One factor to consider: Some folks will be absolutely terrified to learn they have this disease, which may have real effects. An example: https://en.m.wikipedia.org/wiki/Voodoo_death
“These data suggest that vagus contributes to severe emotional states and may be related to emotional states of immobilization, such as extreme terror. Unfortunately, this immobilization technique is potentially life-threatening for mammals (but not for reptiles). Mammals would undergo states of bradycardia or hypoxia as an over-activation of parasympathetic vagus system. The organs of the oxygen-hungry mammal are deprived of oxygen due to lack of blood flow, and the animal dies.”
It's just one example of a heart-related effect, that's all. Considering that we're all here reading another hypothesis that this is the first-ever respiratory pathogen to infect the heart, it doesn't seem that much of a stretch.
We totally should research whether fear can lead to physical heart damage, but I would bet that "stress in general" is the source of this damage, not only emotional stress. See:
I do recall reading few articles that support it as an actual condition and makes logical sense that for some that will be a factor - lost loved one in same family, increases the odds of catching the virus and also a broken heart. Truly a tradgerday on many levels. Also mindful that the impact of this pandemic will see many indirect deaths in the years to come and the scale of things won't be measured in people who died and tested positive, but how the rest live.
well actually it's only some sorts of gout, caused by Polycythemia Vera https://rarediseases.org/rare-diseases/polycythemia-vera/ "Gout and kidney stone associated with polycythemia vera occur due to the high turnover of red blood cells, which results in higher-than-normal uric acid production." So it overproduces red blood cells, and the parent comment said there was a theory covid-19 was causing a decrease in red blood cell production so I conjured the amusing scenario in my head of the two diseases fighting each other.
I ask because I was recently doing background checks on a substance to mitigate nitric oxide induced lung damage (produced by damaged cells) which would work by by converting it to urea ... so maybe more than just amusing.
That paper uses computer models of protein interactions not actual ethyrocyte on vero 6 cultured COVID experiment. It's an interesting line of investigation but I want to see more in vitro and ideally in vivo findings supporting that before I believe it.
Yeah, it's simulating protein-protein interaction. Very much bleeding edge of research, stuff like this needs biological validation before you should trust it.
is this 1 in 5 in people who are otherwise asymptomatic as well? I guess not, or we would be seeing a lot more dead but I wonder if there are any heart attacks occurring in otherwise asymptomatic people and not being marked down as Covid-19 related.
we are seeing a lot more dead in heavily affected regions. and there is no statistics about why they died... Personally I think this is quite worrying with a lot of people now thinking we put masks on and then can go back to work. If this is indeed having serious side effects, we need to eradicate this. Meaning total lockdown except absolute necessities (e.g. ask: will people die of physical reasons if this service is out for a week) worldwide, implemented yesterday.
Probably not for even another month. Because it will stop working, for practical reasons. People will have to go back to work, or be evicted. Go out for necessities, shopping around to find any, increasing their exposure instead of decreasing it. Go job interviewing. All sorts of fallout, which actually increases travel and potential infection, instead of reducing it.
Its easy for us middle-class folks to say "Just stay at home and eat cake!" This whole lockdown thing is divided on class lines. Just look in the window at the McD's drive-thru. Those folks don't have the luxury of staying home.
The people calling the shots are all firmly on one side of this class divide. Will there be the political willpower to break quarantine when virtually all of our politicians from city councils all the way up to national leaders are financially secure and, more often than not, old enough to be particularly at risk?
Infrastructure will begin to break down if we don't do regular maintenance. That means spare parts, which means manufacturing, which means raw materials. Food has a similar supply chain issue.
Break the infrastructure enough that public sanitation stops working properly, and the Covid-19 deaths will be a rounding error in the excess death rate.
Except we are still doing all those things. Maintenance[1] is happening. Factories are working. Food is being grown. Truckers are still hauling.
Read the shut down orders issued by your state. Read the list of essential jobs listed in those orders. All of those things that you listed are essential jobs, that are still being done. If your factory makes masks, you're essential. If your factory makes screws that are used in a factory that makes masks, you're also essential. If your mine digs up iron ore that goes to a smelter, that goes to a factory that makes screws that are used in a factory that makes masks - you're also essential.
Yes, this means that a lot of people are essential. But even halving the number of person-to-person interactions the average person has leads to a big reduction in transmissions.
[1] I live in Seattle, three weeks into a shutdown, and just two days ago, power crews were doing preventative maintenance on the power line leading into my building.
Well, all the individual maintenance is being cancelled. Home maintenance; dentist appointments; tax accountant meetings; checkups; physical therapy. Heck even housecleaning, haircuts and sports.
There will be a cost to all this - small business starts that fail across the board, loans and mortgages in default, cars repossessed, restaurants closing everywhere. Hard to get a job for most people with so many businesses closed, hard to get to a job with no car.
We're all getting behind, it will be hard to catch up again, costs will go up after this is over, everyone will have more debt. It may take months or years for the hiccups to go away.
Home Depot is still open. Plumbers, electricians, AC guys, etc., are essential businesses. Your tax accountant can work with you over the phone.
Cancelled checkups and dentist appointments are an unfortunate consequence of living with this virus. Lifting the lockdown on them may well result in more net damage to people's health at this point - but maybe not. This is one of the first things we need to think about re-opening.
Haircuts are by no means essential, and I don't understand why you threw them into the list.
The problems that arise from this aren't exactly the apocalypse porn of "There will be no food, no running water, and people will be dying in the streets, as civilization falls apart around them."
> There will be a cost to all this - small business starts that fail across the board, loans and mortgages in default, cars repossessed, restaurants closing everywhere.
This kind of economic cost is going to be paid anyways, regardless of whether we take the road of "Tens of thousands of deaths, more lockdown" or "Millions of deaths, no lockdown". People just aren't going to consume as normal in the middle of a raging pandemic. Small businesses will be falling apart, as their owner-operators get sick, and/or die. Jobs will be lost, because not enough people are crazy enough to be booking a vacation in the middle of this.
No doubt its necessary. But it comes with a cost, which I think we agree on. And it will be a surprisingly high cost, for all sorts of unexpected reasons. Possibly resulting in a recession.
Right. What I'm really hoping is that those of us who were going into an office to do a job that everyone involved fully well knew could be done from home (e.g., software dev) won't be forced back into close-quarters again just because a "safe-at-home" order has been lifted (besides, I have asthma and my wife has hypertension).
Until we beat this thing (which probably means a vaccine being widely-available, so... another year at least), any job that can be done remotely, should absolutely be done remotely. And I, for one, won't be setting foot in a cafe or restaurant or going to a conference until this is all over.
And my kids won't be going back to school either. Guess we're homeschooling now.
exactly my thoughts. yet in my country some especially non-essential people are still being forced into their offices. their only job is to increase future dividends. which, at this point, is a longshot to be civil...
> We are trying to hold the fort until reinforcements (better treatments, vaccines, etc)
We may also be developing herd immunity, if the previously-infected are less likely to be reinfected. If that’s the case, those presenting antibodies could go back to a normal existence faster.
>I wonder if there are any heart attacks occurring in otherwise asymptomatic people and not being marked down as Covid-19 related.
Possible but also important to keep in mind that heart damage does not necessarily translate into an immediate heart attack. It can lead to reduced heart function and a host of other heart-related problems that may not manifest in the form of a fatality for years (if ever). The same goes for the reported lung damage that many Covid-19 victims apparently suffer.
The early claim of "1 in 5 people" is a lie. Further along they clarify that it is 1 in 5 people who are hospitalized. And they say about half die. Put this together with the real world mortality statistics, and it makes me want to see some rigorous peer review before I get worried.
right, I can't help but think, given the state medical systems worldwide are in right now a rise in heart attacks might go unnoticed. Like if it were .1% of asymptomatics get a heart attack it could be some time before it popped up on someone's radar. But probably that is my natural paranoia.
ACE2 is also found in several other organs in which they are
seeing multiple organ failure with this virus so it likely is can bind to them and contribute to damage in these organs including the heart but as OP says there are multiple ways the heart could be affected
Loss of ACE2 receptors in the heart can cause impaired heart function
Also there is a close connection between the heart, kidney, kidneys and other organs.
For instance, ACE1 and ACE2 receptors are involved in a complex hormonal system that manages your blood volume, blood pressure, etc. Antihypertensive drugs target this system at different points. (ACE inhibitor drugs such as Lisinopril target the ACE1 receptor and don't bind much to ACE2 at all)
Liver failure can present with symptoms similar to asthma because if your kidneys can't get rid of water, the water will leak out of your lungs.
I had a friend who passed away last year from a bacterial infection that got to his heart. We all have bacteria that live on our skin without problems, but if you get a wound they can get into your blood and go to your heart.
He had heart valve damage which is bad because if your heart valves work improperly, it can damage your blood the way you can 'damage' cream by whipping it. This can cause clots to go into your lungs or your brain with bad results either way.
He had open heart surgery but they had a hard time restarting his heart and he was in a coma for a few months before they removed his feeding tube.
One reason why penicillin was a miracle was that all sorts of people who got even minor wounds (e.g. soldiers, children, farmers, ...) would progress like that before WWII.
My understanding is that myocarditis is a possible, albeit rare, complication of many viral illnesses?
Additionally, respiratory failure causes a massive strain on the heart, so it’s not hugely surprising that many patients would have heart complications.
It would be interesting to know how many patients without respiratory distress develop these cardiac symptoms.
This doctor in Wales says that myocarditis is a leading cause of death for his covid patients in ITU, and that this often happens after they've started to recover from the respiratory stuff. https://youtu.be/ejlbCmRJMW4?t=472
This headline is definitely a lot scarier than the actual body of the study.
The most likely cause of the heart damage by far is the systemic inflammation induced by pneumonia. We know this because pneumonia patients of all types often have heart strain afterwards[1]. But that damage is very rarely permanent as the risk subsides back to baseline given enough time.
Until we see evidence of heart issues in patients without pneumonia complications, we shouldn't be any more scared of covid-19 as we were before. In particular young and healthy people still have very little risk from infection. Patients who recover without serious complications should not be afraid of hidden heart damage.
I don't think it's premature, no. We have a lot of data indicating that it's a respiratory disease. It should be studied, almost any coronavirus anomaly is worth studying, but we know what conclusion to expect.
Based on all the YouTube videos by doctors I've watched, heart failure is a known, expected and quite common consequence of severe respiratory disease.
I would find a better authority than 'youtube doctors' for the health of anyone you love. Some are great, but all are in it for attention. The ultimate motives of many online attenion seekers, no matter their profession are, lets say, unclear.
agree on the overall point, but the ultimate motve seems plainly clear to me: stature and esteem. it's an underlying motive too widely shared among the animal kingdom to assume otherwise.
whether any given youtuber deserves that stature and esteem is certainly unclear, as that takes direct observation of the person over time to ascertain.
I would not describe teachers or those who post on HN as "in it for attention".
Though I have not posted on youtube, I see no reason to describe those who
have as attention seekers.
I don't think anyone's denied that respiratory diseases can be linked to heart problems. The question is whether they're linked through the normal mechanism of systemic failure, or if the coronavirus specifically targets heart tissue as the doctor in the article suggests.
Perhaps you are correct that this is not a cause for alarm, but the way the headline and the first few paragraphs are written, it seems the author is trying to induce anxiety in people reading it, presenting heart damage as inevitable and factual.
> Until we see evidence of heart issues in patients without pneumonia complications
That's exactly what they're seeing, and why this article was written:
"An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress."
Unfortunately the article doesn't say what percent of people with cardiac damage did not have respiratory issues as well.
Patients who had heart disease before their coronavirus infections were much more likely to show heart damage afterward. But some patients with no previous heart disease also showed signs of cardiac damage. In fact, patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage.
Isn't it likely that the patients who had no preexisting heart conditions actually had undiagnosed preexisting heart conditions?
Yeah, this logic is used often in epidemiology, and this thought comes to my head every single time.
We also don't probably know all the possible heart conditions out there!
Finally, while someone might not have a condition (disease), they also might not have good function of the heart, this is not considered a pre-existing condition. This tends to happen with people who are overweight, leading to arteriosclerosis, but since the norm has moved so far in one direction, our criteria for disease might have moved as well.
Finally, the lungs and heart work in coordination to bring oxygen to the rest of the body. If the lungs stop functioning (which may not have direct symptoms that we expect)... I think it's pretty easy to fill in the rest.
Worse than undiagnosed, they are unmanaged preexisting heart conditions.
If two people have similar heart damage but one knows about it and manages the hypertension that caused it, who is in worse shape if a disease adds stress to your system?
That's circular logic. If patient A dies of heart failure during a covid-19 infection, you should not be concluding that the patient likely had a heart issue prior to the covid-19 infection.
Sure, it might be the case, but you cannot draw any conclusion here unless you compare it to other pneumonia cases.
The heart damage would be more meaningful in patients who have had clean EKGs prior to being diagnosed with covid-19. Here in the US covid symptoms are most likely causing a good number of adults to see a doctor after decades of no medical checkups or for for the first time.
Due to the fact that there's not a good agreed upon standard as what counts as a "covid19 death", there's absolutely no way you can draw any sort of meaningful death rate.
I.e. in Connecticut, there was a "covid19 infant death". Except that infant died at home due to a horrible accident. Arrived at the hospital deceased. Postmortem, was tested and coronavirus positive, therefore was counted as "Covid19 Death" and "infant dies of coronavirus!!!" in the news.
Death rates and case numbers are terribly skewed, and the data we have is abysmal.
CDC just massively changed the definition of what a "positive" case means. PCR tests have a notorious accuracy problem, so previously the definition of a positive case was consecutive positive PCR/RT-PCR tests.
Now the definition has changed to "if any test has ever come back positive, then positive".
To be clear, this new definition means that if you test positive, then have two consecutive negative tests, you're still counted as a positive case.
Just this redefinition could account for a large part of the increases in "positive" cases we're seeing.
Couple this with allocation of funds and resources based on positive cases and death totals, and you have a situation where it's in everyone's best interest to inflate the numbers as much as possible.
We saw the same issues during HIV/AIDS "crisis".
Be very skeptical of any numbers, rates and data you're seeing. At this point, the CDC and state agencies are refusing to publish their source data (which is very strange).
Hospitalization rates for people aged 20-44 are in the range of 15% to 20%. You might want to read up on the experience of COVID-19 hospitalization before you decide that there's little risk from infection.
I'm not sure I buy it as we don't have any idea how many people actually have the disease. I have to assume the denominator is of those tested, X% required hospitalisation. If it is those confirmed to have the disease, and because clearly the whole population hasn't been tested the results are skewed as we only test people with severe symptoms.
Right those population level samples only started on a limited basis in a few areas last week. For now the actual denominator is a total unknown; the range of upper and lower bounds is so wide as to be effectively useless for planning.
That is percentage of confirmed cases that wind up with hospitalization.
However we mostly don't try to confirm cases if it won't affect the care we give. We just tell them to self-isolate. We therefore will not have good statistics on what percentage of cases are confirmed until after the immediate crisis is over and we test to see how many have antibodies.
So your figure is, "Of young people who have it severely enough to get tested, 15-20% get hospitalized." This says nothing about what fraction of cases are severe enough to get tested.
Also note that we undercount deaths. If a person dies and was never confirmed to have COVID-19, they are also not counted as a COVID-19 death. Nobody knows how big this undercount factor is.
All good points. But paulsutter's message remains: young people are at significant risk. Yes, the risk for older people and those with pre-existing conditions in higher. But the parent poster's characterization of the risk for young people as "very little" is dangerous.
This is also why I don't really like that some propose various "herd immunity" schemes - we simply don't know what the virus actually does to people in practice, even if it does not outright kill them. So it seems very irresponsible to propose schemes like that at this point in time.
More detail on above: published March 30th, the percentages are expected hospitalisations based on total population of infected (including mild/asymptomatic usually untested).
Data is from Table 3 near end of paper, table title: “Estimates of the proportion of all infections that would lead to hospitalisation, obtained from a subset of cases reported in mainland China“
let me preface this by mentioning that i havent been tested for covid-19.
two weeks ago i've been having real issues breathing. it felt like my upper body was borderline paralyzed and i had to really force myself to fully breathe in. this wasn't constant but happened every day for several hours each. especially at night.
i got worried that i might have the virus so i checked my temperature and oxygen blood saturation as well as my pulse.
temperature was fine (36.6°C-37.2°C), blood saturation was in the normal range, however it dropped from 97-100 when i wasnt having any issues to 94-97. my pulse rate however went from usually ~75-80 to >110 whenever i had breathing problems.
it went away last week.. or so i though. i had another episode of that this morning, it was only for 3 hours today, however. it seems to be going away, but if it actually was (or is) the virus... it seems plausible to me.
but i'm a person without any medical knowledge so ... listen to the people actually treating the patients, not random armchair specialists like they're frequent on hacker news -- especially in threads about covid-19.
I've had the exact same symptoms as you:
* Chest pain and breathing difficulties that gets worse at night.
* Actually ended up on hospital twice because of it.
* Pulse and blood pressure went high too.
You could be having panic attacks; based on the fact you've got numbers, it sounds to me like you're actively monitoring your own blood saturation, which already implies you may be worrying too much about things like that. Don't underestimate the effects of worry and stress. If it's temporary and you don't have other symptoms then you probably don't have the virus.
This is classic anxiety. I've spoke with a surprising number of people who've never experienced something like this before, never thought they could get anxiety/panic attacks, think they have the virus, etc. In some cases, even a mild fever (99-100) isn't crazy; the human body is a fucked up piece of machinery, and reading all the news every day, even comments like the one I'm writing, it starts convincing itself that it has the virus even when it doesn't.
You just need to disconnect. Its both hard, and easy. Play video games. Focus on work if you're able. Shut out the news, Trump, all of that. Try to meditate. Pray. Cook. Go for walks. If it gets especially bad, I've had a couple friends who have gotten anxiety prescriptions from their doctor over the phone (its very common right now).
I'm not a doctor, but each time I hear about a possible diagnostic about panic attacks, it feels like somebody tells a patient having a rhinovirus "your symptoms are explained by the runny-nose illness!". I.e. just stating the symptom (sympathetic/parasympathetic system going weird, heart too fast, etc) but phrasing it as if it was found to be the cause.
Yes. Because then they have the duty to explicitly rule out non-psychogenic causes (like a pinched vagus nerve, viral infections, a pulmonary oedema, etc).
Sometimes it feels just like the "panic attack" is a wild card they default to when the investigation would be too complicated and the patients looks like anxious anyway (which is probably because the patients' body is playing castanets, who would not be scared of that? But they seem to invert cause and effect).
I mean, panic attacks have no "real" cause by definition. They are your body overreacting in response to a perceived threat that isn't really there; they are a type of cognitive distortion. If a panic attack was in response to a "real" cause, it wouldn't be a panic attack, it would be a normal response to a threat.
I know, but look, it is not the correct behavior of the body, right? So obviously something is wrong, and I find it hard to believe that the problem is from the mind if the patient is not himself stating it. In most cases, if he has an anxiety problem, he would straightly start by talking about it, like "I have been in wrong terms with my neighbors for years, and now just thinking they are next door is hurting my chest and making me hard to breathe"...
I admit that in some cases the problem origin could have been repressed, but this is not very common.
> "I have been in wrong terms with my neighbors for years, and now just thinking they are next door is hurting my chest and making me hard to breathe"...
Not at all. Anxiety is hearing the boss music in a video game and not seeing any enemies. I'll often find myself so tense I'm holding my breath with no ability to rationalize why I'm in that state. It's a real bastard.
You're right. So (I agree with you but from here I'm trying to think about some path to search an explanation) maybe could it be explained by some long-term learning of the body-mind connection under repeated stress situations (like being in a crowd while being self-conscious), and then it repeats itself without the obvious stimulus?
What I resent, actually, is when physicians are presented with a package of somatic symptoms and sympathetic/parasympathetic symptoms, and readily discard the somatic part in order to jump to the "panic attack" conclusion.
> if he has an anxiety problem, he would straightly start by talking about it
In my experience, with an OCD component with general anxiety, it can twist your thoughts so much that it's difficult to unpick what the root problem is, other than a general and overwhelming feeling of "Something's wrong". I've often likened it to having two threads running - one is your normal, rational thoughts, and the other is irrational/incoherent, anxiety fueled nonsense, which often overrides the first - but it took me months (if not more) to be able to articulate it in those terms and keep some semblance of a rational thought process rather than just going into a blind panic for no reason.
When it was first happening, it definitely felt like something of a physical origin, as I could feel my heart rate going up and up, my mouth going dry, and breathing wasn't easy (and you think the panic is _due_ to those symptoms). However, as I was getting very similar symptoms from trying to ignore certain recurring thoughts (just coupled with an overwhelming compulsion to do certain things in response), it pointed me at an anxiety-based cause pretty quickly. Without that side of it, I'd not sure when I'd've come to that conclusion.
I'm now more or less at the point where it's 'just' my OCD obsessions that set me off, which are at least foreseeable and thus somewhat more manageable, but I'll still occasionally have periods where all I feel is "something _very_ bad's about to happen"/"something's wrong"/"I need to be anywhere but here" for no apparent reason. The analogy in other post about hearing the boss music is apt - that's exactly how they feel. Thankfully they're not full-blown panic attacks (no shortness of breath or chest pain), but heart rate jumps ~40BPM, not having a wall behind me _really_ freaks me out, and I can't concentrate on anything else or really talk to anyone. They're short-lived (30 seconds-10 minutes), but it's a really sudden onset (it hits me like a wall) and I feel jumpy for the rest of the day.
Slowing my breathing helps - deliberately breathing in for 5s, then out for 5s, and trying to focus on that seems to shorten the duration, and in the situations where I can tell one is coming (OCD triggered - I usually feel increasingly tense rather than it being so sudden), it can sometimes prevent them. Drinking water also helps for those - my mouth going dry is one of the first physical things I notice, and that just increases the anxiety. Keeping my mouth wet for that period helps stop that feedback loop.
You're right to point me out that the state can actually origin in pure, causeless, anxiety. Thanks, I was blinded by the reasoning I wanted to defend.
However I think that there could be cases where it would come from, e.g. thyroid instability. Usually nobody is monitored 24/7 on its thyroid hormone levels, etc. Could be also adrenal glands. Maybe when they are weak, or subject to autoimmune problems, their secretions can be irregular, or their reactions to stimuli can be too weak, too strong, quick or slow.
Then the subject would not be anymore resilient to normal stress. That would explain why normal stress => pathological effects on some people.
Then again the organ-level defects could be themselves a consequence of elevated stress during long periods, so one could raise the question about which is first of the egg or chicken...
Panic is a normal response to many situations. Panic can also be an abnormal response to normal stuff. When people experience panic that interferes with their day to day life, and causes them distress they may have an anxiety disorder.
Anxiety disorders are distressing and debilitating, and they lead to years of life lost to disability. Some of them have high rates of death by suicide.
Luckily, they're also very treatable. Most people experience pretty good recovery from an evidence based talking therapy. Sometimes that needs to be combined with medication, and sometimes the talking therapy needs to be repeated in a year or so.
So, hopefully, when people say "this sounds like a panic disorder" what they're really saying is "I understand the distress you're in, and here's some things that may help".
It doesn't even have to be a full on panic attack to raise your heart rate. I notice that when I am feeling anxious or read too much social media/news that my heart rate is elevated as a result.
Incidentally, I went the other way. I somehow got fixated on my breathing[1], and "thought" (rationally I knew it was wrong, but the anxiety overrides) that I wasn't breathing enough unless I forced myself to, to the point I didn't sleep for multiple nights as I was convinced I would be in trouble if I fell asleep. Got a cheap O2 sat. meter, checked it was above ~95, even after holding my breath for tens of seconds, and after a couple of hours it didn't bother me anymore. I think seeing actual evidence was enough to jolt me out of it, at least in that case.
Still got my baseline, for lack of a better word, OCD compulsions, but they're at least somewhat more manageable than that was.
[1] OCD/GAD can sometimes latch onto some weird things out of the blue, at least for me - having a diagnosis of central sleep apnea didn't really help either
Damn I had the same thing. I'm not particularly worried about covid19 when it comes to myself personally but I felt like it was hard to breathe and I don't do it often enough. As dumb as it sounds I panicked about forgetting to breath.
It was surreal because I'm not really worried usually about my health or wellbeing, if anything I should take it more seriously. I just gasped cold air from window and skipped sleeping that night.
One thing to try to relax is to do breathing exercises. Deep breath from the nose for 4-5 seconds, hold for a few seconds and exhale over 6-8 seconds. This will lower your pulse and reflex you.
Try to refrain from constantly reading about Covid19. I find this brings stress to me and I relapse to same problems as you. Pick a time of day, as early as possible and concentrate your reading on the topic then.
Possibly an allergic/asthmatic response to something in your environment. It's worth keeping tabs on whether you used any cleaners, were outside, or in a specific room of your home when the breathing issues occurred.
I deal with a panic disorder and what you're describing sounds super similar to what a garden-variety panic attack is like. Especially the part about your heart rate rising but your oxygen saturation staying pretty much the same (the difference between 94-97 and 97-100 is within the normal variation during physical activity). What's likely happening is that your brain is latching onto some small thing, like laying down on your back and putting more pressure on your diaphragm. Instead of interpreting that small thing as totally normal, your brain interprets it as a "warning sign," because of your stress/anxiety around COVID, and it goes into panic mode. At this point, it's pumping out a lot of chemicals that stimulate what's called a "fight or flight" response; it's your natural response to any perceived threat, real or otherwise. Those chemicals will cause your heart rate to increase and will often cause shortness of breath. Usually these can last 45 minutes-a few hours and will subside. Deep breathing exercises work for some people, but I find that when I focus on my breathing I end up spiraling more, so I focus on grounding exercises and progressive muscle relaxation. I'd recommend trying those out next time you have a bout of that and see if it helps :)!
Absolutely this. I've struggled with panic attacks that came on secondary to medical issues in the past couple years, and the elevated heart rate and perceived breathing problems are textbook. Other things to lookout for are: impending sense of doom (fixated on the idea something's wrong), lights appear brighter or have halos, bounding pulse (you feel your heart beating hard), eyelid twitching, amongst others.
Block breathing will help. Inhale into your belly until you can't hold more air, hold for 5, exhale slowly. Take a couple of normal breaths, then repeat the block breath. Do it for 10 minutes.
Other things to note: before and after the panic attack, you're in a "prodromal period", which means you're susceptible to subsequent attacks. Try to stay away from stimulants, like caffeine, and, honestly, get the hell off the internet and away from news.
Something of an aside, but I've actually found caffeine (400mg/day + variable amount in drinks) _helps_ with OCD-induced panic attacks. If I do have an attack, it seems somewhat worse, but it makes it _significantly_ easier to shift my attention away from obsessive thoughts, thus avoiding triggering the attack in the first place.
I was pointed towards it by this paper - https://www.ncbi.nlm.nih.gov/pubmed/19573497 It's a pretty weak basis for making treatment decisions (n=24, caffeine was used as the control against d-amphetamine, both showed some effect), but my doctor and I reasoned that there was fairly limited risk in trying it. Other studies seem to have shown similar results - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559101/
I'm having the exact same experience. I live a few miles from the first outbreak location near Seattle. I first started experiencing symptoms at the end of February. Shortness of breath, extreme fatigue, loss of appetite, dry cough, and a fluctuating temperature that never went beyond mild fever (37.5C / 99.5F). My most concerning symptom was the sensation that I just couldn't get enough air.
I went to the ER one night in early March because I felt like I was going to pass out. They gave me a chest X-ray, blood tests, nasal flu swab, and ECG. Everything came back normal. No pneumonia visible in the X-Ray.
I continued to rest and recover, and things finally started to get back to normal a couple weeks ago. I thought I'd kicked this thing, whatever it was. But then the shortness of breath returned. (I've not had fever or cough.) I've cycled like this -- between struggling for breath and feeling normal -- for over 4 weeks now. I'm currently experiencing another downturn where I find it difficult to breathe normally. During my difficulties breathing, I find that standing up seems to help the most.
I'm open to the possibility that this is psychogenic. I've tried to avoid reading about the news, and that helps to distract me. But there doesn't seem to be any obvious psychological trigger to my breathing difficulties. I just wish I could get back to normal.
There's so much blind speculation in this comment section. The kind that's intriguing and fun when it's about engineering/math/whatever, but dangerous when it's about the health effects of an ongoing pandemic.
Guess what? ALL discussion about treatments for Covid-19 is speculation.
That a Darwin award winner and his insane, political activist wife, neither of whom had Covid-19, ingested toxic chemicals (probably after indulging in mind altering chemicals) is not very good evidence that discussion on Hacker News should be curtailed in any way.
Don't mess with pet meds no matter how tempting it may be. We have horses so we have phenylbutazone which is tempting to use instead of aspirin, ivermectin which you might be tempted to use instead of otc parental for roundworms, also a huge jar of thyroid hormone that might help you lose weight.
This man was killed because he drank fish tank cleaner. Frankly, I don’t believe his death is causally linked to certain people speculating that hydroxychlorouine might be an effective treatment.
Censoring comment sections on HN just because one moron in a million might take it upon themselves to do something stupid and get themselves killed?
Have you heard of the expression "the cure is worse than the disease"? It applies as much to what you and cowpig are proposing as it does to what that man chose to do.
Speculating about how the virus works on the internet, especially in the confident kind of tone I'm seeing in this comment section, leads people to take that speculation as fact, repeat it, and then you have misinformation spreading on an ongoing health crisis that people use to inform decisions they make in their lives which affect themselves and others.
I am not a doctor myself, but I am dating one, and helped her prepare for her (likely endless) shift in the COVID-19 unit at the hospital two weekends ago. I was shocked at how much more serious the health effects were than the internet had led me to believe, and I don't use facebook avoid low-quality journalism.
There’s definitely some danger in people downplaying this virus, I totally agree. But I don’t see that happening in this comment section. I see people discussing how the virus might work, and trying to explain why these examples have been observed.
That is the HN-equivalent of the same thing. I've heard multiple doctors tell me their worst patients are the smartest ones, because they're used to thinking for themselves and then make dangerous modifications to their advice without understanding all of the reasoning and context behind it (which they cannot explain in a sitting).
There's a possibly equal danger of exaggerating the severity of the virus, which we may be experiencing right now.
Bias towards either direction is still bias. Educated discussion and critical thought are all we can rely on.
If that leads us to the conclusion (as it has led me) that the severity of this disease has been inflated, I think that's a worthy topic of debate and evaluation. Not a taboo subject to be avoided "because someone somewhere might not take it seriously enough and then do something stupid".
This could be said about any time, any disease, or well... anything ever on internet. I for one am glad folks share their opinions here, if one can't distinguish between speculations, opinions and facts then problem lies elsewhere.
I too have my wife a doctor, and I was shocked how little and behind-the-curve their covid infection information is. Most specialist doctors here treated covid in 'what the heck are people worried about, just another flu, right' fashion till maybe 2 weeks ago. Mind you, we talk about Switzerland here with northern italy 50-100km from here, and experts in their (non-virology) fields like urology surgeon, nephrologist, radiologist, emergency doctor(!) and so on.
> Most specialist doctors here treated covid in 'what the heck are people worried about, just another flu, right' fashion till maybe 2 weeks ago.
I consider statements about what "most specialist doctors" were doing, especially without citation, to be a form of the misinformation I'm talking about.
If there were people who didn't take the oncoming pandemic seriously enough, they should probably revisit their priors and processes by which they come to conclusions.
But it doesn't mean we should start posting about it on the internet as justification for speculating on things we don't understand, and simultaneously casting doubt on the expertise or authority of an entire group of professionals.
Dude you are so out of touch here - I was talking about our friends - if your wife is indeed a doctor, then you have tons of those in your inner circle. This is first hand experience, nothing less, in biggest Swiss hospital, nothing less. There you have it, a citation from person directly talking to those mentioned.
An update - just learned that 1 year old daughter of our friends, both are doctors, is tested positive, probably from her nursery/child carer. The poor little thing is sick for more than a week. They still think they are OK to continue to work and not being sick since only one of them shows mild symptoms which could be anything. How the fuck is that possible? With doctors? En Suisse?
Some doctors, while experts in their narrow field, are just doing what they are told and don't do much research outside of their field. Please don't tell everybody to just blindly trust appointed experts, that can be a dangerous advice in these times.
HN is peculiar. It's one of the few forums where you can find rocket scientists talking about rocket science. Much more important, when talking about rocket science, non rocket scientists often state their experience is from playing KSP. I mean, people often declare their ignorance when writing a comment, without being afraid of any negative consequence. This is good. It means its an educated audience -- uneducated audiences rarely assume incompetence. An educated audience does not require as much of "nanny" moderation, for lack of a better term.
I hope HN mantains this profile, and I hope this profile applies to medical science as much as it applies to rocket science. I've learnt a lot about rocket science from discussions here, and I hope to learn a lot about medical science from discussions here. All without any danger of assembling and flying my own rockets, or cooking my own medication. I am very aware that Dunning-Kruger applies to everyone, myself included.
If you think there's a lot of blind (and wild!) speculation happening here, you should see what's happening in hospitals by physicians and infectious disease experts!
We're just seeing how the sausage is made in a medical crisis. And it is never pretty.
We? My experience has been that Hacker News is filled with world-class experts on all manner of subjects. I've no doubt infectious diseases is one of those subjects, as well.
Supposing for a second that you're right, you still need the average upvoter/downvoter to be able to tell the difference between the opinions of world-class experts and convincing but baseless speculation for the whole system not to become a misinformation machine.
And even if you have that, there's always a risk that someone out there reads the most dangerously stupid comments and interpret them as gospel no matter how downvoted.
Since when did the goal of the Internet become to protect people from harmful information? This has been used as a justification for mass censorship and it needs to stop.
> and are not speculating on an internet message board for thousands of random people to read.
I don't know about the USA, but on TV here (Italy), yes they do.
EDIT to avoid sounding too snarky: there are plenty of experts many times on TV, however the public is not aware of the unknowns and the constant challenging of ideas that usually occurs in scientific settings (and so the press).
The result is that there are often contradictory statements which confuse the general population (also the press is not helping at all), which considers "science" as "truth".
The medical literature is itself a shot in the dark right now.
For instance it is good that hydrochloroquone is being trialled, I might want it myself, but it is notorious that antiparasite and antibiotic drugs kill viruses in vitro but kill patients if they do anything at all in vivo.
I think the right place to draw the line is: speculation is fine, medical advice is not.
Of course, we can argue about what constitutes medical advice. I think there needs to be a call to be a call to action (IMO, an implicit call to action would qualify if it's strong enough).
Nobody who tries to shape public discussion is ever working in my interest. If a system is so fragile that it can't withstand people talking about it, poking at it, and suggesting alternatives, that system deserves to fail. The impulse to reach for censorship is the same impulse that has created historical abominations. I categorically reject all censorship, even of medical speculation.
Speculation lies half-way to understanding correctly any complex problem from all sides. As long as is filtered by logic and including the known facts falling in its place, speculation is a good thing, not bad.
Heart arrest can be also external (deliberate crime or medical error) so is important to discuss and understand any anomaly. Physicians and nurses are about at the end of their forces (and incredibly upset) in many places.
That danger is contingent on credulous readers being in position to act on the misinformation. When people here speculate about an airliner's flight envelope, misled readers generally aren't going to go crash 737s.
I remember a schooltrip we made to a museum. Some old guy told us an anecdote about mushroom books. How was it determined how many skulls a mushroom should get? Well, he explained there was this guy who had eaten poisonous mushrooms for the purposes of rating them. One mushroom he had eaten made him very sick and he was all alone, and apparently barely made it out alive. That one got three skulls.
Buyers beware, and if you are not, thank you for your sacrifice.
that's why health officials were telling us not to use masks, not just because supply is short and they need them for health workers but probably more so because:
- viral load is important and that's far too complicated for people to understand, just talk about it in binary sick/not sick.
- having better protection incentivizes people taking more risk, better not do that
- people might not comprehend that masks are imperfect and can fail, better just to tell them they don't work.
health is important, and the way you learn about things is by talking about them. treating it like a special scary topic that only experts should be able to talk about not only leads to disinformation, it leads to lack of trust.
It's not "mysterious". Myocarditis is a common result of viral infections of any kind, and can persist for weeks after recovering from the virus itself.
"In addition, angiotensin converting enzyme 2, the receptor for SARS-CoV-2, is expressed on myocytes and vascular endothelial cells, so there is at least theoretical potential possibility of direct cardiac involvement by the virus"
The most sane hypothesis I've seen is that the virus will attack any cell with the ACE2 receptor, including the heart and kidneys:
"Angiotensin converting enzyme 2 (ACE2) is an enzyme attached to the outer surface (cell membranes) of cells in the lungs, arteries, heart, kidney, and intestines."
This would require the virus to enter the bloodstream from the lungs, which is possible after sufficient alveolar damage.
I wish these articles would be more specific about what they mean by "pre-existing heart conditions". I have slightly high blood pressure which has been known to enter hypertension territory before (by like 1 point), but I think mostly stays a bit below there. Never know how worried I should be.
It's interesting that the chloroquine has possibly been linked to cardiac arrest. Is is chloroquine, or possibly the virus that is causing? Or maybe both in combination?
So, I've been battling this bug for the last three weeks or so, probably caught it on the way back from my last job in Finland. I expected an empty plane instead it was packed like it was the last train out of San Fernando and everybody was scared there never would be another one.
After a week or so symptoms started in spite of having self-isolated already after the flight, so that's why I figure that is where I caught it, no positive confirmation because tests are still pretty rare around here but all the symptoms are present. At least I hope that I did not infect anybody else by taking that precaution. One thing I noticed (besides the hacking cough that does not seem to want to go away) was a pretty highly elevated heartrate at rest. Up to 20% higher than normal.
I already had some lung damage to my right lung due to an earlier pneumonia, but also played saxophone which does a good job of teaching you how to breathe properly and may improve your lungcapacity a bit.
The last couple of weeks have been a continuous rodeo of improvement and falling back again, today is the first day that I have a bit more energy, other than that the time over the last weeks was mostly spent sleeping.
Today is the first time I've seen my heart rate at rest below 60, and I take that as a very good sign that I'm on the tail end of this.
Wouldn't wish this on my worst enemy.
If you can avoid this bug you really should. I totally believe that if I had had a worse general condition that I may have ended up in the hospital, and given the extra strain on the heart I find the heart damage not so much mysterious as logical. After all, if your lung capacity decreases due to fluid in your lungs then your heart and chest muscles will have to work harder (possibly much harder) to get your blood O2 levels to saturation (if they still can...).
There is a hypothesis [0] that the virus attacks red blood cells and impacts their capacity to transport O2, and that the lung damage is actually caused by that, and not directly by the virus. Elevated heart rate makes a lot of sense.
The study seems to be based entirely on computational modeling. As far as I know, there is no direct "wet lab" experimental evidence for its hypothesis. Hopefully people will investigate further soon.
No, "theory" is simply a provable "hypothesis". Doesn't have to be proven, just provable.
The thing is, a theory can never be completely proven. We can never completely discount the possibility of making a new observation or experiment that disproves the theory (hence "falsifiability").
That's why, for example, the "germ theory" is a correct term, even though its probability of being correct is so close to 100% that we could just call it the "truth".
Same here - cold, flu, infection, and yes, hangover. I always assumed it was the same for everyone, but apparently not everyone has an elevated heart rate when hung over - or perhaps they just don't notice it as much.
It does sound like you're close to shaking the bug, and congrats on that! I think I'm a couple days ahead of you; I didn't monitor RHR while I had active symptoms, but anecdotally, I did start feeling a little less rough a couple days before the fever broke this past Saturday. (I also only had active symptoms for about 12 days all told, so I may have had a less severe case just in general.)
Not that you probably need telling, but don't assume that the end of active symptoms means straight back to status quo ante. There's a lot we don't know about COVID-19, but it is a pneumonia, and the association between pneumonia and myocarditis in general is well known. Safer to assume you have it than don't, and give yourself at least a couple of weeks to convalesce, making sure to avoid straining your heart.
No, for sure, I will take it easy for at least two weeks past last symptoms but thank you for the reminder. Can't wait for this to be over. I normally don't care about my heart rate at all, know my resting heart rate is 58 or thereabouts which is quite low but never was a problem. Then, few days after symptoms started I woke up with my heart going really fast and that's when I started to take notice.
Same! Spring's my favorite season, especially early spring as the world comes back to life. Not being able to be safely out in it, even to the limited extent of our own backyard, hurts.
Is avoiding this bug a realistic goal for most of us? It simply won't be feasible to keep people locked down until a safe and effective vaccine is available (at least 18 months, maybe longer). Transmission is still going on due to essential activities, and voluntary compliance is going to get gradually worse. So the reality is that something like 70% of us will be infected before herd immunity causes infections to burn out in large areas.
But it's certainly worth delaying infection for a while if you can. The treatment protocols are improving every day.
I don't think you have any real scientific basis for those numbers. I doubt most people can reduce their risk of infection to 50% unless they take extreme and unsustainable steps. Please state your assumptions and show your math.
If 70% of people get it, you have a baseline risk of 30% of getting it.
My assumption is that a sizeable fraction of people either:
* Already got it
* Don’t take hand washing seriously or do it wrong
* Are bad at avoiding touching their face
* Unnecessarily touch surfaces when out (i.e. door with hand, rather than sleeve/bag, whatever)
* Don’t practice distancing well
* Are in a job where they must interact with the public
If you do all of the above correctly, my guess is you can raise your odds of avoiding from 30% to 50-60%.
It’s not based on any math, but I don’t think there’s any definite math to base it on. I could be wrong in either direction.
Nonetheless I think it’s sufficient to argue that it is not inevitable that and individual will get it and everyone should not even bother to avoid it.
I do nearly everything except distance well if I am forced back to work and have to take public transportation. I live in Boston and this is my fear. I avoid people now but I doubt much people can keep this sustained for 6-months.
I'm trying to understand your numbers and I'm hung up on what may just be a coincidence. You say if 70% of people get it, you have a baseline risk of 30% of getting it.
Is that the normal way of phrasing risk? My expectation would be that there is a 30% chance of not getting it. Am I misreading your comment or is my definition of risk somehow backward?
Oops. Just a typo. I meant baseline chance of 30% of not getting it. So I figure, with precautions, you have a more than 30% chance of being in that 30%.
I totally agree with your "wouldn't wish this on my worst enemy" - this is probably the worst pneumonia-flu-like sickness I went (still going?) through. I am now convinced that if I will catch it (or some mutated off-spring of this) again, I might not make it.
Looks like I got it too about 3 or 4 weeks ago. No cough, no fewer, just a growing chest pain. Went to doctor back then, he prescribed antibiotics against pneumonia, and send me home. Thing that really scared me was (is) constant mild trouble breathing. It is hard to walk any distance and you have to catch wind after walking upstairs - never happened to me before. As you described "ups" and "downs" - you kind of feel ok for a day or so, and then boom, feeling like walking dead again. Worst part (to me) is that I cannot for the life of me (no pun intended) to explain this to my SO - she thinks once you got sick and got better, everything else is bs and "you just don't want to leave the house" etc. Better is forever, right?
I would like to wish you (and all of us) best of luck and as much recovery as you can get. Take care.
Covid-19 is a type of virus that does not mutate much at all. It has error correction in replication.
Across all the variants found globally so far, there have only been changes to 20 base pairs - most of which (possibly all) do absolutely nothing.
Your immunity will likely make any re-infection much much lighter - even many years from now.
Interestingly, Coronaviruses generally, can still re-infect you even after you've developed immunity (or been vaccinated) - albeit to a much lesser extent. It's one advantage they have over influenza, and why they can get away with error correction.
can you, or someone who understands this, explain to the layperson what this means.
the last sentence in particular, what does reinfection have to do with error correction (what is error correction (assuming it has to do with the genome)?)
Because without error correction the mutation rate goes way up which might get you to squeak by an already alerted immune system and achieve reinfection. That's why you get new strains of the flu all the time. Error correction means that the genome will be very close to the one observed the previous time, so if you want to re-infect you need the immunity to last relatively short or be less than perfect. That secondary (or even later) infection would normally go unnoticed though.
Yes yes yes!! I have had this thing for 5 weeks now. And one thing that I saw last week is that my heart rate was between 100 and 120 for some time even when laying down (I got an oximeter early on). Right now I want to think I feel better, but it has been so many ups and downs with this virus, that I don't know what to think.
As you very well say, this is no playing matter. I am sure my recovery will be long. If a normal Pneumonia takes so much time (a friend of mine had it last year and 1 year later he is still not 100% back), this virus will definitely take even more patience for the physiotherapeutic stage.
You be very careful please, if it has been going for that long and you are still not getting better then you may have a secondary infection going (further down, in your lungs) and you may not be getting enough O2. Please make sure you sleep front down so that your lungs can work better (the bulk of the active surface of your lungs is on your back), fluid will drain to the bottom and you may be able to get some more needed oxygen. Also, if possible, get tested, that way at least you are confirmed which might speed things up a bit by the time you need it. Be sure to tell your doctor about it (GP, assuming you have one) and to call EMS when you feel you are losing it. Calling EMS too late is in many cases a contributing cause for really bad cases or fatalities, there is no 'toughing this out' if your body can't cope.
Random speculation aside, if you (like me) are currently at the tail end of COVID-19 and beginning your convalescence from it, it's wise to assume you have some degree of myocarditis and behave accordingly - that is, as best you can, avoid activities that may strain your heart and circulatory system for a couple weeks to a month following end of active COVID-19 symptoms.
I'm not a doctor, and this isn't medical advice, but it isn't alarmism either. It's well known that pneumonias, however caused, tend to be rough on the heart. So it's just common sense to regard this pneumonia the same way.
Look at it this way. If you aren't at risk, but assume that you are, the worst that happens is nothing. If you are at risk, and assume that you aren't, you may well not be so lucky. So, especially when you may not be able to rely on the usual degree of hospital support - better safe than sorry.
There's a growing body of evidence that C19 attacks hemoglobin in the blood, with the effects similar to malaria (where the parasite uses hemoglobin as a nutrient source): blood with depleted hemoglobin simply can't carry as much oxygen, so people start gasping for air, their lungs swell, and then pneumonia kills them. Crucially, gasping for air seems to happen well before the onset of pneumonia. This also explains why diabetics are more severely affected.
If that's the case, ventilators aren't going to help if you use air in them, without supplemental oxygen: even if you pump air into the patient's lungs, their blood simply won't be able to carry sufficient oxygen. You need to supplement with oxygen.
It also explains why (hydroxy)chloroquine helps: if it stops/reduces depletion of hemoglobin (which it does [*]), the patient may never progress to pneumonia, because their blood is able to carry sufficient oxygen.
For those who already have pneumonia, supplemental oxygen would be vital if they also have C19. Standard ARDS treatment protocol will not work well.
197 comments
[ 3.0 ms ] story [ 211 ms ] thread“These data suggest that vagus contributes to severe emotional states and may be related to emotional states of immobilization, such as extreme terror. Unfortunately, this immobilization technique is potentially life-threatening for mammals (but not for reptiles). Mammals would undergo states of bradycardia or hypoxia as an over-activation of parasympathetic vagus system. The organs of the oxygen-hungry mammal are deprived of oxygen due to lack of blood flow, and the animal dies.”
If so, this would be an easy hypothesis to test based on heart rate.
But also, do the rats in voodoo death have heart damage? These covid patients do. If the rats don’t, then you’re quite off track.
We totally should research whether fear can lead to physical heart damage, but I would bet that "stress in general" is the source of this damage, not only emotional stress. See:
https://www.medicalnewstoday.com/articles/295664
https://www.medicalnewstoday.com/articles/317478
I do recall reading few articles that support it as an actual condition and makes logical sense that for some that will be a factor - lost loved one in same family, increases the odds of catching the virus and also a broken heart. Truly a tradgerday on many levels. Also mindful that the impact of this pandemic will see many indirect deaths in the years to come and the scale of things won't be measured in people who died and tested positive, but how the rest live.
An amusing, non-serious, scenario.
and for you https://monarchinitiative.org/disease/MONDO:0005571
Among the speculation is that a blood transfusion may be a viable treatment.
https://www.cureus.com/articles/29004-acetazolamide-nifedipi...
But that was a year ago, so not COVID.
Its easy for us middle-class folks to say "Just stay at home and eat cake!" This whole lockdown thing is divided on class lines. Just look in the window at the McD's drive-thru. Those folks don't have the luxury of staying home.
Break the infrastructure enough that public sanitation stops working properly, and the Covid-19 deaths will be a rounding error in the excess death rate.
Read the shut down orders issued by your state. Read the list of essential jobs listed in those orders. All of those things that you listed are essential jobs, that are still being done. If your factory makes masks, you're essential. If your factory makes screws that are used in a factory that makes masks, you're also essential. If your mine digs up iron ore that goes to a smelter, that goes to a factory that makes screws that are used in a factory that makes masks - you're also essential.
Yes, this means that a lot of people are essential. But even halving the number of person-to-person interactions the average person has leads to a big reduction in transmissions.
[1] I live in Seattle, three weeks into a shutdown, and just two days ago, power crews were doing preventative maintenance on the power line leading into my building.
There will be a cost to all this - small business starts that fail across the board, loans and mortgages in default, cars repossessed, restaurants closing everywhere. Hard to get a job for most people with so many businesses closed, hard to get to a job with no car.
We're all getting behind, it will be hard to catch up again, costs will go up after this is over, everyone will have more debt. It may take months or years for the hiccups to go away.
Cancelled checkups and dentist appointments are an unfortunate consequence of living with this virus. Lifting the lockdown on them may well result in more net damage to people's health at this point - but maybe not. This is one of the first things we need to think about re-opening.
Haircuts are by no means essential, and I don't understand why you threw them into the list.
The problems that arise from this aren't exactly the apocalypse porn of "There will be no food, no running water, and people will be dying in the streets, as civilization falls apart around them."
> There will be a cost to all this - small business starts that fail across the board, loans and mortgages in default, cars repossessed, restaurants closing everywhere.
This kind of economic cost is going to be paid anyways, regardless of whether we take the road of "Tens of thousands of deaths, more lockdown" or "Millions of deaths, no lockdown". People just aren't going to consume as normal in the middle of a raging pandemic. Small businesses will be falling apart, as their owner-operators get sick, and/or die. Jobs will be lost, because not enough people are crazy enough to be booking a vacation in the middle of this.
Until we beat this thing (which probably means a vaccine being widely-available, so... another year at least), any job that can be done remotely, should absolutely be done remotely. And I, for one, won't be setting foot in a cafe or restaurant or going to a conference until this is all over.
And my kids won't be going back to school either. Guess we're homeschooling now.
We are trying to hold the fort until reinforcements (better treatments, vaccines, etc) arrive.
We may also be developing herd immunity, if the previously-infected are less likely to be reinfected. If that’s the case, those presenting antibodies could go back to a normal existence faster.
Possible but also important to keep in mind that heart damage does not necessarily translate into an immediate heart attack. It can lead to reduced heart function and a host of other heart-related problems that may not manifest in the form of a fatality for years (if ever). The same goes for the reported lung damage that many Covid-19 victims apparently suffer.
ACE2 is also found in several other organs in which they are seeing multiple organ failure with this virus so it likely is can bind to them and contribute to damage in these organs including the heart but as OP says there are multiple ways the heart could be affected
Loss of ACE2 receptors in the heart can cause impaired heart function
https://www.youtube.com/watch?v=jAW6VBWTiAA#t=8m
For instance, ACE1 and ACE2 receptors are involved in a complex hormonal system that manages your blood volume, blood pressure, etc. Antihypertensive drugs target this system at different points. (ACE inhibitor drugs such as Lisinopril target the ACE1 receptor and don't bind much to ACE2 at all)
Liver failure can present with symptoms similar to asthma because if your kidneys can't get rid of water, the water will leak out of your lungs.
I had a friend who passed away last year from a bacterial infection that got to his heart. We all have bacteria that live on our skin without problems, but if you get a wound they can get into your blood and go to your heart.
He had heart valve damage which is bad because if your heart valves work improperly, it can damage your blood the way you can 'damage' cream by whipping it. This can cause clots to go into your lungs or your brain with bad results either way.
He had open heart surgery but they had a hard time restarting his heart and he was in a coma for a few months before they removed his feeding tube.
One reason why penicillin was a miracle was that all sorts of people who got even minor wounds (e.g. soldiers, children, farmers, ...) would progress like that before WWII.
My understanding is that myocarditis is a possible, albeit rare, complication of many viral illnesses?
Additionally, respiratory failure causes a massive strain on the heart, so it’s not hugely surprising that many patients would have heart complications.
It would be interesting to know how many patients without respiratory distress develop these cardiac symptoms.
The most likely cause of the heart damage by far is the systemic inflammation induced by pneumonia. We know this because pneumonia patients of all types often have heart strain afterwards[1]. But that damage is very rarely permanent as the risk subsides back to baseline given enough time.
Until we see evidence of heart issues in patients without pneumonia complications, we shouldn't be any more scared of covid-19 as we were before. In particular young and healthy people still have very little risk from infection. Patients who recover without serious complications should not be afraid of hidden heart damage.
[1] https://www.health.harvard.edu/heart-health/heart-attack-ris...
Isn’t this premature given the lack of data?
We’re seeing an anomaly documented and being studied. It’s not cause for alarm. But neither does it merit such dismissal.
whether any given youtuber deserves that stature and esteem is certainly unclear, as that takes direct observation of the person over time to ascertain.
That's exactly what they're seeing, and why this article was written:
"An initial study found cardiac damage in as many as 1 in 5 patients, leading to heart failure and death even among those who show no signs of respiratory distress."
Unfortunately the article doesn't say what percent of people with cardiac damage did not have respiratory issues as well.
Patients who had heart disease before their coronavirus infections were much more likely to show heart damage afterward. But some patients with no previous heart disease also showed signs of cardiac damage. In fact, patients with no preexisting heart conditions who incurred heart damage during their infection were more likely to die than patients with previous heart disease but no COVID-19-induced cardiac damage.
Isn't it likely that the patients who had no preexisting heart conditions actually had undiagnosed preexisting heart conditions?
We also don't probably know all the possible heart conditions out there!
Finally, while someone might not have a condition (disease), they also might not have good function of the heart, this is not considered a pre-existing condition. This tends to happen with people who are overweight, leading to arteriosclerosis, but since the norm has moved so far in one direction, our criteria for disease might have moved as well.
Finally, the lungs and heart work in coordination to bring oxygen to the rest of the body. If the lungs stop functioning (which may not have direct symptoms that we expect)... I think it's pretty easy to fill in the rest.
If two people have similar heart damage but one knows about it and manages the hypertension that caused it, who is in worse shape if a disease adds stress to your system?
Sure, it might be the case, but you cannot draw any conclusion here unless you compare it to other pneumonia cases.
I.e. in Connecticut, there was a "covid19 infant death". Except that infant died at home due to a horrible accident. Arrived at the hospital deceased. Postmortem, was tested and coronavirus positive, therefore was counted as "Covid19 Death" and "infant dies of coronavirus!!!" in the news.
Death rates and case numbers are terribly skewed, and the data we have is abysmal.
CDC just massively changed the definition of what a "positive" case means. PCR tests have a notorious accuracy problem, so previously the definition of a positive case was consecutive positive PCR/RT-PCR tests.
Now the definition has changed to "if any test has ever come back positive, then positive".
To be clear, this new definition means that if you test positive, then have two consecutive negative tests, you're still counted as a positive case.
Just this redefinition could account for a large part of the increases in "positive" cases we're seeing.
Couple this with allocation of funds and resources based on positive cases and death totals, and you have a situation where it's in everyone's best interest to inflate the numbers as much as possible.
We saw the same issues during HIV/AIDS "crisis".
Be very skeptical of any numbers, rates and data you're seeing. At this point, the CDC and state agencies are refusing to publish their source data (which is very strange).
https://www.statista.com/statistics/1105402/covid-hospitaliz...
However we mostly don't try to confirm cases if it won't affect the care we give. We just tell them to self-isolate. We therefore will not have good statistics on what percentage of cases are confirmed until after the immediate crisis is over and we test to see how many have antibodies.
So your figure is, "Of young people who have it severely enough to get tested, 15-20% get hospitalized." This says nothing about what fraction of cases are severe enough to get tested.
Also note that we undercount deaths. If a person dies and was never confirmed to have COVID-19, they are also not counted as a COVID-19 death. Nobody knows how big this undercount factor is.
0–9 years 0 13 0·00% (0·00–0·00)
10–19 years 1 50 0·0408% (0·0243–0·0832)
20–29 years 49 437 1·04% (0·622–2·13)
30–39 years 124 733 3·43% (2·04–7·00)
40–49 years 154 743 4·25% (2·53–8·68)
50–59 years 222 790 8·16% (4·86–16·7)
60–69 years 201 560 11·8% (7·01–24·0)
70–79 years 133 263 16·6% (9·87–33·8)
≥80 years 51 76 18·4% (11·0–37·6)
Data is from Table 3 near end of paper, table title: “Estimates of the proportion of all infections that would lead to hospitalisation, obtained from a subset of cases reported in mainland China“
lots of young athletes die from it after coming back too hard/fast from flu
two weeks ago i've been having real issues breathing. it felt like my upper body was borderline paralyzed and i had to really force myself to fully breathe in. this wasn't constant but happened every day for several hours each. especially at night.
i got worried that i might have the virus so i checked my temperature and oxygen blood saturation as well as my pulse.
temperature was fine (36.6°C-37.2°C), blood saturation was in the normal range, however it dropped from 97-100 when i wasnt having any issues to 94-97. my pulse rate however went from usually ~75-80 to >110 whenever i had breathing problems.
it went away last week.. or so i though. i had another episode of that this morning, it was only for 3 hours today, however. it seems to be going away, but if it actually was (or is) the virus... it seems plausible to me.
but i'm a person without any medical knowledge so ... listen to the people actually treating the patients, not random armchair specialists like they're frequent on hacker news -- especially in threads about covid-19.
There's been something going around since Jan at least, although it's impossible to know if it's Covid-related or something else.
I do have the other symptoms though. Only the fever is missing.
You just need to disconnect. Its both hard, and easy. Play video games. Focus on work if you're able. Shut out the news, Trump, all of that. Try to meditate. Pray. Cook. Go for walks. If it gets especially bad, I've had a couple friends who have gotten anxiety prescriptions from their doctor over the phone (its very common right now).
Sometimes it feels just like the "panic attack" is a wild card they default to when the investigation would be too complicated and the patients looks like anxious anyway (which is probably because the patients' body is playing castanets, who would not be scared of that? But they seem to invert cause and effect).
I admit that in some cases the problem origin could have been repressed, but this is not very common.
Not at all. Anxiety is hearing the boss music in a video game and not seeing any enemies. I'll often find myself so tense I'm holding my breath with no ability to rationalize why I'm in that state. It's a real bastard.
What I resent, actually, is when physicians are presented with a package of somatic symptoms and sympathetic/parasympathetic symptoms, and readily discard the somatic part in order to jump to the "panic attack" conclusion.
In my experience, with an OCD component with general anxiety, it can twist your thoughts so much that it's difficult to unpick what the root problem is, other than a general and overwhelming feeling of "Something's wrong". I've often likened it to having two threads running - one is your normal, rational thoughts, and the other is irrational/incoherent, anxiety fueled nonsense, which often overrides the first - but it took me months (if not more) to be able to articulate it in those terms and keep some semblance of a rational thought process rather than just going into a blind panic for no reason.
When it was first happening, it definitely felt like something of a physical origin, as I could feel my heart rate going up and up, my mouth going dry, and breathing wasn't easy (and you think the panic is _due_ to those symptoms). However, as I was getting very similar symptoms from trying to ignore certain recurring thoughts (just coupled with an overwhelming compulsion to do certain things in response), it pointed me at an anxiety-based cause pretty quickly. Without that side of it, I'd not sure when I'd've come to that conclusion.
I'm now more or less at the point where it's 'just' my OCD obsessions that set me off, which are at least foreseeable and thus somewhat more manageable, but I'll still occasionally have periods where all I feel is "something _very_ bad's about to happen"/"something's wrong"/"I need to be anywhere but here" for no apparent reason. The analogy in other post about hearing the boss music is apt - that's exactly how they feel. Thankfully they're not full-blown panic attacks (no shortness of breath or chest pain), but heart rate jumps ~40BPM, not having a wall behind me _really_ freaks me out, and I can't concentrate on anything else or really talk to anyone. They're short-lived (30 seconds-10 minutes), but it's a really sudden onset (it hits me like a wall) and I feel jumpy for the rest of the day.
Slowing my breathing helps - deliberately breathing in for 5s, then out for 5s, and trying to focus on that seems to shorten the duration, and in the situations where I can tell one is coming (OCD triggered - I usually feel increasingly tense rather than it being so sudden), it can sometimes prevent them. Drinking water also helps for those - my mouth going dry is one of the first physical things I notice, and that just increases the anxiety. Keeping my mouth wet for that period helps stop that feedback loop.
However I think that there could be cases where it would come from, e.g. thyroid instability. Usually nobody is monitored 24/7 on its thyroid hormone levels, etc. Could be also adrenal glands. Maybe when they are weak, or subject to autoimmune problems, their secretions can be irregular, or their reactions to stimuli can be too weak, too strong, quick or slow.
Then the subject would not be anymore resilient to normal stress. That would explain why normal stress => pathological effects on some people.
Then again the organ-level defects could be themselves a consequence of elevated stress during long periods, so one could raise the question about which is first of the egg or chicken...
Anxiety disorders are distressing and debilitating, and they lead to years of life lost to disability. Some of them have high rates of death by suicide.
Luckily, they're also very treatable. Most people experience pretty good recovery from an evidence based talking therapy. Sometimes that needs to be combined with medication, and sometimes the talking therapy needs to be repeated in a year or so.
So, hopefully, when people say "this sounds like a panic disorder" what they're really saying is "I understand the distress you're in, and here's some things that may help".
Still got my baseline, for lack of a better word, OCD compulsions, but they're at least somewhat more manageable than that was.
[1] OCD/GAD can sometimes latch onto some weird things out of the blue, at least for me - having a diagnosis of central sleep apnea didn't really help either
It was surreal because I'm not really worried usually about my health or wellbeing, if anything I should take it more seriously. I just gasped cold air from window and skipped sleeping that night.
Focus on exhaling, emptying your lungs.
Try to refrain from constantly reading about Covid19. I find this brings stress to me and I relapse to same problems as you. Pick a time of day, as early as possible and concentrate your reading on the topic then.
Block breathing will help. Inhale into your belly until you can't hold more air, hold for 5, exhale slowly. Take a couple of normal breaths, then repeat the block breath. Do it for 10 minutes.
Other things to note: before and after the panic attack, you're in a "prodromal period", which means you're susceptible to subsequent attacks. Try to stay away from stimulants, like caffeine, and, honestly, get the hell off the internet and away from news.
Something of an aside, but I've actually found caffeine (400mg/day + variable amount in drinks) _helps_ with OCD-induced panic attacks. If I do have an attack, it seems somewhat worse, but it makes it _significantly_ easier to shift my attention away from obsessive thoughts, thus avoiding triggering the attack in the first place.
I was pointed towards it by this paper - https://www.ncbi.nlm.nih.gov/pubmed/19573497 It's a pretty weak basis for making treatment decisions (n=24, caffeine was used as the control against d-amphetamine, both showed some effect), but my doctor and I reasoned that there was fairly limited risk in trying it. Other studies seem to have shown similar results - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6559101/
I went to the ER one night in early March because I felt like I was going to pass out. They gave me a chest X-ray, blood tests, nasal flu swab, and ECG. Everything came back normal. No pneumonia visible in the X-Ray.
I continued to rest and recover, and things finally started to get back to normal a couple weeks ago. I thought I'd kicked this thing, whatever it was. But then the shortness of breath returned. (I've not had fever or cough.) I've cycled like this -- between struggling for breath and feeling normal -- for over 4 weeks now. I'm currently experiencing another downturn where I find it difficult to breathe normally. During my difficulties breathing, I find that standing up seems to help the most.
I'm open to the possibility that this is psychogenic. I've tried to avoid reading about the news, and that helps to distract me. But there doesn't seem to be any obvious psychological trigger to my breathing difficulties. I just wish I could get back to normal.
I hope moderators do something about it.
That a Darwin award winner and his insane, political activist wife, neither of whom had Covid-19, ingested toxic chemicals (probably after indulging in mind altering chemicals) is not very good evidence that discussion on Hacker News should be curtailed in any way.
I stay away.
Have you heard of the expression "the cure is worse than the disease"? It applies as much to what you and cowpig are proposing as it does to what that man chose to do.
In this case, a Darwin award seems more appropriate to me than blaming anyone for speculating based on low quality data.
I am not a doctor myself, but I am dating one, and helped her prepare for her (likely endless) shift in the COVID-19 unit at the hospital two weekends ago. I was shocked at how much more serious the health effects were than the internet had led me to believe, and I don't use facebook avoid low-quality journalism.
Bias towards either direction is still bias. Educated discussion and critical thought are all we can rely on.
If that leads us to the conclusion (as it has led me) that the severity of this disease has been inflated, I think that's a worthy topic of debate and evaluation. Not a taboo subject to be avoided "because someone somewhere might not take it seriously enough and then do something stupid".
I too have my wife a doctor, and I was shocked how little and behind-the-curve their covid infection information is. Most specialist doctors here treated covid in 'what the heck are people worried about, just another flu, right' fashion till maybe 2 weeks ago. Mind you, we talk about Switzerland here with northern italy 50-100km from here, and experts in their (non-virology) fields like urology surgeon, nephrologist, radiologist, emergency doctor(!) and so on.
For once, thank you internet and (also) HN users!
I consider statements about what "most specialist doctors" were doing, especially without citation, to be a form of the misinformation I'm talking about.
If there were people who didn't take the oncoming pandemic seriously enough, they should probably revisit their priors and processes by which they come to conclusions.
But it doesn't mean we should start posting about it on the internet as justification for speculating on things we don't understand, and simultaneously casting doubt on the expertise or authority of an entire group of professionals.
An update - just learned that 1 year old daughter of our friends, both are doctors, is tested positive, probably from her nursery/child carer. The poor little thing is sick for more than a week. They still think they are OK to continue to work and not being sick since only one of them shows mild symptoms which could be anything. How the fuck is that possible? With doctors? En Suisse?
Some doctors, while experts in their narrow field, are just doing what they are told and don't do much research outside of their field. Please don't tell everybody to just blindly trust appointed experts, that can be a dangerous advice in these times.
I hope HN mantains this profile, and I hope this profile applies to medical science as much as it applies to rocket science. I've learnt a lot about rocket science from discussions here, and I hope to learn a lot about medical science from discussions here. All without any danger of assembling and flying my own rockets, or cooking my own medication. I am very aware that Dunning-Kruger applies to everyone, myself included.
We're just seeing how the sausage is made in a medical crisis. And it is never pretty.
And even if you have that, there's always a risk that someone out there reads the most dangerously stupid comments and interpret them as gospel no matter how downvoted.
I don't know about the USA, but on TV here (Italy), yes they do.
EDIT to avoid sounding too snarky: there are plenty of experts many times on TV, however the public is not aware of the unknowns and the constant challenging of ideas that usually occurs in scientific settings (and so the press).
The result is that there are often contradictory statements which confuse the general population (also the press is not helping at all), which considers "science" as "truth".
For instance it is good that hydrochloroquone is being trialled, I might want it myself, but it is notorious that antiparasite and antibiotic drugs kill viruses in vitro but kill patients if they do anything at all in vivo.
The truth will out but it will take a while.
Of course, we can argue about what constitutes medical advice. I think there needs to be a call to be a call to action (IMO, an implicit call to action would qualify if it's strong enough).
Heart arrest can be also external (deliberate crime or medical error) so is important to discuss and understand any anomaly. Physicians and nurses are about at the end of their forces (and incredibly upset) in many places.
That's the price we pay for open discourse.
I don't think this is true. It's entirely possible to have open discourse without over-selling one's own loosely-informed speculation.
The problem with censorship is that you often just end up substituting one set of nonsense for another.
Buyers beware, and if you are not, thank you for your sacrifice.
that's why health officials were telling us not to use masks, not just because supply is short and they need them for health workers but probably more so because:
- viral load is important and that's far too complicated for people to understand, just talk about it in binary sick/not sick.
- having better protection incentivizes people taking more risk, better not do that
- people might not comprehend that masks are imperfect and can fail, better just to tell them they don't work.
health is important, and the way you learn about things is by talking about them. treating it like a special scary topic that only experts should be able to talk about not only leads to disinformation, it leads to lack of trust.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6...
"In addition, angiotensin converting enzyme 2, the receptor for SARS-CoV-2, is expressed on myocytes and vascular endothelial cells, so there is at least theoretical potential possibility of direct cardiac involvement by the virus"
The most sane hypothesis I've seen is that the virus will attack any cell with the ACE2 receptor, including the heart and kidneys:
"Angiotensin converting enzyme 2 (ACE2) is an enzyme attached to the outer surface (cell membranes) of cells in the lungs, arteries, heart, kidney, and intestines."
This would require the virus to enter the bloodstream from the lungs, which is possible after sufficient alveolar damage.
ref: https://en.wikipedia.org/wiki/Angiotensin-converting_enzyme_...
As an aside, although Wikipedia doesn't mention it, testicular cells also express ACE2, leading to some worry about downstream fertility effects:
https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v...
After a week or so symptoms started in spite of having self-isolated already after the flight, so that's why I figure that is where I caught it, no positive confirmation because tests are still pretty rare around here but all the symptoms are present. At least I hope that I did not infect anybody else by taking that precaution. One thing I noticed (besides the hacking cough that does not seem to want to go away) was a pretty highly elevated heartrate at rest. Up to 20% higher than normal.
I already had some lung damage to my right lung due to an earlier pneumonia, but also played saxophone which does a good job of teaching you how to breathe properly and may improve your lungcapacity a bit.
The last couple of weeks have been a continuous rodeo of improvement and falling back again, today is the first day that I have a bit more energy, other than that the time over the last weeks was mostly spent sleeping.
Today is the first time I've seen my heart rate at rest below 60, and I take that as a very good sign that I'm on the tail end of this.
Wouldn't wish this on my worst enemy.
If you can avoid this bug you really should. I totally believe that if I had had a worse general condition that I may have ended up in the hospital, and given the extra strain on the heart I find the heart damage not so much mysterious as logical. After all, if your lung capacity decreases due to fluid in your lungs then your heart and chest muscles will have to work harder (possibly much harder) to get your blood O2 levels to saturation (if they still can...).
[0] see thread and linked paper: https://twitter.com/yishan/status/1244717172871409666
The study seems to be based entirely on computational modeling. As far as I know, there is no direct "wet lab" experimental evidence for its hypothesis. Hopefully people will investigate further soon.
Would it be more appropriate then to call it a hypothesis?
The thing is, a theory can never be completely proven. We can never completely discount the possibility of making a new observation or experiment that disproves the theory (hence "falsifiability").
That's why, for example, the "germ theory" is a correct term, even though its probability of being correct is so close to 100% that we could just call it the "truth".
https://en.wikipedia.org/wiki/Holiday_heart_syndrome
Not that you probably need telling, but don't assume that the end of active symptoms means straight back to status quo ante. There's a lot we don't know about COVID-19, but it is a pneumonia, and the association between pneumonia and myocarditis in general is well known. Safer to assume you have it than don't, and give yourself at least a couple of weeks to convalesce, making sure to avoid straining your heart.
Same! Spring's my favorite season, especially early spring as the world comes back to life. Not being able to be safely out in it, even to the limited extent of our own backyard, hurts.
But it's certainly worth delaying infection for a while if you can. The treatment protocols are improving every day.
Maybe 50-60% odds of avoiding? Still high odds of getting it, but not so high that it’s inevitable.
My assumption is that a sizeable fraction of people either:
* Already got it
* Don’t take hand washing seriously or do it wrong
* Are bad at avoiding touching their face
* Unnecessarily touch surfaces when out (i.e. door with hand, rather than sleeve/bag, whatever)
* Don’t practice distancing well
* Are in a job where they must interact with the public
If you do all of the above correctly, my guess is you can raise your odds of avoiding from 30% to 50-60%.
It’s not based on any math, but I don’t think there’s any definite math to base it on. I could be wrong in either direction.
Nonetheless I think it’s sufficient to argue that it is not inevitable that and individual will get it and everyone should not even bother to avoid it.
Is that the normal way of phrasing risk? My expectation would be that there is a 30% chance of not getting it. Am I misreading your comment or is my definition of risk somehow backward?
Looks like I got it too about 3 or 4 weeks ago. No cough, no fewer, just a growing chest pain. Went to doctor back then, he prescribed antibiotics against pneumonia, and send me home. Thing that really scared me was (is) constant mild trouble breathing. It is hard to walk any distance and you have to catch wind after walking upstairs - never happened to me before. As you described "ups" and "downs" - you kind of feel ok for a day or so, and then boom, feeling like walking dead again. Worst part (to me) is that I cannot for the life of me (no pun intended) to explain this to my SO - she thinks once you got sick and got better, everything else is bs and "you just don't want to leave the house" etc. Better is forever, right?
I would like to wish you (and all of us) best of luck and as much recovery as you can get. Take care.
Across all the variants found globally so far, there have only been changes to 20 base pairs - most of which (possibly all) do absolutely nothing.
Your immunity will likely make any re-infection much much lighter - even many years from now.
Interestingly, Coronaviruses generally, can still re-infect you even after you've developed immunity (or been vaccinated) - albeit to a much lesser extent. It's one advantage they have over influenza, and why they can get away with error correction.
the last sentence in particular, what does reinfection have to do with error correction (what is error correction (assuming it has to do with the genome)?)
why is that an advantage over influenza?
As you very well say, this is no playing matter. I am sure my recovery will be long. If a normal Pneumonia takes so much time (a friend of mine had it last year and 1 year later he is still not 100% back), this virus will definitely take even more patience for the physiotherapeutic stage.
Best of luck!
I'm not a doctor, and this isn't medical advice, but it isn't alarmism either. It's well known that pneumonias, however caused, tend to be rough on the heart. So it's just common sense to regard this pneumonia the same way.
Look at it this way. If you aren't at risk, but assume that you are, the worst that happens is nothing. If you are at risk, and assume that you aren't, you may well not be so lucky. So, especially when you may not be able to rely on the usual degree of hospital support - better safe than sorry.
If that's the case, ventilators aren't going to help if you use air in them, without supplemental oxygen: even if you pump air into the patient's lungs, their blood simply won't be able to carry sufficient oxygen. You need to supplement with oxygen.
It also explains why (hydroxy)chloroquine helps: if it stops/reduces depletion of hemoglobin (which it does [*]), the patient may never progress to pneumonia, because their blood is able to carry sufficient oxygen.
For those who already have pneumonia, supplemental oxygen would be vital if they also have C19. Standard ARDS treatment protocol will not work well.
https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surf...
It could also be a side effect of chloroquine.
Frustrating how little we know at this point.