I would welcome a handbook like this for individual or family use at home if hospitals become overwelmed and can no longer accommodate even seriously ill patients. The featured handbook looks very useful, but it's written for medical professionals in a hospital setting. I'm thinking about a handbook with instructions on how to do life critical procedures as best as possible with the resources one might have at home. Off the top of my head, one topic could be about the use of a bag valve mask[1] (as a "ventilator"), how to make one at home, when should it be used, things like that.
Somewhat related, Chinese CDC posted their official guidance on mask usage. Google translate:
I. The general public
(1) Home and outdoor, no people gathered, well ventilated. It is not recommended to wear a mask.
(2) Being in a crowded place, such as office, shopping, restaurant, conference room, workshop, etc .; or taking a box elevator or public transportation. In low- and medium-risk areas, it is recommended that you wear spare masks (disposable medical masks or medical surgical masks) with you, and wear them when in close contact with other people (less than or equal to 1 meter). In high-risk areas, disposable medical masks are recommended.
(3) For those with cold symptoms such as coughing or sneezing. It is recommended to wear disposable medical or surgical masks.
(4) For those who live together with those who are separated from home and discharged from rehabilitation. It is recommended to wear disposable medical or surgical masks.
2. Personnel in specific places
(1) It is located in densely populated hospitals, bus stations, railway stations, subway stations, airports, supermarkets, restaurants, public transportation, and community and unit import and export places. In medium and low risk areas, it is recommended that workers wear disposable medical masks or surgical surgical masks. In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above.
(2) In prisons, nursing homes, welfare homes, mental health medical institutions, school classrooms, construction site dormitories and other densely populated places. In medium and low-risk areas, it is recommended that you always wear spare masks (disposable medical masks or surgical surgical masks) with you daily, and wear masks when people gather or come into close contact with one another (less than or equal to 1 meter). In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above; other personnel wear disposable medical masks.
Key personnel
Suspected cases, confirmed cases, and asymptomatic infections of new coronavirus pneumonia; close contacts of new coronavirus pneumonia; immigrants (from entry to end of quarantine). It is recommended to wear medical surgical masks or protective masks without exhalation valve that conform to KN95 / N95 and above.
Occupational exposure
(1) Medical personnel such as general outpatient clinics and wards; emergency medical personnel in medical institutions in low-risk areas; administrative personnel, police, security, cleaning, etc. engaged in epidemic prevention and control. Medical surgical masks are recommended.
(2) Personnel working in the ward and ICU of patients diagnosed with a new type of coronavirus pneumonia, suspected case patients; medical staff at designated medical institutions for fever clinics; medical staff in emergency departments of medical institutions in middle and high risk areas; epidemiological investigations and experiments Room testing, environmental disinfection personnel; transfer of confirmed and suspected cases. Medical protective masks are recommended.
(3) Operators engaged in the collection of respiratory specimens; staff who perform tracheotomy, tracheal intubation, bronchoscopy, sputum suction, cardiopulmonary resuscitation, or lung transplantation, pathological anatomy in patients with new-type coronavirus pneumonia. Suggestion: hood-type (or full-type) powered air-supply filter respirator, or half-plane power-supply air-filter respirator with goggles or full screen; P100 anti-particulate filter should be used for both types of respiratory protection Elements and filter elements should not be reused. Use protective equipment after disinfection.
This blog has interesting information, like how to properly remove a mask to avoid infecting yourself @ 14:59, and to not contaminate your house with outdoor clothing by leaving it outside: https://youtu.be/yyucJekT87E (turn on subtitles)
I'm sorry if it's slightly off topic, but could we 3D print plastic masks? It seems they could at least protect from the biggest droplets. Better than nothing, I would say. Even we could create a transparent full facial mask, protecting the eyes.
While not exactly what you're after re: DYI, the WHO has published guidance on home care for patients presenting while mild symptoms in addition to their clinical care guidelines:
- Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts[1]
- Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected[2]
I still do think hospitals can benefit from this material. The issue I'm having right now is relaying this information to the right people. Also, living in a non-English speaking country, I have no idea if health professionals are having problems with the language barrier regarding getting themselves informed with the latest insights about covid-19. Plus, a great deal of people are playing it off.
I skimmed the home care thing posted by someone else. It said to use paper towels instead of towels to dry your hands.
I almost never use towels to dry my hands. If you use paper towels, flush them down the toilet. (Assuming it won't be a plumbing problem. I can't do this currently because I live in a hundred year old building and my lease forbids it because the plumbing can't handle it.)
But you can also just let your hands air dry. You don't have to dry them at all.
From what I gather, they resort to ventilators with Coronavirus not due to paralysis of the lungs but due to inflammation and pneumonia (aka fluid in the lungs).
Here are some ventilator substitutes in such cases:
If you have fluid in your lungs and can't adequately clear it doing lung clearance in the shower, sleep propped up. A recliner is one option or prop yourself up on pillows against the headboard.
If you are having breathing issues, absolutely do not lay flat on your back. It can cause half your lung surface to be blocked by fluid and this is a good way to basically drown. Instead, lay on your side or prop yourself up. It will reduce the amount of lung surface blocked by fluid.
Ideally, have some caffeine, fluids and salt to help open up the airways and support mucus production and then go do lung clearance before trying to sleep. Then lay down on your side or prop yourself up somehow.
(Yes, I'm aware: Ideally, you should be hospitalized at that point. I didn't want my child hospitalized when he was an infant and had pneumonia, so I laid him on my chest and slept sitting up for three nights after he started antibiotics so he could breathe. I've got an incurable lung condition. I routinely deal with fluid in my lungs without seeing a doctor. It can be done.)
Obviously, ideally, see a doctor and all that. I'm only leaving this comment because the medical system is overwhelmed and that's not always going to be an option. There are going to be people in this crisis who can get info off the internet or have basically nothing because there aren't enough doctors, ventilators, etc to go around.
"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."
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.
In other words, anything that helps get phlegm and fluid out of the lungs. If you are doing lung clearance at home, you don't want to, say, mechanically suction out the lungs because you probably don't have the means to properly sterilize the equipment. Non invasive methods that don't require equipment are best for home care. Lots of people with lung issues end up very sick or dead because their home care equipment is not adequately maintained and grows nasty stuff which then gets delivered directly into the lungs.
If you use paper towels, flush them down the toilet
Please don't do this. They don't break down in water. Even if your personal house plumbing could handle it, the main sewage will not if everyone starts doing this, leading to serious blockages.
Then I suggest you just air dry your hands as much as possible, which is what I typically do. Or install a hot air hand dryer at home.
I'm pretty appalled at the official recommendation to basically create a trash can full of damp paper products in an area with a deathly ill patient and didn't want to outright say that because people give me so much shit for expressing opinions of that sort.
Paper is nasty stuff to begin with. Wet paper is a horrifying breeding ground of horribleness. Especially if it is just going to sit there for hours and possibly have other nasty stuff added to the mix.
I cannot possibly overstate how strongly I feel that the official recommendation to create a trash can full of damp paper in an area with a sick person in the name of good hygiene falls under the category of "Are you insane and trying to kill people?"
Against covid-19 and human viruses in general, as a means to limit spread, a trashcan full of damp paper is likely safer than a trashcan full of dry paper, dry snot in your pocket or similar alternatives.
A virus needs living human/animal cells to procreate, (I guess) it's less likely to spread from a damp vs. dry and dusty material, and is likely to decontaminate much sooner - even the mentioned nastiness could be decomposing the virus.
Whether the sick person is likely to get a secondary infection is another issue, though I'm not sure why you consider wet paper a horrible breeding ground.
I took her point to mean bacterial and fungal (mould) grot rather than viral. Given sufficient time that could become a problem, but you'd have to leave it a few weeks I'd have thought. Still, it's a valid consideration for immune-compromised people.
I really don't want to stay in this discussion, but did want to suggest to you in specific that you might find it interesting to look up articles about stunting and the role of chronic low grade infection due to poor hygiene. The term that gets used is "enteric" something or other.
I googled "stunting enteric infections" and came up with these two articles, for example:
The TLDR: Lack of adequate food is not the full explanation for stunting. Poor hygiene in the general environment plays a significant role.
General cleanliness of your general environment has significant health impacts. We know this in the abstract. We know Sick Building Syndrome exists and we know entire neighborhoods have worse health because they have all the things the NIMBYs kept out of their neighborhood.
But people get bizarrely dismissive of the idea when it's a specific instance involving them in specific. Then it's all "Nuh-uh!" And "Do you have clinical studies?" And "That article you posted is orthogonal..."
It seems to me, you are outright dismissing paper-towels-in-trash-can approach, in both home and hospital use, no matter how it's managed, while recommending not drying or hot air dryers as a less bad substitute.
Do you have any references linking paper towel (disposal) in particular, as an added risk for drug-resistant bacteria, stunting enteric infections, sick building syndrome or your other claims?
Wet paper is a horrifying breeding ground of horribleness.
I would especially be interested in this claim, as I would intuitively expect paper to be a worse environment for dangerous organisms than most other damp indoor locations.
First link on "hot air hand drying" shows bacterial spreading a breading[1], and a search on "paper towels" yields a paper[2] says paper drying is more sanitary than not drying or hot air drying.
I will suggest you spend a little time looking up articles about how hospitals actively breed antibiotic resistant infections. They are a primary source of such infections.
I think I've already reached my limit for the night for trying to politely discuss this with people in this thread.
I'm glad info from China is filtering over onto the rest of the internet. So much vital information, especially about how to keep safe as an individual, is only available on WeChat in Mandarin.
I wonder what the handbook for the billions of people in hundreds of countries without adequate health care infrastructure is. Our data points so far has been from mostly dismal first world responses with capability to report skewed statistics due to system under testing. But the reality is, most of the world will respond to this outbreak the same way they did the Spanish Flu. It would be interesting to see outcome of the first post herd-immunity country.
Vnzla has got strategically ties with Cuba, whom have already been exporting antivirals in great amounts to China, they will be fine, tho their prisons might suffer, just like most of latam prison population
If you want to worry worry about the US homeless population and those poor people on Mexican us sponsored migratory concentration camps and us Ice concentration camps as well
Not sure why you're getting downvoted. Philanthropy is philanthropy, and i don't see anything wrong with appreciating when someone does something good.
The philanthropy is certainly admirable and appreciated, though, it shouldn't immediately discount intent for those whose job it is to worry about stuff like that.
But personally, I do think it's pretty clearly well intentioned on it's face. And I'm very thankful this is out and I hope it saves lives.
It’s not that it’s against the rules. It’s just that you’ll be downvoted by those that hate billionaires and that will impact your ability to comment. I’m glad I accumulated enough karma from before HN became like this that I can handle losing some karma to say what others have been silenced from saying by downvoters.
That's a serious handbook about prevention and treatment, whoever to medical professionals or normal people. And it's more valuable to those medical in the fire line now, You still can watch the news about doctors or nurses treating potential patients without masks or any protect suit. It is a high risk to anyone, Once hospitals been infected even overwhelmed, We will be a very dangerous situation.
Perhaps People panic at the beginning in a piece of uncertain information about diseases, but now there is a handbook or practices something and some people have already experienced this and sum up some experiences, It deserved be paid attention to.
Yes. This is seriously useful information. This is how supportive treatment to get patients though the illness is done, from people who have done it. It's a very complex process. There are drugs and treatments which help, but only when accompanied by elaborate testing and monitoring. This hospital has worked out how to do this for a large number of patients. They have a dedicated facility that does only this. That's needed.
Looks good. I question the survivorship bias from the "0% fatality". They could have had no bad cases or just got lucky. Wouldn't a measurement of how many people it spread to at the hospital be better? The guide seems pretty legitimate though.
I wonder if the U.S is going to use these drugs or if most docs will be too conventional to use these drugs off label.
"Antiviral Treatment...
lopinavir/ritonavir (2 capsules, po q12h} combined with arbidol (200 mg po ql 2h)...chloroquine phosphate can be used on adults...
Interferon nebulization
Darunavir/cobicistat hdarunavir/ cobicistat (1 tablet qd) or favipiravir (starting dose of 1600 mg followed by 600 mg tid) is an
alternative option after the ethical review. Simultaneous use of three or more antiviral
drugs is not recommended. "
I wonder if the U.S is going to use these drugs or if most docs will be too conventional to use these drugs off label.
Domestic therapeutic recommendations from a number of European countries (e.g. France, Italy, Switzerland, Belgium) includes use of these medications, so I think it likely they will.
Yeah I heard that too. It's at most an HA protein inhibitor, while the SARS-CoV-2 likely to bind with ACE2 receptor. Also it requires high concentration of the drug.
While posting this link was thinking, if this book can be done in restructured text with pdf generated using sphinx and subsequently extend it for country specific conditions and language with the help of local medical staff. It can become a very helpful knowledge base which can be referred to by practitioners and will be very useful for developing countries and clinics in remote areas.
It's probably wise to take survivorship bias into account here. Also, I think the focus is on the wrong data point. Wouldn't it be better to look at hospitals with the best/fastest recovery rate? Or look at hospitals with the highest fatality rates to understand what specifically is causing that?
Regarding the self-care document, I'd never heard of acetaminophen before so had to look it up but perhaps medical people know the term? I'd half guesses by seeing the precautions though.
In the UK it's generally called Paracetamol and is in a lot of over-the-counter medicine.
Why does everyone want to reduce the fever with pills?
The immune system works best when there is a fever and if you suppress it you are just trading long term complications for short term relief. In the Covid-19 case it would IMO be much better to drink lots of fluids and just let the fever run its course.
> Editor's note (19 March 2020): Since the publication of this article, the World Health Organization has updated its advice on the official Twitter account: "Based on currently available information, WHO does not recommend against the use of ibuprofen."
Yeah, messy situation, but I'll take their word and the Chinese doctors for it whom have been administering ibuprofen to measure success
Note that even if the WHO changed its recommendation, french doctors still recommend to _not_ take anti-inflammatory. Use paracetamol instead (but not more than usual). Maybe they didn't get the memo yet, I can't tell.
I would welcome a handbook like this for individual or family use at home if hospitals become overwelmed and can no longer accommodate even seriously ill patients. The featured handbook looks very useful, but it's written for medical professionals in a hospital setting. I'm thinking about a handbook with instructions on how to do life critical procedures as best as possible with the resources one might have at home. Off the top of my head, one topic could be about the use of a bag valve mask[1] (as a "ventilator"), how to make one at home, when should it be used, things like that.
[1] https://en.wikipedia.org/wiki/Bag_valve_mask
There's a Chinese tutorial of how to make ~n90 grade masks with HEPA and SMS non-woven fabric.
https://www.zhihu.com/question/367499169/answer/996640281
Somewhat related, Chinese CDC posted their official guidance on mask usage. Google translate:
I. The general public
(1) Home and outdoor, no people gathered, well ventilated. It is not recommended to wear a mask.
(2) Being in a crowded place, such as office, shopping, restaurant, conference room, workshop, etc .; or taking a box elevator or public transportation. In low- and medium-risk areas, it is recommended that you wear spare masks (disposable medical masks or medical surgical masks) with you, and wear them when in close contact with other people (less than or equal to 1 meter). In high-risk areas, disposable medical masks are recommended.
(3) For those with cold symptoms such as coughing or sneezing. It is recommended to wear disposable medical or surgical masks.
(4) For those who live together with those who are separated from home and discharged from rehabilitation. It is recommended to wear disposable medical or surgical masks.
2. Personnel in specific places
(1) It is located in densely populated hospitals, bus stations, railway stations, subway stations, airports, supermarkets, restaurants, public transportation, and community and unit import and export places. In medium and low risk areas, it is recommended that workers wear disposable medical masks or surgical surgical masks. In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above.
(2) In prisons, nursing homes, welfare homes, mental health medical institutions, school classrooms, construction site dormitories and other densely populated places. In medium and low-risk areas, it is recommended that you always wear spare masks (disposable medical masks or surgical surgical masks) with you daily, and wear masks when people gather or come into close contact with one another (less than or equal to 1 meter). In high-risk areas, it is recommended that workers wear medical surgical masks or protective masks that comply with KN95 / N95 and above; other personnel wear disposable medical masks.
Key personnel
Suspected cases, confirmed cases, and asymptomatic infections of new coronavirus pneumonia; close contacts of new coronavirus pneumonia; immigrants (from entry to end of quarantine). It is recommended to wear medical surgical masks or protective masks without exhalation valve that conform to KN95 / N95 and above.
Occupational exposure
(1) Medical personnel such as general outpatient clinics and wards; emergency medical personnel in medical institutions in low-risk areas; administrative personnel, police, security, cleaning, etc. engaged in epidemic prevention and control. Medical surgical masks are recommended.
(2) Personnel working in the ward and ICU of patients diagnosed with a new type of coronavirus pneumonia, suspected case patients; medical staff at designated medical institutions for fever clinics; medical staff in emergency departments of medical institutions in middle and high risk areas; epidemiological investigations and experiments Room testing, environmental disinfection personnel; transfer of confirmed and suspected cases. Medical protective masks are recommended.
(3) Operators engaged in the collection of respiratory specimens; staff who perform tracheotomy, tracheal intubation, bronchoscopy, sputum suction, cardiopulmonary resuscitation, or lung transplantation, pathological anatomy in patients with new-type coronavirus pneumonia. Suggestion: hood-type (or full-type) powered air-supply filter respirator, or half-plane power-supply air-filter respirator with goggles or full screen; P100 anti-particulate filter should be used for both types of respiratory protection Elements and filter elements should not be reused. Use protective equipment after disinfection.
https://zhuanlan.zhihu.com/p/114129365
This blog has interesting information, like how to properly remove a mask to avoid infecting yourself @ 14:59, and to not contaminate your house with outdoor clothing by leaving it outside: https://youtu.be/yyucJekT87E (turn on subtitles)
I'm sorry if it's slightly off topic, but could we 3D print plastic masks? It seems they could at least protect from the biggest droplets. Better than nothing, I would say. Even we could create a transparent full facial mask, protecting the eyes.
Here is an open-source 3D mask model:
https://www.3dnatives.com/en/mask-against-covid-19-180320205...
That design has no water-repellent part.
Better design for an effectual makeshift mask made with household items, in English, with video illustration: https://www.consumer.org.hk/ws_en/news/specials/2020/mask-di...
While not exactly what you're after re: DYI, the WHO has published guidance on home care for patients presenting while mild symptoms in addition to their clinical care guidelines:
- Home care for patients with COVID-19 presenting with mild symptoms and management of their contacts [1]
- Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected [2]
- All WHO technical guidance [3]
[1] https://www.who.int/publications-detail/home-care-for-patien...
[2] https://www.who.int/publications-detail/clinical-management-...
[3] https://www.who.int/emergencies/diseases/novel-coronavirus-2...
A collaborative guide to COVID-19 care
https://covid-at-home.info/
I still do think hospitals can benefit from this material. The issue I'm having right now is relaying this information to the right people. Also, living in a non-English speaking country, I have no idea if health professionals are having problems with the language barrier regarding getting themselves informed with the latest insights about covid-19. Plus, a great deal of people are playing it off.
as best as possible with the resources one might have at home.
Previous comment by me along those lines:
https://news.ycombinator.com/item?id=22595343
I skimmed the home care thing posted by someone else. It said to use paper towels instead of towels to dry your hands.
I almost never use towels to dry my hands. If you use paper towels, flush them down the toilet. (Assuming it won't be a plumbing problem. I can't do this currently because I live in a hundred year old building and my lease forbids it because the plumbing can't handle it.)
But you can also just let your hands air dry. You don't have to dry them at all.
From what I gather, they resort to ventilators with Coronavirus not due to paralysis of the lungs but due to inflammation and pneumonia (aka fluid in the lungs).
Here are some ventilator substitutes in such cases:
If you have fluid in your lungs and can't adequately clear it doing lung clearance in the shower, sleep propped up. A recliner is one option or prop yourself up on pillows against the headboard.
If you are having breathing issues, absolutely do not lay flat on your back. It can cause half your lung surface to be blocked by fluid and this is a good way to basically drown. Instead, lay on your side or prop yourself up. It will reduce the amount of lung surface blocked by fluid.
Ideally, have some caffeine, fluids and salt to help open up the airways and support mucus production and then go do lung clearance before trying to sleep. Then lay down on your side or prop yourself up somehow.
(Yes, I'm aware: Ideally, you should be hospitalized at that point. I didn't want my child hospitalized when he was an infant and had pneumonia, so I laid him on my chest and slept sitting up for three nights after he started antibiotics so he could breathe. I've got an incurable lung condition. I routinely deal with fluid in my lungs without seeing a doctor. It can be done.)
Obviously, ideally, see a doctor and all that. I'm only leaving this comment because the medical system is overwhelmed and that's not always going to be an option. There are going to be people in this crisis who can get info off the internet or have basically nothing because there aren't enough doctors, ventilators, etc to go around.
What is lung clearance?
From GP's linked comment:
"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."
From my previous comment linked above:
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.
In other words, anything that helps get phlegm and fluid out of the lungs. If you are doing lung clearance at home, you don't want to, say, mechanically suction out the lungs because you probably don't have the means to properly sterilize the equipment. Non invasive methods that don't require equipment are best for home care. Lots of people with lung issues end up very sick or dead because their home care equipment is not adequately maintained and grows nasty stuff which then gets delivered directly into the lungs.
Please don't do this. They don't break down in water. Even if your personal house plumbing could handle it, the main sewage will not if everyone starts doing this, leading to serious blockages.
https://duckduckgo.com/html?q=paper%20towels%20flush
Then I suggest you just air dry your hands as much as possible, which is what I typically do. Or install a hot air hand dryer at home.
I'm pretty appalled at the official recommendation to basically create a trash can full of damp paper products in an area with a deathly ill patient and didn't want to outright say that because people give me so much shit for expressing opinions of that sort.
Paper is nasty stuff to begin with. Wet paper is a horrifying breeding ground of horribleness. Especially if it is just going to sit there for hours and possibly have other nasty stuff added to the mix.
I cannot possibly overstate how strongly I feel that the official recommendation to create a trash can full of damp paper in an area with a sick person in the name of good hygiene falls under the category of "Are you insane and trying to kill people?"
Against covid-19 and human viruses in general, as a means to limit spread, a trashcan full of damp paper is likely safer than a trashcan full of dry paper, dry snot in your pocket or similar alternatives.
A virus needs living human/animal cells to procreate, (I guess) it's less likely to spread from a damp vs. dry and dusty material, and is likely to decontaminate much sooner - even the mentioned nastiness could be decomposing the virus.
Whether the sick person is likely to get a secondary infection is another issue, though I'm not sure why you consider wet paper a horrible breeding ground.
I took her point to mean bacterial and fungal (mould) grot rather than viral. Given sufficient time that could become a problem, but you'd have to leave it a few weeks I'd have thought. Still, it's a valid consideration for immune-compromised people.
I really don't want to stay in this discussion, but did want to suggest to you in specific that you might find it interesting to look up articles about stunting and the role of chronic low grade infection due to poor hygiene. The term that gets used is "enteric" something or other.
I googled "stunting enteric infections" and came up with these two articles, for example:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3617052/
https://pediatrics.aappublications.org/content/138/6/e201606...
The TLDR: Lack of adequate food is not the full explanation for stunting. Poor hygiene in the general environment plays a significant role.
General cleanliness of your general environment has significant health impacts. We know this in the abstract. We know Sick Building Syndrome exists and we know entire neighborhoods have worse health because they have all the things the NIMBYs kept out of their neighborhood.
But people get bizarrely dismissive of the idea when it's a specific instance involving them in specific. Then it's all "Nuh-uh!" And "Do you have clinical studies?" And "That article you posted is orthogonal..."
It seems to me, you are outright dismissing paper-towels-in-trash-can approach, in both home and hospital use, no matter how it's managed, while recommending not drying or hot air dryers as a less bad substitute.
Do you have any references linking paper towel (disposal) in particular, as an added risk for drug-resistant bacteria, stunting enteric infections, sick building syndrome or your other claims?
I would especially be interested in this claim, as I would intuitively expect paper to be a worse environment for dangerous organisms than most other damp indoor locations.
First link on "hot air hand drying" shows bacterial spreading a breading[1], and a search on "paper towels" yields a paper[2] says paper drying is more sanitary than not drying or hot air drying.
[1] https://www.health.harvard.edu/blog/the-bacterial-horror-of-...
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538484/
I will suggest you spend a little time looking up articles about how hospitals actively breed antibiotic resistant infections. They are a primary source of such infections.
I think I've already reached my limit for the night for trying to politely discuss this with people in this thread.
You have a good evening, so to speak.
100% that.
https://www.theguardian.com/world/2020/mar/16/uks-sewage-sys...
Just the playbook I think we need...
I'm glad info from China is filtering over onto the rest of the internet. So much vital information, especially about how to keep safe as an individual, is only available on WeChat in Mandarin.
Has any of this been collected anywhere?
What kind of info? Would love to know more.
I wonder what the handbook for the billions of people in hundreds of countries without adequate health care infrastructure is. Our data points so far has been from mostly dismal first world responses with capability to report skewed statistics due to system under testing. But the reality is, most of the world will respond to this outbreak the same way they did the Spanish Flu. It would be interesting to see outcome of the first post herd-immunity country.
I'm terrified for how this may play out in Venezuela.
Vnzla has got strategically ties with Cuba, whom have already been exporting antivirals in great amounts to China, they will be fine, tho their prisons might suffer, just like most of latam prison population
If you want to worry worry about the US homeless population and those poor people on Mexican us sponsored migratory concentration camps and us Ice concentration camps as well
Are you sure that easy access to antivirals is effective against covid19?
That seems contrary to what I'm hearing from other expert sources.
Looks like the handbook was funded by Jack Ma and Alibaba. There's also an online forum setup for doctors https://covid-19.alibabacloud.com/
Props to Jack. This, along with his donation of a million masks and half million testing kits, shows selfless entrepreneurship.
Not sure why you're getting downvoted. Philanthropy is philanthropy, and i don't see anything wrong with appreciating when someone does something good.
The philanthropy is certainly admirable and appreciated, though, it shouldn't immediately discount intent for those whose job it is to worry about stuff like that.
But personally, I do think it's pretty clearly well intentioned on it's face. And I'm very thankful this is out and I hope it saves lives.
I think we all know why he's getting downvoted but it's against the rules to talk about it.
It’s not that it’s against the rules. It’s just that you’ll be downvoted by those that hate billionaires and that will impact your ability to comment. I’m glad I accumulated enough karma from before HN became like this that I can handle losing some karma to say what others have been silenced from saying by downvoters.
https://slatestarcodex.com/2019/07/29/against-against-billio...
You can see what HN is right here
https://news.ycombinator.com/item?id=22624606
That's a serious handbook about prevention and treatment, whoever to medical professionals or normal people. And it's more valuable to those medical in the fire line now, You still can watch the news about doctors or nurses treating potential patients without masks or any protect suit. It is a high risk to anyone, Once hospitals been infected even overwhelmed, We will be a very dangerous situation.
Perhaps People panic at the beginning in a piece of uncertain information about diseases, but now there is a handbook or practices something and some people have already experienced this and sum up some experiences, It deserved be paid attention to.
Yes. This is seriously useful information. This is how supportive treatment to get patients though the illness is done, from people who have done it. It's a very complex process. There are drugs and treatments which help, but only when accompanied by elaborate testing and monitoring. This hospital has worked out how to do this for a large number of patients. They have a dedicated facility that does only this. That's needed.
I just tried to promote this on Twitter. They halted my ad.
Try this link: https://www.alibabacloud.com/universal-service/pdf_reader?sp...
https://blog.twitter.com/en_us/topics/company/2020/An-update...
Very interesting how the health care guidelines of the dutch RIVM would probably at various points in time have been against the twitter policy.
Looks good. I question the survivorship bias from the "0% fatality". They could have had no bad cases or just got lucky. Wouldn't a measurement of how many people it spread to at the hospital be better? The guide seems pretty legitimate though.
I wonder if the U.S is going to use these drugs or if most docs will be too conventional to use these drugs off label.
"Antiviral Treatment... lopinavir/ritonavir (2 capsules, po q12h} combined with arbidol (200 mg po ql 2h)...chloroquine phosphate can be used on adults... Interferon nebulization Darunavir/cobicistat hdarunavir/ cobicistat (1 tablet qd) or favipiravir (starting dose of 1600 mg followed by 600 mg tid) is an alternative option after the ethical review. Simultaneous use of three or more antiviral drugs is not recommended. "
Domestic therapeutic recommendations from a number of European countries (e.g. France, Italy, Switzerland, Belgium) includes use of these medications, so I think it likely they will.
e.g. Belgium:
https://epidemio.wiv-isp.be/ID/Documents/Covid19/COVID-19_In...
Do you know if the other countries you mentioned have equivalent documents to the one you linked for Belgium?
Arbidol is totally fake Russian medicine though, shame on China for falling for the scam.
Yeah I heard that too. It's at most an HA protein inhibitor, while the SARS-CoV-2 likely to bind with ACE2 receptor. Also it requires high concentration of the drug.
It's been discussed in China back in Feb.
https://www.zhihu.com/question/369651688/answer/998764757
https://zhuanlan.zhihu.com/p/104331976
https://zhuanlan.zhihu.com/p/105098611
https://zhuanlan.zhihu.com/p/105309573
TL;DR it's controversial.
While posting this link was thinking, if this book can be done in restructured text with pdf generated using sphinx and subsequently extend it for country specific conditions and language with the help of local medical staff. It can become a very helpful knowledge base which can be referred to by practitioners and will be very useful for developing countries and clinics in remote areas.
Home quarantine for two weeks or until I can finally hear the news that 0 cases for Covid-19. I am keeping the house clean and so as myself.
It's probably wise to take survivorship bias into account here. Also, I think the focus is on the wrong data point. Wouldn't it be better to look at hospitals with the best/fastest recovery rate? Or look at hospitals with the highest fatality rates to understand what specifically is causing that?
More like location bias. This hospital is near Alibaba HQ and likely have previous cooperation with Alibaba Health
Why not try Herbs which were proven to cure people even during the 1918 Spanish Flu. Lomatium Root was used during that time with success. http://debrasnaturalgourmet.com/lomatium-root-possibly-the-b...
because generations of the smartest spent their career on something scientifically proven to be far better - it is called modern medicine.
Thank you for sharing this. I appreciate the natural medicine perspective, though most of HN is hostile to it
There's a crowdsourced handbook here, please contribute:
ToC: https://coronavirustechhandbook.com/
Doctors: https://coronavirustechhandbook.com/doctors
Self-care: https://docs.google.com/document/d/1DioVg-8nu25up0JMdd-w3AsJ...
Also EMCrit’s IBCC project has a chapter on COVID: https://emcrit.org/ibcc/covid19/
And it’s a recurring subject on their podcast: https://emcrit.org/
Regarding the self-care document, I'd never heard of acetaminophen before so had to look it up but perhaps medical people know the term? I'd half guesses by seeing the precautions though.
In the UK it's generally called Paracetamol and is in a lot of over-the-counter medicine.
Acetaminophen is just the American word for Paracetamol.
Why does everyone want to reduce the fever with pills?
The immune system works best when there is a fever and if you suppress it you are just trading long term complications for short term relief. In the Covid-19 case it would IMO be much better to drink lots of fluids and just let the fever run its course.
I'm not a doctor so you shouldn't listen to me, listen to the awesome Dr Campbell instead, https://www.youtube.com/watch?v=gJqSdmNNwW4
Most of the proximate-causes of death from COVID-19 come from the immune system in overdrive killing healthy cells in addition to infected ones.
Not sure you want a stronger immune system in that case; you probably want to reduce inflammation directly.
Experts seem to rapidly change of opinion about that :
https://www.sciencealert.com/who-recommends-to-avoid-taking-...
Actually not sure who to trust about this anymore.
Yeah, messy situation, but I'll take their word and the Chinese doctors for it whom have been administering ibuprofen to measure success
Note that even if the WHO changed its recommendation, french doctors still recommend to _not_ take anti-inflammatory. Use paracetamol instead (but not more than usual). Maybe they didn't get the memo yet, I can't tell.
Fever works well for dealing with bacteria, not with cytokine storm induced pneumonia, which is what covid induces
Is this already been supplied to doctors in US? If not, I can fwd it to anybody who is a doctor in US.
Sadly, a lot of US hospitals currently don't have the resources to do all this. Some can't even get enough N95 masks.
Link isn't loading for me, anyone have a backup?