases, COVID-19 causes mild to moderate illness, according to a report of a joint World Health Organization-China mission of 25 infectious disease experts held in China late last month.
At a press conference on March 9, Maria Van Kerkhove, technical lead of the WHO Health Emergencies Program, had this to say about the symptoms for a so-called “mild” case: “This mild infection starts normally with a fever, although it may take a couple of days to get a fever. You will have some respiratory symptoms; you have some aches and pains. You’ll have a dry cough. This is what the majority of individuals will have.”
It is “nothing that will make you feel like you need to run to a hospital,” says Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
A mild case of COVID-19 in and of itself is not dangerous. But in some cases — more commonly in older people and in people with underlying health issues — a mild case can progress to a moderate case that could require some supportive care such as fluids for dehydration, typically in an emergency room or urgent care center, especially if hospitals are overwhelmed by the most acute cases.
Symptoms of being moderately ill with COVID-19 include coughing, fever above 100.4, chills and a feeling that you don’t want to or can’t get out of bed, says Adalja.
Some patients also experience shortness of breath, although that can occur in various ways. “Shortness of breath is a wide spectrum and whether we consider treatment will be based on how short of breath they are, their age and other health conditions,” says Galea.
“Is it shortness of breath after climbing a flight of stairs or when there’s no activity — for example, when you’re just sitting in a chair?” says Dr. Theresa Madaline, hospital epidemiologist at the Montefiore Health System in New York City.
In either case, there’s cause for concern with a confirmed or suspected COVID-19 case. “Shortness of breath [with this virus] is a symptom to always check with a health care provider. Period,” says Dr. Kenneth E. Lyn-Kew, a pulmonologist in the Section of Critical Care Medicine and Department of Medicine at National Jewish Health in Denver.
That’s because shortness of breath can be caused by low oxygen levels in the blood. Blood carries oxygen to organs and tissues, and low levels can lead to organ shutdown or even death.
For patients with moderate symptoms, hospitalization is unlikely unless they are having difficulty drawing a breath or are dehydrated. Signs of dehydration can include increased thirst, dry mouth, decreased urine output, yellow urine, dry skin, a headache and dizziness.
But there’s another possible development within the “mild to moderate” classification. “Some of those individuals will go on to develop a mild form of pneumonia,” Van Kerkhove says. While pneumonia can often resolve on its own, especially in younger people, in older people and in those with underlying health conditions, pneumonia can be life-threatening or require hospitalization, especially if their immune system is weak.
In these instances, without supplemental oxygen or, if needed, a respirator to aid breathing, a patient’s organs can shut down and the patient can die, says Galea. People with pneumonia can also get secondary bacterial infections, which can be life-threatening and require treatment with intravenous antibiotics.
A case that is “mild to moderate” will last about two weeks from the first signs of symptoms to recovery, WHO says.
Serious, severe, extreme
According to the report of the WHO-China joint mission, in about 1 in 5 patients, the infection gets worse. About 14% of cases can develop into severe disease, where patients may need supplemental oxygen. And 6% of cases become critical and may experience septic shock — a significant drop in blood pressure that can lead to stroke, heart or respiratory failure, failure of other organs or death.
For article click HERE