COVID-19
COVID-19, also known as the novel coronavirus, was discovered in Wuhan, China in 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 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 document U.S. case occurred in a 35-year-old patient in 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 somehow has some 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 largely failed. Bribery has failed. Most nations now are looking at 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]
Reports suggest that coronavirus is capable of moving back in time.[2].
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
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." Chest X-ray is an important diagnostic tool. If Radiology recommends clinical correlation, please defriend them.
Differential Diagnosis
- Upper GI bleed
- Lower GI bleed
- Diabetic foot ulcer
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.[3]
Treatments
Treatment is largely supportive as there are no known treatments for COVID-19. Interventions such as prayer, screaming "WHY GOD WHY?!" and remdesivir are currently going. A study involving Kaletra (lopinavir/ritonavir) produced disappointment 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 recommended has not been implemented in the United States due to large opposition of military health care professionals who state that eliminating NSAIDs essentially eliminates all that a military health care professional can offer.
Special Considerations
- Personal protective equipment (PPE) - Supplies have been dwindling worldwide. 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, N7, N5, N4, N3, N2, and N1 masks, and even these are running low. In the United States, health care professionals are depleting surgical masks 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 result. 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.[4]
- 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).[5][6] It speaks volume that all of the blame has been directed at COVID-19, not Anesthesia.
- 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.[7] 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.
Resources
References
- ↑ U.S. Hospitals to Close After Patients Test Positive for COVID-19 (Gomerblog)
- ↑ WHO Warns Outbreaks In Victorian England Confirm Coronavirus Capable Of Spreading Through Time (The Onion)
- ↑ Habit, I Guess: OB/GYNs Accidentally Swabbing Vaginas for COVID-19 (Gomerblog)
- ↑ COVID-19 Tips: What to Do When No Facemasks Are Available (Gomerblog)
- ↑ COVID-19: House Relief Package to Provide Billions & Billions of Dollars of Toilet Paper (Gomerblog)
- ↑ COVID-19: Congress to Send 1,000 Pills of Xanax to Every American (Gomerblog)
- ↑ Match Day! Med Students Find Out Where They’ll Be Ruling-Out COVID-19 on July 1st (Gomerblog)
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