Coronavirus Helpline Numbers

The Toughest Triage — Allocating Ventilators in a Pandemic The Covid-19 pandemic has led to severe shortages of many essential goods and services, from hand sanitizers and N-95 masks to ICU beds and ventilators. Although rationing is not unprecedented, never before has the American public been faced with the prospect of having to ration medical goods and services on this scale. Of all the medical care that will have to be rationed, the most problematic will be mechanical ventilation. Several countries, but not the United States, have already experienced a shortage of ventilators. Although shortages of other goods and services may lead to deaths, in most cases it will be the combined effects of a variety of shortages that will result in worse outcomes. Mechanical ventilation is different. When patients’ breathing deteriorates to the point that they need a ventilator, there is typically only a limited window during which they can be saved. And when the machine is withdrawn from patients who are fully ventilator-dependent, they will usually die within minutes. Anticipating the need to allocate ventilators to the patients who are most likely to benefit, clinicians should proactively engage in discussions with patients and families regarding do-not-intubate orders for high-risk subgroups of patients before their health deteriorates. Once patients have already been placed on mechanical ventilation, decisions to withdraw it are especially fraught. In the weeks ahead, physicians in the United States may be asked to make decisions that they have never before had to face, and for which many of them will not be prepared. Though some people may denounce triage committees as “death panels,” in fact they would be just the opposite — their goal would be to save the most lives possible in a time of unprecedented crisis. To read more- https://www.nejm.org/doi/full/10.1056/NEJMp2005689?query=featured_home Source-The New England Journal Of Medicine Authors- Robert D. Truog, M.D., Christine Mitchell, R.N., and George Q. Daley, M.D., Ph.D. Do Such situation may arise in India in the Near Future? Share your views Doctors.

x-ray chest of first case of Corona virus pneumonia patient aged 61 years male who died during treatment in WUHAN city of China.

Therapeutic Potential for Tetracyclines in the Treatment of COVID‐19 This article is protected by copyright. All rights reserved Conflict of interest: The authors declare no conflicts of interest. Currently there is a race against time to identify prophylactic and therapeutic treatments against COVID-19. Until these treatments are developed, tested and mass produced, it might be prudent to look into existing therapies that could be effective against this virus. Based on the available evidence we believe that tetracyclines may be effective agents in the treatment of COVID-19. Tetracyclines (e.g. tetracycline, doxycycline, and minocycline) are highly lipophilic antibiotics that are known to chelate zinc compounds on matrix metalloproteinases (MMPs). Coronaviruses are also known to heavily rely on host MMPs for survival, cell infiltration, cell to cell adhesion, and replication, many of which have zinc as part of their MMP complex. It is possible that the zinc chelating properties of tetracyclines may also aid in inhibiting COVID-19 infection in humans limiting their ability to replicate within the host. Tetracyclines might be also able to inhibit RNA replication on positive-sense single stranded RNA, like COVID-19. For example, one study deduced a mechanism discerning how doxycycline could potentially treat the dengue virus. They also showed that at normal human body temperature and fever conditions, doxycycline significantly inhibited the virus’ own serine protease as well as noting a concentration dependent decrease in viral replication. They also found that doxycycline inhibited the post infection replication in addition to reducing the viruses’ ability to enter the cultured cells. Another study showed that retroviral load was decreased by 70% when cells were treated with the doxycycline at human body temperature We believe that tetracyclines can be potential therapeutic agents for COVID-19 that is hiding in plain sight. Moreover, tetracyclines overall are much safer agents than other potential agents that have been considered to treat COVID-19, such as chloroquine or antiretroviral drugs. We strongly urge international research groups to consider investigating the potential therapeutic efficacy of tetracycline antibiotics in treating COVID-19. To read more- https://accpjournals.onlinelibrary.wiley.com/doi/epdf/10.1002/phar.2395 Source- accpjournals

China embarks on clinical trial for corona virus vaccine China has started the first phase of a clinical trial for a novel coronavirus vaccine, records show, as the world's scientists race to find a way to combat the deadly pathogen. It comes after US health officials said last week they had started a trial to evaluate a possible vaccine in Seattle.The Chinese effort began on March 16—the same day as the US announcement—and is expected to continue until the end of the year, according to a filing in the country's Clinical Trial Registry. "Volunteers of the COVID-19 phase one trial have already started receiving the vaccine," a staff member involved in the government-funded project told AFP on Sunday. To read more- https://medicalxpress.com/news/2020-03-china-embarks-clinical-trial-virus.html

Geriatric female with PMHx DM, HTN, A fib on Xarelto, chronic facial asymmetry present to ED following fall at home, change in mental status and febrile. Suggestions? Should I sent for COVID-19 test.