geoffrey modest medical blogs

An intriguing Chinese study suggested benefit by infusing convalescent plasma from a prior infected Covid-19 patient into 5 critically ill patients (see  covid Rx convalescent serum jama2020  in dropbox or doi:10.1001/jama.2020.4783 ). Details: -- 5 critically ill patients with laboratory confirmed Covid-19, ARDS, severe pneumonia with rapid progression, and continuously high viral load despite antiviral treatment; PaO 2 /FIO 2  <300; and on mechanical ventilation -- all were treated with convalescent plasma transfusion from donors who recovered from Covid-19 infection, were subsequently negative for SARS-CoV-2, and had serum SARS-CoV-2 specific ELISA antibody titer >1:1000 and a neutralizing antibody titer >40 Cases: --1: 70+ yo male  admitted 2 days after symptom onset,  with no coexisting chronic diseases, in critical condition with bacterial pneumonia, severe ARDS, multi-organ dysfunction syndrome. On methylprednisolone and lopinavir/ritonavir (LPV/r), inte

a recent mathematical modeling study based on Singapore suggested that quarantine, social/workplace distancing, and school closure were key to decreasing spread of SARS-CoV-2 (see  covid nonmed interventions singapore lancetinfdz2020  in dropbox, or  doi.org/10.1016/ S1473-3099(20)30162-6) Details: -- mathematical modeling was based on:     -- the FluTE influenza epidemic simulation model (accounts for demography, host movement, and social contact rates in workplaces, schools, and homes) to estimate the likelihood of human-to-human transmission of SARS-CoV-2 if local containment fails.     -- the geographical, demographic, and epidemiologic model of Singapore were used as the synthetic but realistic representation of the Singaporean population at the household and individual levels, using national 2010 census data     -- assumption that 7.5% of infections are asymptomatic (based on the flu data of 7.5%-22.7%), the mean incubation period was 5.3 days, and the duration of

thought i would circulate this. from a person on the blog list (not wanting to be credited). this is from seattle, and is about 3 weeks old. i expect Boston will be at level of seattle pretty soon.... this was after my blog on myocarditis, and the cardiac items were highlighted. geoff —- “We've been told not to share info, but we are all doing it anyway. Since  COVID  is now deemed endemic in the XXXX area, and to quote a reliable source, the rest of the country is just "lagging behind," thought I'd share some relevant details, including from CDC teleconference today for  COVID  providers. - as we all assumed, it has been in community spread locally for weeks. We have seen idiopathic ARDS cases since early/mid-Feb. Retrospective testing is being done where possible. - the numbers presented in media do not reflect actual cases, obvs. Testing here only started 2/28. Our first CONFIRMED death was 2/23. =XXX State Lab can only run 26kits/day, though they