Difference between revisions of "COVID-19"

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[[File:COVID-19.jpg|400px|thumb|right|''Close-up of a**hole COVID-19'']]
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[[File:COVID-19.jpg|500px|thumb|right|''Close-up of a**hole COVID-19'']]
  
 
'''COVID-19''', also known as the novel coronavirus, was discovered in Wuhan, China on December 2019 and has been a goddamn pain-in-the-ass ever since.
 
'''COVID-19''', also known as the novel coronavirus, was discovered in Wuhan, China on December 2019 and has been a goddamn pain-in-the-ass ever since.
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'''Epidemiology'''
 
'''Epidemiology'''
 
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According to the [[World Health Organization]], the United States [[Centers for Disease Control and Prevention|Centers for Disease Control & Prevention (CDC)]], and our friend Tim, there are currently more than 35 billion confirmed cases of '''COVID-19'''.  This speaks to the huge burden of disease on human beings considering the Earth's population is less than 8 billion.
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According to the [[World Health Organization]], [[Centers for Disease Control and Prevention]], and our friend Tim, there are currently more than 35 billion confirmed cases of '''COVID-19'''.  This speaks to the huge burden of disease on human beings considering the Earth's population is less than 8 billion.
  
The first reports were first reported in first reports by the Chinese Centers for Disease Control and Prevention on December 2019 in the city of Wuhan, China.  Reports found that those aged 70 to 79 years had a case fatality rate of 8%, those aged 80 years or older had a case fatality rate of 15%, and those already decreased had a case fatality rate of 100%.  The first documented U.S. case occurred in a relatively-young patient from Washington State, who returned from Wuhan on January 20, 2020.  For Americans, this is when sh*t started to get real.
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The first reports were first reported in first reports by the Chinese Centers for Disease Control and Prevention on December 2019 in the city of Wuhan, China.  The first documented U.S. case occurred in a 35-year-old patient from Washington State, who returned from Wuhan on January 20, 2020.  For Americans, this is when sh*t started to get real.
  
In a matter of months, '''COVID-19''' had spread to all continents except Antarctica, suggesting that Antarctica has partial immunity. It had even spread to Earth's inner core.<ref>[https://gomerblog.com/2020/03/breaking-earths-inner-core-tests-positive-for-coronavirus/ Breaking: Earth’s Inner Core Tests Positive for Coronavirus (Gomerblog)]</ref> The [[World Health Organization]] declared that '''COVID-19''' was officially a pandemic, thus becoming the last major medical society to realize this.  With the exception of China, Taiwan, and South Korea, measures aimed at containment have failed.  Bribery has failed.  Most nations have opted for strategies involving mitigation or masturbation, whichever one means "to reduce the severity or spread."
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In a matter of months, '''COVID-19''' had spread to all continents except Antarctica, suggesting that Antarctica has partial immunity.  The [[World Health Organization]] declared that '''COVID-19''' was officially a pandemic, thus becoming the last major medical society to realize this.  With the exception of China, Taiwan, and South Korea, measures aimed at containment have failed.  Bribery has failed.  Most nations have opted for strategies involving mitigation or masturbation, whichever one means "to reduce the severity or spread."
  
 
In the United States, the NBA was suspended when its first player, Rudy Gobert, tested positive for coronavirus.  As students or teachers tested positive for '''COVID-19''', schools closed, including New York City's public school system, which is the largest in the country.  As patients and health care professionals tested positive for '''COVID-19''', hospitals followed suit and closed as well.<ref>[https://gomerblog.com/2020/03/hospitals-close-patients-test-positive-covid-19/ U.S. Hospitals to Close After Patients Test Positive for COVID-19 (Gomerblog)]</ref>  Social distancing was rapidly implemented (Spring Breakers in Florida were exempt), which disrupted orthopedic surgeons the most as they had to suspend bro hugs for 60 days and shelter-in-place at the hospital gym indefinitely.<ref>[https://gomerblog.com/2020/03/covid-19-update-orthopods-suspend-bro-hugs/ COVID-19 Update: Orthopods Suspend Bro Hugs for 60 Days (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/orthopaedic-surgeons-directed-to-shelter-in-hospital-gym-until-covid-19-clears/ Orthopaedic Surgeons Directed to Shelter in Hospital Gym Until COVID-19 Clears (Gomerblog)]</ref>  Cases of PTSD spiked in the Anesthesia population on account of Sudoku supply deficits.<ref>[https://gomerblog.com/2020/03/covid-19-anesthesiologist-sudoku-supplies/ COVID-19: Self-Quarantined Anesthesiologist Running Dangerous Low on Sudoku Supplies (Gomerblog)]</ref>  Batman was infected, thus becoming the first case of human-to-Batman transmission.<ref>[https://gomerblog.com/2020/03/batman-diagnosed-covid-19/ Breaking: Batman Diagnosed with COVID-19 (Gomerblog)]</ref>  The situation got so dire that the [[Centers for Disease Control and Prevention|CDC]] declared "we are effed" while aliens postponed their invasion of Earth due to concerns over '''COVID-19'''.<ref>[https://gomerblog.com/2020/03/covid-19-cdc-zombie-apocalypse/ COVID-19: CDC Says “We’re Totally Effed” in a Zombie Apocalypse (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/aliens-postpone-earth-invasion-due-to-coronavirus-concerns/ Aliens Postpone Earth Invasion Due to Coronavirus Concerns (Gomerblog)]</ref>
 
In the United States, the NBA was suspended when its first player, Rudy Gobert, tested positive for coronavirus.  As students or teachers tested positive for '''COVID-19''', schools closed, including New York City's public school system, which is the largest in the country.  As patients and health care professionals tested positive for '''COVID-19''', hospitals followed suit and closed as well.<ref>[https://gomerblog.com/2020/03/hospitals-close-patients-test-positive-covid-19/ U.S. Hospitals to Close After Patients Test Positive for COVID-19 (Gomerblog)]</ref>  Social distancing was rapidly implemented (Spring Breakers in Florida were exempt), which disrupted orthopedic surgeons the most as they had to suspend bro hugs for 60 days and shelter-in-place at the hospital gym indefinitely.<ref>[https://gomerblog.com/2020/03/covid-19-update-orthopods-suspend-bro-hugs/ COVID-19 Update: Orthopods Suspend Bro Hugs for 60 Days (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/orthopaedic-surgeons-directed-to-shelter-in-hospital-gym-until-covid-19-clears/ Orthopaedic Surgeons Directed to Shelter in Hospital Gym Until COVID-19 Clears (Gomerblog)]</ref>  Cases of PTSD spiked in the Anesthesia population on account of Sudoku supply deficits.<ref>[https://gomerblog.com/2020/03/covid-19-anesthesiologist-sudoku-supplies/ COVID-19: Self-Quarantined Anesthesiologist Running Dangerous Low on Sudoku Supplies (Gomerblog)]</ref>  Batman was infected, thus becoming the first case of human-to-Batman transmission.<ref>[https://gomerblog.com/2020/03/batman-diagnosed-covid-19/ Breaking: Batman Diagnosed with COVID-19 (Gomerblog)]</ref>  The situation got so dire that the [[Centers for Disease Control and Prevention|CDC]] declared "we are effed" while aliens postponed their invasion of Earth due to concerns over '''COVID-19'''.<ref>[https://gomerblog.com/2020/03/covid-19-cdc-zombie-apocalypse/ COVID-19: CDC Says “We’re Totally Effed” in a Zombie Apocalypse (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/aliens-postpone-earth-invasion-due-to-coronavirus-concerns/ Aliens Postpone Earth Invasion Due to Coronavirus Concerns (Gomerblog)]</ref>
  
Throughout March, '''COVID-19''' continued to spread at an alarming rate: the Mars rover, ''Curiosity'', tested positive for coronavirus, thus becoming the first case of interplanetary spread; Heaven & Hell tested positive, suggesting that we may still need to practice hand hygiene in the afterlife; and the lost city of Atlantis has tested positive.  New York has become the epicenter for '''COVID-19''' in the United States, but one lucky resident of New York City has tested negative.<ref>[https://gomerblog.com/2020/03/breaking-new-york-city-resident-tests-negative-for-covid-19/ BREAKING: New York City Resident Tests Negative for COVID-19 (Gomerblog)]</ref>  Though she didn't test positive, the 134-year-old Statue of Liberty sheltered-in-place on Liberty Island given her age puts her at higher risk of complications if infected with '''COVID-19'''.<ref>[https://gomerblog.com/2020/03/covid-19-lady-liberty-shelters-place/ COVID-19: Lady Liberty Shelters in Place on Liberty Island (Gomerblog)]</ref>  Left with no other choice, the CDC placed all of New York City under one ventilator.<ref>[https://gomerblog.com/2020/03/cdc-decides-to-put-all-of-new-york-on-a-ventilator/ CDC Decides to Put All of New York on a Ventilator (Gomerblog)]</ref>  Unfortunately any gains made with this were offset when a colossal coronavirus invaded downtown Manhattan and devoured New York City whole.<ref>[https://gomerblog.com/2020/03/colossal-coronavirus-about-to-devour-new-york-city/ Colossal coronavirus about to devour New York City (Gomerblog)]</ref>
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Reports suggest that coronavirus is capable of moving back in time.<ref>[https://www.theonion.com/who-warns-outbreaks-in-victorian-england-confirm-corona-1842123259/ WHO Warns Outbreaks In Victorian England Confirm Coronavirus Capable Of Spreading Through Time (The Onion)]</ref>
 
 
Reports suggest that coronavirus is capable of traveling back in time.<ref>[https://www.theonion.com/who-warns-outbreaks-in-victorian-england-confirm-corona-1842123259/ WHO Warns Outbreaks In Victorian England Confirm Coronavirus Capable Of Spreading Through Time (The Onion)]</ref>
 
 
 
President Trump had set his sights on reopening the United States by Easter time, but this was derailed when the Easter Bunny tested positive for coronavirus.<ref>[https://gomerblog.com/2020/03/easter-bunny-positive-coronavirus/ Easter Bunny Tests Positive for Coronavirus (Gomerblog)]</ref>  Palliative Care was consulted and is currently having a family meeting with all 327 million Americans.  It is believed consensus will be reached to make the United States [[DNR]].<ref>[https://gomerblog.com/2020/03/covid-19-update-palliative-care-makes-u-s-dnr/ COVID-19 Update: Palliative Care Makes U.S. DNR (Gomerblog)]</ref>  Until that happens, hospitals are scrambling to ensure health care professionals have an adequate supply of [[ICD-10]] codes.<ref>[https://gomerblog.com/2020/03/supply-of-icd-10-codes-for-covid-19-dangerously-low/ Supply of ICD-10 Codes for COVID-19 “Dangerously Low” (Gomerblog)]</ref>  Remarkably, infectious diseases doctors are remaining calm, even if they are getting paged anywhere from 40,000 to 100,000 times per day.<ref>[https://gomerblog.com/2020/03/covid-19-thankful-on-call-id-doc-paged-only-43589-times-today/ COVID-19: Thankful On-Call ID Doc Paged Only 43,589 Times Today (Gomerblog)]</ref>
 
  
  
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'''Symptoms'''
 
'''Symptoms'''
 
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Symptoms can range from no to yes.  The most common include fever, nonproductive [[Cough|cough]], [[Dyspnea|shortness of breath]], loss of smell, loss of taste, myalgias, and anorexia.  Less common symptoms include sore throat, rectal prolapse, and urethral discharge.  In very rare instances, it can present as a scrotal abscess.  The majority of cases are mild, with exception of the deadly ones.  Spring weather makes differentiating between allergy symptoms and '''COVID-19''' symptoms very challenging.<ref>[https://gomerblog.com/2020/03/tips-is-it-allergies-or-covid-19/ Tips: Is It Allergies or COVID-19? (Gomerblog)]</ref>  The first confirmed U.S. case was a 35-year-old male with minimal medical problems who ended up being hospitalized for 11 days.  F**K.  
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Symptoms can range from no to yes.  The most common include fever, nonproductive [[Cough|cough]], [[Dyspnea|shortness of breath]], myalgias, and anorexia.  Less common symptoms include sore throat, rectal prolapse, and urethral discharge.  In very rare instances, it can present as a scrotal abscess.
  
  
 
'''Signs'''
 
'''Signs'''
 
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The most concerning exam finding is the identification of a surgical mask over the patient's mouth.   
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The most concerning exam finding is the identification of a surgical mask over the patient's mouth.  That can't be good.   
 
 
Unlike other situations, vital signs can be quite useful.  Don't be fooled: though the documented [[Respiratory Rate|respiratory rate]] reads as 16, it is most likely 17Objective fever supports subjective fevers and hypoxemia supports a patient's complaint of "I'm feeling hypoxemic."  Cardiopulmonary exam findings may include tachycardia, wheezing, or crackles, but that does require making contact with the patient.  [[Chest X-Ray|Chest X-ray]] is an important diagnostic tool.  If [[Radiology's Circle of Tests|Radiology]] recommends [[Clinical Correlation|clinical correlation]] after remarking on pulmonary infiltrates, please defriend them.
 
  
As both the patient and health care professional have the potential to quickly decompensate, attention must be paid to bothIf both decompensate at the same time and only one bed is available, a game of [[Rock-Paper-Scissors]] should decide the outcome.
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Unlike other situations, vital signs can be quite usefulDon't be fooled: though the documented [[Respiratory Rate|respiratory rate]] reads as 16, it is most likely 17.  Objective fever supports subjective fevers and hypoxemia supports a patient's complaint of "I'm feeling hypoxemic."  Cardiopulmonary exam findings may include tachycardia, wheezing, or crackles, but that does require making contact with the patient.  [[Chest X-Ray|Chest X-ray]] is an important diagnostic tool.  If [[Radiology's Circle of Tests|Radiology]] recommends [[Clinical Correlation|clinical correlation]] after remarking on pulmonary infiltrates, please defriend them.  
  
  
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'''Diagnosis'''
 
'''Diagnosis'''
 
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Diagnosis is best achieved through diagnostic kits, whose status is currently listed as "theoretical" in the United States despite being 3 months into the pandemic.  With the eventual coordination of America's public and private sectors in early March, over 1 million flawed kits were expected to be available by the end of March 2020.  A Silicon Valley company Cepheid developed a rapid point-of-care '''COVID-19''' test that produced results in an hour or less.  Unfortunately, the U.S. Food and Drug Administration rejected this test in favor of a slow-as-balls one produced by some guy named Ted.  He hopes to roll out 12 tests to the country by the end of the year.  The expected turnaround time on Ted's test is 1 decade.<ref>[https://gomerblog.com/2020/03/fda-rejects-rapid-covid-19-test-favor-slow-as-balls-one/ FDA Rejects Rapid COVID-19 Test in Favor of Slow-as-Balls One (Gomerblog)]</ref>  Given the low number of tests available, CDC has prioritized the critically-ill or famous as the first persons who should be tested.<ref>[https://gomerblog.com/2020/03/cdc-test-kits-are-low-critically-ill-famous-people-only/ CDC: Test Kits Are Low, Critically Ill & Famous People Only (Gomerblog)]</ref>
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Diagnosis is best achieved through diagnostic kits, whose status is currently listed as "theoretical" in the United States despite being 3 months into the pandemic.  With the eventual coordination of U.S. private and public sectors, over 1 million flawed kits are expected to be available by the end of March 2020.  The optimal specimen is an upper respiratory tract sample obtained via nasopharyngeal swab.  The U.S. has had difficulty obtaining appropriate specimens, though this is largely attributable to frontline OB/GYNs collecting samples from the vagina and not the nasopharynx.<ref>[https://gomerblog.com/2020/03/ob-gyns-swabbing-vaginas-covid-19/ Habit, I Guess: OB/GYNs Accidentally Swabbing Vaginas for COVID-19 (Gomerblog)]</ref>
 
 
The optimal specimen is an upper respiratory tract sample obtained via nasopharyngeal swab, using the precision of a [[Da Vinci|da Vinci]] robot.<ref>[https://gomerblog.com/2020/03/da-vinci-key-defeating-covid-19/ Da Vinci Will Be Key in Defeating COVID-19, Says No One (Gomerblog)]</ref> The U.S. has had difficulty obtaining appropriate specimens, though this is largely attributable to frontline OB/GYNs collecting samples from the vagina and not the nasopharynx.<ref>[https://gomerblog.com/2020/03/ob-gyns-swabbing-vaginas-covid-19/ Habit, I Guess: OB/GYNs Accidentally Swabbing Vaginas for COVID-19 (Gomerblog)]</ref>  The main hurdle now is obtaining a nasopharyngeal sample that doesn't come back hemolyzed.<ref>[https://gomerblog.com/2020/03/covid-19-samples-hemolyzed/ Damn It! All U.S. COVID-19 Samples Coming Back Hemolyzed (Gomerblog)]</ref>  If this can be overcome, then healthcare professionals will address the next possible issue, one that occurred during this year's influenza season: if a '''COVID-19''' sample tests positive for ''C. difficile''.<ref>[https://gomerblog.com/2018/12/flu-swab-positive-c-diff/ That Can’t Be Good: Flu Swab Positive for C. Diff (Gomerblog)]</ref>
 
  
  
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'''Prevention'''
 
'''Prevention'''
 
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There are no known vaccines at the moment for the public to refuse.<ref>[https://gomerblog.com/2020/03/cdc-coronavirus-vaccine/ CDC: Coronavirus Vaccine Will Be Ready for Refusal By Anti-Vaxxers By 2021 (Gomerblog)]</ref>
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There are no known vaccines at the moment for the public to refuse.
 
   
 
   
  
 
'''Treatments'''
 
'''Treatments'''
 
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Treatment is largely supportive in the form of excess toilet paper, Bob Ross painting videos, and Z-Pak prescriptions.<ref>[https://gomerblog.com/2020/03/brilliant-butthole-sign-diagnostic-tp-hoarding/ Study: ‘Brilliant Butthole Sign’ Diagnostic of TP Hoarding (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/breaking-covid-19-found-in-toilet-paper/ Breaking: COVID-19 Found in Toilet Paper (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/dr-fauci-bob-ross-infinite-loop/ Dr. Fauci Implores We All Watch Bob Ross on Infinite Loop Immediately (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/primary-care-docs-z-pak/ Primary Care Docs Happily Handing Out Z-Pak Prescriptions to Coronavirus Patient (Gomerblog)]</ref>  There are currently no known treatments for '''COVID-19'''.  Interventions such as prayer, screaming "WHY GOD WHY?!" and remdesivir are currently ongoing.  A study involving Kaletra (lopinavir/ritonavir) produced disappointing results, as did the ones that looked at [[Sodium Bicarbonate|sodium bicarb]] and [[Precordial Thump|precordial thumps]].  There was controversy when French health minister, Olivier Véran, warned that [[NSAIDs]] should be avoided In patients with confirmed '''COVID-19'''.  This recommendation has not been adopted in the United States due to large opposition on behalf of military health care professionals who state that eliminating [[NSAIDs]] essentially eliminates all that a military health care professional can offer.<ref>[https://gomerblog.com/2020/03/military-doctors-petrified-if-motrin-found-to-worsen-coronavirus/ Military Doctors Petrified if Motrin Found to Worsen Coronavirus (Gomerblog)]</ref>
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Treatment is largely supportive in the form of excess toilet paper.<ref>[https://gomerblog.com/2020/03/brilliant-butthole-sign-diagnostic-tp-hoarding/ Study: ‘Brilliant Butthole Sign’ Diagnostic of TP Hoarding (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/breaking-covid-19-found-in-toilet-paper/ Breaking: COVID-19 Found in Toilet Paper I(Gomerblog)]</ref>  There are currently no known treatments for '''COVID-19'''.  Interventions such as prayer, screaming "WHY GOD WHY?!" and remdesivir are currently ongoing.  A study involving Kaletra (lopinavir/ritonavir) produced disappointing results, as did the ones that looked at [[Sodium Bicarbonate|sodium barb]] and [[Precordial Thump|precordial thumps]].  There was controversy when French health minister, Olivier Véran, warned that [[NSAIDs]] should be avoided In patients with confirmed '''COVID-19'''.  This recommendation has not been adopted in the United States due to large opposition on behalf of military health care professionals who state that eliminating [[NSAIDs]] essentially eliminates all that a military health care professional can offer.
  
  
 
'''Special Considerations'''
 
'''Special Considerations'''
 
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* ''Supply of N95 respirators & surgical masks'' - Supplies have been dwindling worldwide.  U.S. Surgeon General Jerome Adams tweeted "STOP BUYING MASKS!" to Americans, though this had little impact on the American supply chain.  Adams ultimately was caught hoarding masks, but their reintroduction into the health care system only bought another week of time.<ref>[https://gomerblog.com/2020/03/surgeon-general-jerome-adams-caught-hoarding-n95-masks/ COVID-19: U.S. Surgeon General Caught Hoarding All of Nation’s Masks (Gomerblog)]</ref>  Decreased availability of N95 respirators has forced health care professionals to use lower quality N94, N93, N92, N91, N90, N89, N88, N87, N86, N85, N84, N83, N82, N81, N80, N79, N78, N77, N76, N75, N74, N73, N72, N71, N70, N69, N68, N67, N66, N65, N64, N63, N62, N61, N60, N59, N58, N57, N56, N55, N54, N53, N52, N51, N50, N49, N48, N47, N46, N45, N44, N43, N42, N41, N40, N39, N38, N37, N36, N35, N34, N33, N32, N31, N30, N29, N28, N27, N26, N25, N24, N23, N22, N21, N20, N19, N18, N17, N16, N15, N14, N13, N12, N11, N10, N9, N8, N7, N6, N5, N4, N3, N2, and N1 masks, and even these are running low.  The supply of surgical masks has also been depleted even though '''COVID-19''' hasn't peaked.  The [[Centers for Disease Control and Prevention]] has suggested the use of homemade PPE such as bandanas and scarves as a last resort.  Gomerblog has suggested other creative items should the supply of bandanas and scarves become depleted.  Some of these include: sweaty sports cup, jock strap, pantyhose, turtleneck (pulled upwards), winter cap (pulled downwards), Saran Wrap, large condom, tampons (placed in nostrils), ski or SCUBA masks, snorkels, and horse feed bags.<ref>[https://gomerblog.com/2020/03/covid-19-tips-facemasks/ COVID-19 Tips: What to Do When No Facemasks Are Available (Gomerblog)]</ref>. Despite what would appear to be a dire situation, Americas nurses remain upbeat as they can't think if anything else better to do after a 12-hour shift than to make their own personal protective equipment (PPE).<ref>[https://gomerblog.com/2020/03/nurses-excited-to-make-their-own-ppe/ Nurses Excited to Make Their Own PPE (Gomerblog)]</ref>  Morale subsequently rebounded when a study revealed that bandanas were in fact superior to N95 respirators and surgical masks for PPE.<ref>[https://gomerblog.com/2020/03/covid-19-study-bandanas-superior-to-n95s-surgical-masks-for-ppe/ COVID-19 Study: Bandanas Superior to N95s, Surgical Masks for PPE (Gomerblog)]</ref>
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* ''Supply of N95 respirators & surgical masks'' - Supplies have been dwindling worldwide.  U.S. Surgeon General Jerome Adams tweeted "STOP BUYING MASKS!" to Americans, though this had little impact on the American supply chain.  Adams ultimately was caught hoarding masks, but their reintroduction into the health care system only bought another week of time.<ref>[https://gomerblog.com/2020/03/surgeon-general-jerome-adams-caught-hoarding-n95-masks/ COVID-19: U.S. Surgeon General Caught Hoarding All of Nation’s Masks (Gomerblog)]</ref>  Decreased availability of N95 respirators has forced health care professionals to use lower quality N94, N93, N92, N91, N90, N89, N88, N87, N86, N85, N84, N83, N82, N81, N80, N79, N78, N77, N76, N75, N74, N73, N72, N71, N70, N69, N68, N67, N66, N65, N64, N63, N62, N61, N60, N59, N58, N57, N56, N55, N54, N53, N52, N51, N50, N49, N48, N47, N46, N45, N44, N43, N42, N41, N40, N39, N38, N37, N36, N35, N34, N33, N32, N31, N30, N29, N28, N27, N26, N25, N24, N23, N22, N21, N20, N19, N18, N17, N16, N15, N14, N13, N12, N11, N10, N9, N8, N7, N6, N5, N4, N3, N2, and N1 masks, and even these are running low.  The supply of surgical masks has also been depleted even though '''COVID-19''' hasn't peaked.  The [[Centers for Disease Control and Prevention]] has suggested the use of homemade PPE such as bandanas and scarves as a last resort.  Gomerblog has suggested other creative items should the supply of bandanas and scarves become depleted.  Some of these include: sweaty sports cup, jock strap, pantyhose, turtleneck (pulled upwards), winter cap (pulled downwards), Saran Wrap, large condom, tampons (placed in nostrils), ski or SCUBA masks, snorkels, and horse feed bags.<ref>[https://gomerblog.com/2020/03/covid-19-tips-facemasks/ COVID-19 Tips: What to Do When No Facemasks Are Available (Gomerblog)]</ref>
 
 
* ''Supply of health care professionals'' - Contact tracing of the first U.S. cases of '''COVID-19''' led to the 2-week self-quarantine of anywhere from 40 to 200 health care workers.  In the event of a patient surge, such quarantine protocols would eventually deplete the work force.  Subspecialists are the most sensible back-ups given their prior training in medicine or surgery.  OB/GYNs have already volunteered their services on the front line, but radiologists are already being drafted, putting them in the unique position of performing their own [[Clinical Correlation|clinical correlations]].<ref>[https://gomerblog.com/2020/03/radiologist-drafted-into-direct-patient-care-forced-to-perform-own-clinical-correlation/ Radiologist Drafted Into Direct Patient Care, Forced to Perform Own Clinical Correlation (Gomerblog)]</ref>  Orthopedic surgeons are relearning ICU things.<ref>[https://gomerblog.com/2020/03/orthopaedic-surgeons-attempting-to-re-learn-icu-things-🤦%E2%80%8D♂%EF%B8%8F/ Orthopaedic Surgeons Attempting to “Re-learn” ICU Things (Gomerblog)]</ref>  In the extreme scenario shortages still persist, first-year medical students, undergraduate students contemplating a career in health care, and toddlers with Fisher-Price [[Stethoscope|stethoscopes]] will serve as backup.
 
 
 
* ''Supply of ventilators'' - It is very possible that the American trajectory of '''COVID-19''' will mimic Northern Italy, leading to a shortage of ventilators.  To bridge the gap, the American Medical Student Association will provide medical students to bag those patients until ventilators become available.<ref>[https://gomerblog.com/2020/03/covid-19-vent-shortage-med-students-bag/ COVID-19 Solution: In Event of Vent Shortage, Med Students Will Bag Indefinitely (Gomerblog)]</ref>  Additionally, the CDC has pledged to make over 10,000 flawed ventilators.
 
  
* ''COVID-19's effect on global markets'' - '''COVID-19''' has arrested economic activity, causing markets to crash worldwideThe United States has been trying to combat recession through multiple routesThe Federal Reserve Bank of New York has slashed interest rates to near zero and plans to buy back $500 billion in Treasury and security-backed bondsIt is also considering pushing 1 amp of bicarb.  Congress has rapidly approved stimulus packages aimed at providing Americans with more toilet paper and [[Xanax (Alprazolam)|Xanax (alprazolam)]].<ref>[https://gomerblog.com/2020/03/covid-19-house-relief-package-toilet-paper/ COVID-19: House Relief Package to Provide Billions & Billions of Dollars of Toilet Paper (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/covid-19-congress-to-send-1000-pills-of-xanax-to-every-american/ COVID-19: Congress to Send 1,000 Pills of Xanax to Every American (Gomerblog)]</ref>  It speaks volumes that all of the blame thus far has been directed at '''COVID-19''', not [[Blame Anesthesia Algorithm|Anesthesia]], suggesting that the apocalypse has in fact arrived.
+
* ''Supply of health care professionals'' - Contact tracing of the first U.S. cases of '''COVID-19''' led to the 2-week self-quarantine of anywhere from 40 to 200 health care workersIn the event of a patient surge, such quarantine protocols would eventually deplete the work forceSubspecialists are the most sensible back-ups given their prior training in medicine or surgeryOB/GYNs have already volunteered their services on the front line, but radiologists are already being drafted, putting them in the unique position of performing their own [[Clinical Correlation|clinical correlations]].<ref>[https://gomerblog.com/2020/03/radiologist-drafted-into-direct-patient-care-forced-to-perform-own-clinical-correlation/ Radiologist Drafted Into Direct Patient Care, Forced to Perform Own Clinical Correlation (Gomerblog)]</ref> Orthopedic surgeons are relearning ICU things.<ref>[https://gomerblog.com/2020/03/orthopaedic-surgeons-attempting-to-re-learn-icu-things-🤦%E2%80%8D♂%EF%B8%8F/ Orthopaedic Surgeons Attempting to “Re-learn” ICU Things (Gomerblog)]</ref>  In the extreme scenario shortages still persist, first-year medical students and undergraduate students contemplating a career in health care will serve as backup.
  
* ''Match Day: March 20, 2020'' - Amidst social distancing, fourth-year medical students weren't able to congregate at their respective medical schools on this momentous day, instead moving their ceremonies and celebrations online.  This did not dampen their spirits as they all were excited to learn that they had matched at their respective No. 1 '''COVID-19''' hotspot.<ref>[https://gomerblog.com/2020/03/match-day-covid-19-july-1st/ Match Day! Med Students Find Out Where They’ll Be Ruling-Out COVID-19 on July 1st (Gomerblog)]</ref> Some students hope to inoculate themselves with novel coronavirus immediately after [[Match Day]] in the hopes it doesn't interrupt workflow starting on [[July Intern|July 1]].  Other students wish to hold out and get infected at their new residency program.  
+
* ''Supply of ventilators'' - It is very possible that the American trajectory of '''COVID-19''' will mimic Northern Italy's, leading to a shortage of hospital beds & ventilatorsTo bridge the gap, the American Medical Student Association will provide medical students who will bag patients until ventilators become available.
  
* ''Anxiety among healthcare professionals'' - Anxiety runs high among healthcare professionals, not only because of the increased challenges at work due to '''COVID-19''' but the increased challenges outside of the work placeOne example is health care professionals running out of not only masks but toilet paper, as they were too busy dealing with patients to go to grocery stores. Gomerblog and its fans have created a '''COVID-19''' Doomsday playlist in the hopes of keep everyone from going completely insane as laughs and smiles are few and far between.<ref>[https://gomerblog.com/2020/03/music-therapy-gomerblogs-covid-19-doomsday-playlist/ Music Therapy: Gomerblog’s COVID-19 Doomsday Playlist (Gomerblog)]</ref>
+
* ''COVID-19's Effect on the Global Economy'' - '''COVID-19''' has arrested economic activity, causing markets to crash worldwideThe United States has been trying to combat recession with stimulus packages aimed at providing Americans with more toilet paper and [[Xanax (Alprazolam)|Xanax (alprazolam)]].<ref>[https://gomerblog.com/2020/03/covid-19-house-relief-package-toilet-paper/ COVID-19: House Relief Package to Provide Billions & Billions of Dollars of Toilet Paper (Gomerblog)]</ref><ref>[https://gomerblog.com/2020/03/covid-19-congress-to-send-1000-pills-of-xanax-to-every-american/ COVID-19: Congress to Send 1,000 Pills of Xanax to Every American (Gomerblog)]</ref> It speaks volume that all of the blame thus far has been directed at '''COVID-19''', not [[Blame Anesthesia Algorithm|Anesthesia]], suggesting that the apocalypse has in fact arrived.
  
* ''People's Sexiest Man Alive: Dr. Anthony Fauci'' - Dr. Fauci's expertise, calm demeanor, and facts-only approach to the '''COVID-19''' pandemic has been much needed in the absence of otherwise ineffective government leadership.  His recommendation to watch Bob Ross painting videos singlehandedly decreased the average American resting heart rate from 125 to 115.  Because of his leadership since coronavirus reached the United States, the American public finally granted him a much-deserved 15-minute nap.<ref>[https://gomerblog.com/2020/03/nation-gives-fauci-permission-nap/ Nation Gives Fauci Permission to Take 15-Minute Power Nap (Gomerblog)]</ref>  Americans woke him up exactly after 15 minutes, frantically asking him what the hell we need to do next.
+
* ''Match Day 2020'' - Fourth-year medical students weren't able to congregate, instead moving their celebrations online.  This did not dampen their spirits as they all were excited to learn that they had matched at their respective No. 1 '''COVID-19''' hotspot.<ref>[https://gomerblog.com/2020/03/match-day-covid-19-july-1st/ Match Day! Med Students Find Out Where They’ll Be Ruling-Out COVID-19 on July 1st (Gomerblog)]</ref>  Some students hope to inoculate themselves with novel coronavirus immediately after [[Match Day]] in the hopes it doesn't interrupt workflow starting on [[July Intern|July 1]].  Other students are eager to get infected at their new residency program.  
  
  
Line 88: Line 76:
 
----
 
----
 
Oh, most definitely.
 
Oh, most definitely.
 
 
'''Current CDC Guidelines & Advice'''
 
----
 
* Wash your hands for at least 20 minutes
 
* Repeat
 
* Stay inside but if you need to venture out for food or medications, keep at least 1 mile between yourself and others
 
* Cover your cough or sneeze (unless the people around you are confirmed COVID-positive, in which case don't worry about it)
 
* Move to other oxygen-positive, COVID-negative planet
 
* Do not defecate for at least the next 60 days<ref>[https://gomerblog.com/2020/03/preserve-toilet-paper-cdc-against-defecation/ Strongly Recommends Against Defecation (Gomerblog)]</ref>
 
* Never, ever listen to CDC guidelines<ref>[https://gomerblog.com/2020/03/cdc-recommends-not-listening-to-cdc-recommendations/ COVID-19: CDC Recommends Not Listening to CDC Recommendations (Gomerblog)]</ref>
 
  
  
Line 104: Line 81:
 
----
 
----
 
* [https://gomerblog.com/2020/03/an-orthopaedic-surgeon-explains-coronavirus/ Gomerblog's "An Orthopedic Surgeon Explains Coronavirus"]
 
* [https://gomerblog.com/2020/03/an-orthopaedic-surgeon-explains-coronavirus/ Gomerblog's "An Orthopedic Surgeon Explains Coronavirus"]
* [https://open.spotify.com/playlist/42g1kZJH7qiMjkIyp6d6jO?si=pXSvmGWcQ9WAfeG0H760gA Gomerblog's COVID-19 Doomsday Playlist]
 
 
 
'''Related Topics'''
 
----
 
* [[Airborne Precautions]]
 
* [[Contact Precautions]]
 
* [[Cough]]
 
* [[Dyspnea]]
 
* [[Endotracheal Tube]]
 
* [[Hand Sanitizer]]
 
* [[Handwashing]]
 
* [[Pneumonia]]
 
  
  

Revision as of 12:36, 20 March 2020

Close-up of a**hole COVID-19

COVID-19, also known as the novel coronavirus, was discovered in Wuhan, China on December 2019 and has been a goddamn pain-in-the-ass ever since.


Epidemiology


According to the World Health Organization, Centers for Disease Control and Prevention, and our friend Tim, there are currently more than 35 billion confirmed cases of COVID-19. This speaks to the huge burden of disease on human beings considering the Earth's population is less than 8 billion.

The first reports were first reported in first reports by the Chinese Centers for Disease Control and Prevention on December 2019 in the city of Wuhan, China. The first documented U.S. case occurred in a 35-year-old patient from Washington State, who returned from Wuhan on January 20, 2020. For Americans, this is when sh*t started to get real.

In a matter of months, COVID-19 had spread to all continents except Antarctica, suggesting that Antarctica has partial immunity. The World Health Organization declared that COVID-19 was officially a pandemic, thus becoming the last major medical society to realize this. With the exception of China, Taiwan, and South Korea, measures aimed at containment have failed. Bribery has failed. Most nations have opted for strategies involving mitigation or masturbation, whichever one means "to reduce the severity or spread."

In the United States, the NBA was suspended when its first player, Rudy Gobert, tested positive for coronavirus. As students or teachers tested positive for COVID-19, schools closed, including New York City's public school system, which is the largest in the country. As patients and health care professionals tested positive for COVID-19, hospitals followed suit and closed as well.[1] Social distancing was rapidly implemented (Spring Breakers in Florida were exempt), which disrupted orthopedic surgeons the most as they had to suspend bro hugs for 60 days and shelter-in-place at the hospital gym indefinitely.[2][3] Cases of PTSD spiked in the Anesthesia population on account of Sudoku supply deficits.[4] Batman was infected, thus becoming the first case of human-to-Batman transmission.[5] The situation got so dire that the CDC declared "we are effed" while aliens postponed their invasion of Earth due to concerns over COVID-19.[6][7]

Reports suggest that coronavirus is capable of moving back in time.[8]


Virology


Something about betacoronavirus and angiotensin-converting enzyme 2 (ACE2)?


Symptoms


Symptoms can range from no to yes. The most common include fever, nonproductive cough, shortness of breath, myalgias, and anorexia. Less common symptoms include sore throat, rectal prolapse, and urethral discharge. In very rare instances, it can present as a scrotal abscess.


Signs


The most concerning exam finding is the identification of a surgical mask over the patient's mouth. That can't be good.

Unlike other situations, vital signs can be quite useful. Don't be fooled: though the documented respiratory rate reads as 16, it is most likely 17. Objective fever supports subjective fevers and hypoxemia supports a patient's complaint of "I'm feeling hypoxemic." Cardiopulmonary exam findings may include tachycardia, wheezing, or crackles, but that does require making contact with the patient. Chest X-ray is an important diagnostic tool. If Radiology recommends clinical correlation after remarking on pulmonary infiltrates, please defriend them.


Differential Diagnosis


  1. Upper GI bleed
  2. Lower GI bleed
  3. Diabetic foot ulcer
  4. Aortic stenosis
  5. Aortic sclerosis


Diagnosis


Diagnosis is best achieved through diagnostic kits, whose status is currently listed as "theoretical" in the United States despite being 3 months into the pandemic. With the eventual coordination of U.S. private and public sectors, over 1 million flawed kits are expected to be available by the end of March 2020. The optimal specimen is an upper respiratory tract sample obtained via nasopharyngeal swab. The U.S. has had difficulty obtaining appropriate specimens, though this is largely attributable to frontline OB/GYNs collecting samples from the vagina and not the nasopharynx.[9]


This may not be labelled, but a picture's worth a 1000 words

Prevention


There are no known vaccines at the moment for the public to refuse.


Treatments


Treatment is largely supportive in the form of excess toilet paper.[10][11] There are currently no known treatments for COVID-19. Interventions such as prayer, screaming "WHY GOD WHY?!" and remdesivir are currently ongoing. A study involving Kaletra (lopinavir/ritonavir) produced disappointing results, as did the ones that looked at sodium barb and precordial thumps. There was controversy when French health minister, Olivier Véran, warned that NSAIDs should be avoided In patients with confirmed COVID-19. This recommendation has not been adopted in the United States due to large opposition on behalf of military health care professionals who state that eliminating NSAIDs essentially eliminates all that a military health care professional can offer.


Special Considerations


  • Supply of N95 respirators & surgical masks - Supplies have been dwindling worldwide. U.S. Surgeon General Jerome Adams tweeted "STOP BUYING MASKS!" to Americans, though this had little impact on the American supply chain. Adams ultimately was caught hoarding masks, but their reintroduction into the health care system only bought another week of time.[12] Decreased availability of N95 respirators has forced health care professionals to use lower quality N94, N93, N92, N91, N90, N89, N88, N87, N86, N85, N84, N83, N82, N81, N80, N79, N78, N77, N76, N75, N74, N73, N72, N71, N70, N69, N68, N67, N66, N65, N64, N63, N62, N61, N60, N59, N58, N57, N56, N55, N54, N53, N52, N51, N50, N49, N48, N47, N46, N45, N44, N43, N42, N41, N40, N39, N38, N37, N36, N35, N34, N33, N32, N31, N30, N29, N28, N27, N26, N25, N24, N23, N22, N21, N20, N19, N18, N17, N16, N15, N14, N13, N12, N11, N10, N9, N8, N7, N6, N5, N4, N3, N2, and N1 masks, and even these are running low. The supply of surgical masks has also been depleted even though COVID-19 hasn't peaked. The Centers for Disease Control and Prevention has suggested the use of homemade PPE such as bandanas and scarves as a last resort. Gomerblog has suggested other creative items should the supply of bandanas and scarves become depleted. Some of these include: sweaty sports cup, jock strap, pantyhose, turtleneck (pulled upwards), winter cap (pulled downwards), Saran Wrap, large condom, tampons (placed in nostrils), ski or SCUBA masks, snorkels, and horse feed bags.[13]
  • Supply of health care professionals - Contact tracing of the first U.S. cases of COVID-19 led to the 2-week self-quarantine of anywhere from 40 to 200 health care workers. In the event of a patient surge, such quarantine protocols would eventually deplete the work force. Subspecialists are the most sensible back-ups given their prior training in medicine or surgery. OB/GYNs have already volunteered their services on the front line, but radiologists are already being drafted, putting them in the unique position of performing their own clinical correlations.[14] Orthopedic surgeons are relearning ICU things.[15] In the extreme scenario shortages still persist, first-year medical students and undergraduate students contemplating a career in health care will serve as backup.
  • Supply of ventilators - It is very possible that the American trajectory of COVID-19 will mimic Northern Italy's, leading to a shortage of hospital beds & ventilators. To bridge the gap, the American Medical Student Association will provide medical students who will bag patients until ventilators become available.
  • COVID-19's Effect on the Global Economy - COVID-19 has arrested economic activity, causing markets to crash worldwide. The United States has been trying to combat recession with stimulus packages aimed at providing Americans with more toilet paper and Xanax (alprazolam).[16][17] It speaks volume that all of the blame thus far has been directed at COVID-19, not Anesthesia, suggesting that the apocalypse has in fact arrived.
  • Match Day 2020 - Fourth-year medical students weren't able to congregate, instead moving their celebrations online. This did not dampen their spirits as they all were excited to learn that they had matched at their respective No. 1 COVID-19 hotspot.[18] Some students hope to inoculate themselves with novel coronavirus immediately after Match Day in the hopes it doesn't interrupt workflow starting on July 1. Other students are eager to get infected at their new residency program.


Are We Totally Screwed?


Oh, most definitely.


Resources



References


  1. Jump up U.S. Hospitals to Close After Patients Test Positive for COVID-19 (Gomerblog)
  2. Jump up COVID-19 Update: Orthopods Suspend Bro Hugs for 60 Days (Gomerblog)
  3. Jump up Orthopaedic Surgeons Directed to Shelter in Hospital Gym Until COVID-19 Clears (Gomerblog)
  4. Jump up COVID-19: Self-Quarantined Anesthesiologist Running Dangerous Low on Sudoku Supplies (Gomerblog)
  5. Jump up Breaking: Batman Diagnosed with COVID-19 (Gomerblog)
  6. Jump up COVID-19: CDC Says “We’re Totally Effed” in a Zombie Apocalypse (Gomerblog)
  7. Jump up Aliens Postpone Earth Invasion Due to Coronavirus Concerns (Gomerblog)
  8. Jump up WHO Warns Outbreaks In Victorian England Confirm Coronavirus Capable Of Spreading Through Time (The Onion)
  9. Jump up Habit, I Guess: OB/GYNs Accidentally Swabbing Vaginas for COVID-19 (Gomerblog)
  10. Jump up Study: ‘Brilliant Butthole Sign’ Diagnostic of TP Hoarding (Gomerblog)
  11. Jump up Breaking: COVID-19 Found in Toilet Paper I(Gomerblog)
  12. Jump up COVID-19: U.S. Surgeon General Caught Hoarding All of Nation’s Masks (Gomerblog)
  13. Jump up COVID-19 Tips: What to Do When No Facemasks Are Available (Gomerblog)
  14. Jump up Radiologist Drafted Into Direct Patient Care, Forced to Perform Own Clinical Correlation (Gomerblog)
  15. Jump up Orthopaedic Surgeons Attempting to “Re-learn” ICU Things (Gomerblog)
  16. Jump up COVID-19: House Relief Package to Provide Billions & Billions of Dollars of Toilet Paper (Gomerblog)
  17. Jump up COVID-19: Congress to Send 1,000 Pills of Xanax to Every American (Gomerblog)
  18. Jump up Match Day! Med Students Find Out Where They’ll Be Ruling-Out COVID-19 on July 1st (Gomerblog)


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