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Detailed information about Coronavirus can be found HERE.

COVID-19 FOR HEALTHCARE PROFESSIONALS

3/15/2020

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Updated daily. Last updated on 03/15/2020 at 20:10 PM PST.

Let's help each other flatten the curve!

COVID-19 GRAPHS


ADDRESSING VENTILATOR SHORTAGES

Off-label use of one ventilator to save multiple lives.

USEFUL LINKS FOR HEALTHCARE PROFESSIONALS

THIS SECTION IS CURRENTLY UNDER CONSTRUCTION - ADDITIONAL LINKS TO BE ADDED
MAP - Coronavirus interactive map
WHO - online training
CDC - for healthcare professionals
Stanford coronavirus study - please share

CORONAVIRUS RESEARCH

THIS SECTION IS CURRENTLY UNDER CONSTRUCTION - ADDITIONAL LINKS TO BE ADDED
  1. Symptoms of Novel Coronavirus (2019-nCoV) - United States Centers for Disease Control and Prevention (CDC)
  2. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China - JAMA, Wang et al., February 7, 2020
  3. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - Huang et al., The Lancet. January 24, 2020
  4. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study - Chen et al, The Lancet, January 30, 2020
  5. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Pdf] - World Health Organization, Feb. 28, 2020
  6. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) - China CCDC, February 17 2020
  7. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Pdf] - World Health Organization, Feb. 28, 2020
  8. Novel Coronavirus (2019-nCoV) Situation Report-7 - World Health Organization (WHO), January 27, 2020
  9. China's National Health Commission news conference on coronavirus - Al Jazeera. January 26, 2020
  10. Symptoms of Novel Coronavirus (2019-nCoV) - CDC
  11. Novel coronavirus (2019-nCoV) - Australian Government Department of Health
  12. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany - The New England Journal of Medicine, Jan. 30, 2020
  13. 'There's no doubt': Top US infectious disease doctor says Wuhan coronavirus can spread even when people have no symptoms - CNN, Jan. 31, 2020
  14. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus–Infected Pneumonia - Qun Li et al., New England Journal of Medicine, Jan. 29, 2020
  15. Asymptomatic #2019nCoV infection - WHO Tweet, Feb. 1, 2020
  16. Philippines reports coronavirus death, as China toll reaches 304 - Al Jazeera, Feb. 2, 2020
  17. Backer Jantien A, Klinkenberg Don, Wallinga Jacco. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020. Euro Surveill. 2020;25(5):pii=2000062. https://doi.org/10.2807/1560-7917.ES.2020.25.5.2000062
  18. Clinical characteristics of 2019 novel coronavirus infection in China, Guan WJ, Ni ZY, Hu Y, et al., February 9, 2020.
  19. Coronavirus incubation could be as long as 27 days, Chinese provincial government says - Reuters, Feb. 22, 2020
  20. Presumed Asymptomatic Carrier Transmission of COVID-19. JAMA. Bai Y, Yao L, Wei T, et al., February 21, 2020.
  21. Novel Coronavirus (2019-nCoV) situation reports - World Health Organization (WHO)
  22. 2019 Novel Coronavirus (2019-nCoV) in the U.S. -. U.S. Centers for Disease Control and Prevention (CDC)
  23. Outbreak Notification - National Health Commission (NHC) of the People’s Republic of China
  24. Novel coronavirus (2019-nCoV) - Australian Government Department of Health
  25. Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic prediction - Jonathan M. Read et al, Jan. 23,2020.
  26. Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China - Maimuna Majumder and Kenneth D. Mandl, Harvard University - Computational Health Informatics Program - Posted: 24 Jan 2020 Last revised: 27 Jan 2020
  27. Report 3: Transmissibility of 2019-nCoV - 25 January 2020 - Imperial College London‌
  28. Case fatality risk of influenza A(H1N1pdm09): a systematic review - Epidemiology. Nov. 24, 2013
  29. A novel coronavirus outbreak of global health concern - Chen Want et al. The Lancet. January 24, 2020
  30. Symptoms of Novel Coronavirus (2019-nCoV) - CDC
  31. China's National Health Commission news conference on coronavirus - Al Jazeera. January 26, 2020
  32. Wuhan lockdown 'unprecedented', shows commitment to contain virus: WHO representative in China - Reuters. January 23, 2020
  33. Statement on the meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel coronavirus (2019-nCoV) - WHO, January 23, 2020
  34. International Health Regulations Emergency Committee on novel coronavirus in China - WHO, January 30, 2020
  35. Human-to-human transmission of Wuhan virus outside of China, confirmed in Germany, Japan and Vietnam - The Online Citizen, Jan. 29, 2020
  36. Who: "Live from Geneva on the new #coronavirus outbreak"
  37. CDC Confirms Person-to-Person Spread of New Coronavirus in the United States - CDC Press Release, Jan. 30, 2020
  38. CMO confirms cases of coronavirus in England - CMO, UK, Jan. 31, 2020
  39. Coronavirus in France: what you need to know - The Local France, Jan. 31, 2020
  40. First two persons infected with coronavirus identified in Russia - Tass, Jan. 31, 2020
  41. Updated understanding of the outbreak of 2019 novel coronavirus (2019nCoV) in Wuhan, China - Journal of Medical Virology, Jan. 29, 2020
  42. Estimating the effective reproduction number of the 2019-nCoV in China - Zhidong Cao et al., Jan. 29, 2020
  43. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak - Jan. 30, 2020
  44. Coronavirus: Window of opportunity to act, World Health Organization says - BBC, Feb,\. 4, 2020
  45. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China - Wang et. al, JAMA, Feb. 7, 2020
  46. Update on the situation regarding the new coronavirus [transcript] - World Health Organization (WHO), January 29, 2020
  47. WHO: "Live from Geneva on the new #coronavirus outbreak" [video] [audio]
  48. A novel coronavirus outbreak of global health concern - Chen Wang et al., The Lancet. January 24, 2020
  49. Case fatality risk of influenza A(H1N1pdm09): a systematic review - Epidemiology. Nov. 24, 2013
  50. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China - Huang et al., The Lancet. January 24, 2020
  51. Updated understanding of the outbreak of 2019 novel coronavirus (2019nCoV) in Wuhan, China - Journal of Medical Virology, Jan. 29, 2020
  52. NHS Press Conference, Feb. 4 2020 - National Health Commission (NHC) of the People’s Republic of China
  53. Methods for Estimating the Case Fatality Ratio for a Novel, Emerging Infectious Disease - Ghani et al, American Journal of Epidemiology
  54. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China - Wang et. al, JAMA, Feb. 7, 2020
  55. Virus-hit Wuhan speeds up diagnosis, treatment of patients - Xinhua Net, Feb. 2, 2020
  56. Coronavirus: 100,000 may already be infected, experts warn - The Guardian, Jan. 26, 2020
  57. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) [Pdf] - World Health Organization, Feb. 28, 2020
  58. WHO Director-General's opening remarks at the media briefing on COVID-19 - 3 March 2020 - World Health Organization, March 3, 2020
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ITALY. COVID-19 EYEWITNESS ACCOUNTS.

3/13/2020

2 Comments

 
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Below are some of the comments from people whom I know personally and who are witnessing the events unfold in Italy with their own eyes.

​I will update this blog post daily.

03/14/2020. QUOTING JOHN DONATI.

Quoting a friend of mine who lives in the Northern part of Italy (see original text in blue below):
ENGLISH TRANSLATION [by Dr. Danilychev]

[03:13, 3/14/2020] John Donati: "in Italy 50% of the people who are positive for the virus and manifest the symptoms DO NOT have the need for a hospitalization. They stay hoe, usually have symptoms of light/moderate intensity also like the normal flu and get better in one week. 

40% need to be hospitalized for two - three weeks.
10% need ICU [intensive care unit] care.
3-4% of the patients do not survive (at times even the young patients and in good health).

The big issues is that the increasing number of people who are sick AT THE SAME TIME. In Italy, in 2 weeks the number of [ICU hospital] beds and [ventilators - ICU artificial breathing machines] has  tripled and  the number of 
healthcare workers of all kinds has increased to several thousand (over 4,000 [in some regions]) to the point of retired doctors being asked to work.

All of this also means that ANY OTHER TYPE OF MEDICAL TREATMENT NOT CONNECTED TO COVID19 and that's not urgent is postponed until a later date (which means when the situation is going to be back almost to normal).


[03:16, 3/14/2020] John Donati: "Therefore, the biggest problem remains that of containment of the contagion as much as possible. 

Otherwise, we'll arrive at a point that the hospitals will not longer be able to treat patients, both those affected by covid 19 and those affected by any other condition."
[03:13, 3/14/2020] John Donati: "in Italia il 50% delle persone che sono positive al virus e manifestano i sintomi NON hanno bisogno di cure ospedaliere. Stanno a casa, di solito hanno sintomi lievi/di media intensità quasi come una normale influenza e solitamente guariscono in una settimana. 

Il 40% hanno bisogno di cure ospedaliere fino a 2/3 settimane.
Il 10% ha bisogno di cure intensive. 
Il 3-4% dei pazienti non sopravvive (a volte anche pazienti giovani, sani e in forze).

Il problema grande è il numero elevato di persone malate CONTEMPORANEAMENTE. L'Italia in 2 settimane sta triplicando il numero di posti letto e di macchinari per la terapia intensiva e ha aumentato di qualche migliaia (oltre 4.000) il personale sanitario di ogni tipo, arrivando persino a richiamare in servizio i medici in pensione (retirement).

Tutto ciò significa anche che QUALSIASI ALTRO TIPO DI CURA MEDICA non legata al COVID19 e non strettamente necessaria è stata posticipata a data da destinarsi (which means when the situation is going to be back almost to normal)."


[03:16, 3/14/2020] John Donati: "Quindi il problema più grande è e rimane quello di arginare il più possibile il contagio. 
​
Altrimenti si arriverà al punto che gli ospedali non saranno più in grado di curare i pazienti, sia quelli affetti da covid19 che quelli affetti da qualsiasi altra patologia."

03/14/2020. QUOTING SIMONA CORRA'.

Quoting another friend of mine who lives in the Northern part of Italy (see original text in blue below, and some of my replies in black):
[Simona Corrà]: "Here in Milan there are very few contagions at the moment but because all the activities have been stopped: museums, cinemas, schools ... even churches have been closed! The bad things that this virus is carrying are great irrational fear and racism. I really hope it will end soon."

[Simona Corrà]:  "Lombardia, my region, is the one with the most cases"
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[Simona Corrà]: ​"We are fine, even my friends who live in Milan, but we are all closed at home. Only a family member can go out, and only for important reasons (such as going to buy food or going to the pharmacy)."
​
[ Dr. Danilychev]: "It’s one of those things, people think “it’s over there, it will never happen here!”

[Simona Corrà]: "Yes, it is true, it also happened here in Italy. It was thought to be a problem only in China and instead ...

[Simona Corrà]: "also write something to make people understand the seriousness of the problem: people must not panic (among other things, stress lowers the immune system, right?) But people must prevent as much as possible, adopting all the hygiene systems basic and avoiding going to crowded places and, if the situation worsens, staying at home."

03/2020. QUOTING SIMONA CORRA'

Quoting Simona Corrà:
[Simona Corrà]: "[Dr.] Massimo Galli, infectious disease specialist at the Sacco hospital in Milan, declares, 'It is not a simple influence. If people think we are exaggerating, I would like to tell them to come and see what happens in our wards." Patients multiply so doctors and nurses work between 12 and 14 hours a day to exhaustion.'

[Simona Corrà]: "I am writing to you from Milan, the capital of the Lombardia, the Italian region with the most contagions of Coronavirus.

The government has invited all Italians to stay at home, even if we are well, and to go outside only for necessary reasons, such as buying food or get the dog out. Until April 3, many activities must remain closed to avoid the spread of the new Coronavirus COVID-19: schools of all levels, gyms, shopping centers, hairdressers, cinemas, museums, offices whose employees can work from home and so on.

It is no longer just a matter of respecting the simple health rules (like washing your hands, blowing your nose in a handkerchief, staying indoors if you have a fever). Cases of contagion must now be contained because all hospital intensive care are full, and doctors are forced to decide who should be treated before the others, even though they are all urgent cases.

There is no need to panic, it is also scientifically proven that fear and stress lower the immune defenses that must be at the top right in this period! But it is important to give due importance to this global pandemic, since it is no longer a problem for China alone.

If we respect the rules we are given, by doctors and the government, we will save many lives, not just ours.
Here in Italy we say #IoRestoAcasa ("I'm staying at home") and #AndràTuttoBene ("Everything's gonna be all right") because we want to continue living in serenity, keeping fear away."
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    Author

    Dr. Maria Danilychev, M.D., is a San Diego based medical doctor with 20 years of experience and board-certified in Internal Medicine, Geriatrics, Hospice/Palliative Medicine, and as a Hospice Medical Director. Dr. Danilychev also conducts clinical trials and was one of the first responders during 9/11.

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