Munky-Necan

I've been using KDE for a decade and I completely agree. It used to be only better than GNOME because I could remove features from it and now I run completely stock KDE and it's solid compared to anything else.

The second person is more correct: https://www.uptodate.com/contents/coronavirus-disease-2019-c...

UpToDate is what I use to manage patients, and is pretty good.

This isn't typically used even with the option of off label prescription.

> The effects of loci of interest on male and female lifespan are largely the same, although their effect on survival may be slightly stronger in middle age (40–60 years) compared to old age (>80 years).

This is interesting. I have a feeling that because there are many congenital cardiovascular and other congenital diseases that one usually succumbs to in the 40-60 range that is what we are seeing a stronger link to genes here. Unless a parents passes away before the age of 55 from a heart attack it's not considered hereditary.

I find it interesting when studied like this are performed. One of the best predictors of life expectancy in elderly individuals is grip strength; not because of the fact that one has a strong grip, but because a stronger grip means more muscle mass leading to longer life. When I see that iron levels are correlated to longer lifespans I wonder if there's something else going on. Many women, in particular, walk around with iron deficient anemia and don't realize their fatigue is because of their lack of iron. Anyway, I'm excited for this line of research to be further delineated.

Learned helplessness seems like the goal here.

I'm surprised that someone hasn't been shot yet. Unmarked camouflage officers in unmarked vans that do not identify themselves as officers sounds like they might get shot at if they try detaining the wrong person.

I tried to use Brave for a little bit, but it felt like I was apart of a meme. The browser is fine, but it felt invasive and awkward. I can't put my finger on why it made me feel this way; something was just... off.

Firefox and Safari are my two main stays now. Both have privacy focus, although one takes privacy significantly more seriously. They are both phenomenal browsers in my opinion.

Freedom of speech does not equal to freedom of consequence. What I've listened to people lately say is that when they engage in personal attacks they should be allowed to because "Freedom of Speech". Yet, the type of speech that is protected is speech that is against the government.

Being mean, hurtful, and disrespectful against an individual is not protected speech, it's called being a jerk.

I'm hoping that lab grown meat takes off. I believe that this is on par with expanding solar power and electric cars in terms of combating global warming.

Culture negative pneumonia is a relatively common phenomena. It's also quite difficult to get adequate sputum cultures, but in this case where n=60 I'm skeptical that was the issue. There could be a lot of potential causes for this, but COVID is low on the differential.

I want to say that spillover events, or a virus jumping from X host to humans, happens all the time. COVID became a pandemic because human to human transmission was possible from genetic mutation. Usually with spillover events humans are a dead end host and the person infected will be an n=1.

Is there a significant amount of Facebook employees that are actually planning on leaving?

From my experience money talks. Many people will use the logic of "if not me it will be someone else" for their cognitive dissonance to work at morally degenerate organizations. I'd be interested if there was a survey of current employees who would be willing to leave if another entity paid an analogous salary.

At the bottom it has hospital resource usage. It also includes what the resource usage of hospitals was, but it lags about a week behind the current date. That type of data is harder to get.

I'm wondering how good fo a marker this is. We've already had people with significant heart attack symptoms refuse to go to the hospital, so is a similar trend happening here with COVID?

One thing I find a little suspect about this article, although I do respect Axios, is that hospital usage in Texas has not peaked yet and is currently rising (https://covid19.healthdata.org/united-states-of-america/texa...).

The cruise ships were a great Petri dish and so far it is believed that asymptomatic patients comprise 15-20%, but more research is needed.

https://www.niid.go.jp/niid/en/2019-ncov-e/9417-covid-dp-fe-...

This isn't exactly surprising since NO is one of the main chemicals lymphocytes and granulocytes use to kill pathogenic cells.

That was a great read, thank you for sharing!

I want to start by saying, I appreciate your curiosity :)

I think my point above was talking about COVID. The specific example was where I was describing how at scale COVID was going to be a massive problem and have an increasing case fatality ratio as the virus spread. The reason for that is because ~19% of people, I'm probably out of date here and frankly don't feel like looking at Uptodate, go into ARDS. ARDS usually requires high flow oxygen therapy or mechanical ventilation. High flow oxygen essentially means you're hospitalized on a standard medicine floor costing ~$5k per night whereas mechanical ventilation is $10k with crucial nurses managing. A tertiary care hospital in your local probably has between 50-200 ICU beds. Rural hospitals will have 10-30.

Now the the disconnect here is with the statistics. Early estimates were putting COVID at 2-4% CFR because when you have practically unlimited resources you can save the overwhelming majority of patients. But as incident rate increases those supplies become saturated. ARDS is an intense symptomology to treat, this isn't just a cold and it is a tonne of resources. Also, the recovery times from pneumonia that leads to ARDS is usually measured in the months from initial hospitalization. Then on top of all of this COVID has a reproducibility number of 2.5-2.7, but now we're thinking it's actually around 3. Influenza is ~1.3 for reference.

So the key points of why I was afraid: 1) ARDS is life threatening 2) ARDS requires intense nursing/intensivist (ICU doc) care 3) ARDS takes months to recover from 4) COVID has a crazy reproducibility number

Here on Hacker News there are many mathematicians and statisticians who have done centuries of work, so I was told that making an assumption this early was a fools errand because the numbers were not painting the picture that I was describing: a very bad pandemic. I think I was told that because the consequences of a viral pneumonia are not common knowledge and there is a lack understanding of what entails a viral pneumonia. But the main crux of my argument was that the CFR was going to rise from the reported 2-4% all the way up to 5-10% based on the percentage of complications that were occurring. In Wuhan the CFR is 5.9% and there's still 2-3k people on ventilators months later (on top of the fact that in the American medical community there's accusations of a manipulation of those numbers....). The CFR in Italy and France at ~10% at the moment, if not higher.

I hope this explains the entire crux of what my point was earlier. I didn't want to get into too many specifics so as not to offend anyone.

Honestly, I never really thought that the 10,000 hour thing was that lucid to begin with. Certain things are mastered in hundreds of hours while others are "never truly mastered". When I say I learned of it, it was reading the New Yorker article and then hearing it from my favorite kind of philosopher: stoned ones.

I'm going to throw in my two cents as a medical student. There's no way that I could give you a lucid digestion of whether or not this paper has any significance after studying medicine for thousands to tens of thousands of hours. These topics are highly nuanced and incredibly specific to a certain domain of medicine/virology.

Your point on disinformation is also salient. I've noticed that many followers on here are intelligent, but being able to synthesize the Wikipedia article gives one the basics on a topic. There are medical theories and philosophy that contradict normal thinking, but are the fundamentals of practice. I've engaged multiple users on another account about medical principles but was shocked at how resilient people are in their claims when they seriously understand math/statistics but don't understand the medical application of those statistics; the example I can think of is I know what ARDS is, the treatment guidelines for it, how intense the nursing care is, but how many people here have ever watched someone be intubated, let alone do it themselves? There are a lot of intangibles that aren't directly written in a Wikipedia article or cannot be fully realized without actually experiencing them.

I remember learning about the 10,000 hour rule, in that spending 10,000 hours doing something one becomes a master of that domain. After my experience I can say that is not the case with medicine, which has shown me serious humility.

So you're saying that four years from now they will have the "updated" design implemented

We're talking about someone seriously increasing their likelihood for contracting a potentially life threatening illness. 5$ per potential exposure is not exactly that much considering the gravity of the situation.

In the US, that's all I'm comfortable saying. The people I said this to are at an institution 99% of people in the US would recognize.

Not at all. Good sanitation is going to prevent mainly oral-fecal spread of disease, but H1N1 (Swine flu is the most recent H1N1 pandemic) is droplet/airborne spread. Hand washing and physical distancing are key here.

If you're asking about hand washing practices in that era and if that would have prevented the spread, absolutely. Hand washing attenuated SARS spread during the 2002 epidemic by roughly ~50% [1]. I am not an expert in history so I cannot speak to hand hygeine practices during that era. What current research is suggesting is that H1N1 spread was exacerbated by a lack of knowledge to the public [2]. Time and time again public health is predicated on the right knowledge given as quickly as possible; this is the most important key to almost every single disease spread[3].

1)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3323085/

2)https://en.wikipedia.org/wiki/Spanish_flu#Spread

3) https://link.springer.com/article/10.1006/bulm.2002.0317

The common complications, of those initially hospitalized(note this limits our extrapolation for population), that were observed in Wuhan were ARDS, acute cardiac injury 7.2%, acute kidney injury 3.6% [1]. This is most likely analogous to having a mild heart attack(we need to read the EKG and labs here to elucidate the actual prognosis), which is still concerning because long term prognosis is usually poor. Acute kidney injury usually progresses to chronic kidney injury.

On top of both of these you're more than correct that lung function will likely decrease. This virus kills lung tissues and although we have cells that are there to heal lungs, SARS-CoV-2 tissue tropism is highest for these cells (ACE2 receptors on type II pneumocytes).

Dr. Facui is one of the most respected scientists in the medical field. He's either in the top ten or right around the top ten of the most referenced. He is the reason why HIV has killed only ~50 million people. I'm building his credibility because he has stated that he hopes we're over reacting to this [2-3].

1)https://pubmed.ncbi.nlm.nih.gov/32031570/

2) https://thehill.com/homenews/sunday-talk-shows/487639-fauci-...

3) https://www.axios.com/fauci-coronavirus-overreaction-decc88f...

Chernobyl was projected to kill millions. The top epidemiologists in the world projected in the most realistic scenarios that the death toll would have been in the millions prior to the quarantines. Both could have been prevented if people knew the truth well in advance of the crisis.

Call it hyperbole, but the Spanish Flu killed millions because the public was not told the truth soon enough. We were likewise told this was nothing to worry about for months, and now we have ~30%-50% of the US quarantined.

My colleagues are out of PPE and now using scarves because we are so under supplied. CDC guidelines were just changed to allow staff to be exposed to COVID patients without properly protecting themselves.

I was talking with some physicians and providers when I said that I think this will be the Chernobyl like moment of our era: where the truth is hidden from people to prevent a panic paradoxically exacerbating the current crisis. Shockingly, almost all agreed with me.

This one hits too close to home. I told a family member about how this virus doubles every ~5 days which means there will be over a million people in a handful of weeks if we do nothing to abate the spread. That's when I got their attention.

Yes. You need usually an ED physician or CCU physician. We get taught how to do it in medical school, but that doesn't mean we're proficient. You need an ICU nurse level of skill to monitor the vent and it's an intense process. There are some drugs you can give to attenuate oral and esophageal secretions. Usually there's a significant amount of suctioning involved.

How it compares to managing a mask day to day? I honestly don't know, that's something an ICU nurse/respiratory therapist would know.

Bingo, we need nonbiased blinded drug trials otherwise the data could be seriously flawed. There's drug trials for reasons, and even in this pandemic we should respect the rationale for why we established those trials.

Also, I'm finding that this forum is full of incredibly intelligent individuals who demonstrate the a little knowledge is a dangerous thing. It amazes me how often y'all will talk about medicine like you're experts but miss fundamental concepts. May points, like the other poster, sound awesome to lay people, but under the scrutiny of any medical professional would be laughed at.

Do no harm. This is the first line for a reason and when we deviate from strong evidence we will always find regret. If you've talked with your physician and understand the risks, be my guest.

Until we've done a double blind placebo trial we won't even be able to demonstrate efficacy.