[am1m]

Why is the 'total cases' number still such a big deal and still making headlines? It's obvious by now that that is a meaningless number for any country for so many reasons - most of those cases have long since recovered and the actual number could be as high as 10/20/30 times as much. Yet it still gets so much importance. At the very least the focus should shift to number of confirmed active cases, though even that is certainly much, much below the actual number for almost all countries (except maybe in the case of some Pacific islands with a population equal to the number of people who used to visit MTR on a Sunday morning ). IMHO only the number of tests, positivity, number of serious cases, and of course (sadly) the mortality figures should matter.

Originally Posted by DCEite

What is the answer to this low death rate in second wave ? Experts are mostly in agreement over the fact that it is primarily due to younger population being infected mostly in second wave.

However i don't think that can be the only reason. Is the virus mutating to a less lethal form ? Maybe, i am optimistic.

I think it is mainly better treatment protocol. Doctors and scientists have learned more about how this virus affects the human body and are able to treat the symptoms and mitigate the complications arising from this disease better. And that information about what works and more importantly, what does not, is being shared well across hospitals around the world. (Docs please correct if I'm wrong.)

[DCEite]

Has anybody noticed the trend in Europe's Coronavirus second wave ?

The cases in Spain, France, Germany etc. are reaching there previous highs again. However, there is one common trend - the number of deaths are not even half of what it used to be during the first wave.

What is the answer to this low death rate in second wave ? Experts are mostly in agreement over the fact that it is primarily due to younger population being infected mostly in second wave.

However i don't think that can be the only reason. Is the virus mutating to a less lethal form ? Maybe, i am optimistic.

Originally Posted by Lobogris

I monitor my SpO2 several times daily.

But i don't think its required to monitor SpO2 regularly if you don't have breathing difficulty or have confirmed infection. I myself am guilty of checking my SpO2 needlessly and it only serves one purpose - bring about more anxiety due to inherent fluctuations in the readings.

Originally Posted by Gansan

It seems to be somewhat like the digital home BP tester. Whenever I self test it shows such nice readings of below 120/80, I am tempted to stop BP medication! But better sense prevails, and when the doctor tests with his usual instrument the readings are more like 130/90.

Actually, there is something called "coat hypertension". It refers to higher than normal BP readings taken by a nurse/doctor than what would be your actual normal.

More about it here: https://www.mayoclinic.org/diseases-...n/faq-20057792

[paragsachania]

Originally Posted by am1m

Why is the 'total cases' number still such a big deal and still making headlines? It's obvious by now that that is a meaningless number for any country for so many reasons - most of those cases have long since recovered and the actual number could be as high as 10/20/30 times as much. Yet it still gets so much importance. At the very least the focus should shift to number of confirmed active cases, though even that is certainly much, much below the actual number. IMHO only the number of tests, positivity, number of serious cases, and of course (sadly) the mortality figures should matter.

Why just total cases. I think now the number of forwards related to vaccines, medication, magical herbal drinks, False alarms related to symptoms and people falling down have drastically reduced too.

Like I was mentioning earlier, the fear associated with a containment zone in one's neighborhood has also come down so much that if you spot a containment zone poster, you treat that as seriously as a "No Parking in front of gate" stuck in front of that Villa's gate .

Even this thread has nearly gone into sleep mode and I am kinda liking it. Time to focus elsewhere and yet not be complacent.

[vivek95]

Good to see members sharing their experiences here with Covid and allaying the fears. I am yet to reply to my fellow medico friends here who had to go through the covid ordeal. I got last three days off which I utilised to drive Mumbai to my hometown Belgaum after 6.5 months. Took this call as I have high titre of antibodies and in the backdrop of Karnataka lifting all its quarantine rules. All set for a return drive to Bombay now for my night shift again in covid ICU

On the covid front, during home isolation, young individuals like us need not bother much about spo2, however the elderlies above 60 have less lung reserve, so let them monitor it regularly even if symptomatically they aren't feeling breathless. Plenty of silent hypoxia cases we have come across in that age group. Those with Asthma/Chronic obstructive pulmonary disease ( young or old ), spo2 level on room air between 90-92% is absolutely acceptable.

[whencut86]

Originally Posted by DCEite

Has anybody noticed the trend in Europe's Coronavirus second wave ?

The cases in Spain, France, Germany etc. are reaching there previous highs again. However, there is one common trend - the number of deaths are not even half of what it used to be during the first wave.

What is the answer to this low death rate in second wave ? Experts are mostly in agreement over the fact that it is primarily due to younger population being infected mostly in second wave.

However i don't think that can be the only reason. Is the virus mutating to a less lethal form ? Maybe, i am optimistic.

The first time it hit, doctors had no clue what hit them and were trying out different combinations to treat patients. Now 6-8 months into the pandemic, they might have a better grip of things worldwide. This might explain the lesser mortality rates.

[poloman]

Originally Posted by DCEite

Actually, there is something called "coat hypertension". It refers to higher than normal BP readings taken by a nurse/doctor than what would be your actual normal.

More about it here: https://www.mayoclinic.org/diseases-...n/faq-20057792

Totally true. I had high BP diagnosed by doctors >140/90 and prescribed BP medication 10 years back. Bought home BP meter and start monitoring.It was consistently below 130/80 range if you measure with proper resting. Home BP machine have good accuracies now and remove the human error angle and coat hypertension factor from measurement.

[Jeroen]

Originally Posted by DCEite

Has anybody noticed the trend in Europe's Coronavirus second wave ?

The cases in Spain, France, Germany etc. are reaching there previous highs again. However, there is one common trend - the number of deaths are not even half of what it used to be during the first wave.

What is the answer to this low death rate in second wave ? Experts are mostly in agreement over the fact that it is primarily due to younger population being infected mostly in second wave.
]

Obviously, the young taking the brunt of the infections is a factor. But there is also another aspect. The elderly are much more aware now and much more cautious. A lot of elderly people that died were people in care homes and or people with ongoing medical conditions.

Those folks and their carers are acutely aware of the risk and adhere much more strictly to the various guidelines on social distancing, maks etc.

Another reason is that people stay home when they so much as suspect they might have caught the virus. The number of employees calling in sick for a few days has risen exponentially.

I don't have the exact numbers for all of this. But these are some effects and difference between the first and the second wave.

Just about all the friends in my age group (well over 60) are still very cautious. We are the ones that still try to socially distance. We will walk away from any situation with a lot of folks etc. yesterday my wife went shopping, but came home empty handed. Too many folks in the supermarket to her liking. And even the number of people in the supermarket is regulated and controlled we just dont take chances. We will try again a few hours later or the next day.

We do go out now and then again. Restaurants and cafe have to abide to very strict Corona rules. Less people, tables further apart etc. But even so, if a particular establishment is already half full we pass and look for something else.

Jeroen

[srishiva]

Got this whatsapp forward purportedly written by Kiran Mazumdar Shaw. Found a link to the same.

https://yourstory.com/herstory/2020/...ar-shaw-biocon

The tests mentioned and analysis is really well detailed.

[DigitalOne]

Originally Posted by DCEite

Has anybody noticed the trend in Europe's Coronavirus second wave ?

The cases in Spain, France, Germany etc. are reaching there previous highs again. However, there is one common trend - the number of deaths are not even half of what it used to be during the first wave.

What is the answer to this low death rate in second wave ? Experts are mostly in agreement over the fact that it is primarily due to younger population being infected mostly in second wave.

However i don't think that can be the only reason. Is the virus mutating to a less lethal form ? Maybe, i am optimistic.

This is not only a Europe trend but it is worldwide. In the US, the second wave hit states like FL, AZ, TX etc but death rates were less than half than the early affected regions like NYC, NJ. Even in India the daily deaths have peaked around 1000 per day even though the number of new cases are breaking daily records.

Multiple reasons for this:
- Less viral loads; milder disease. Italian doctors have referred to this earlier.
- Younger people getting it, and recovering without any issues.
- Treatments getting better. Dexamethasone for patients on late stage Covid has been effective.

The virus is highly infectious, but less severe for those affected.

As Kiran Mazumdar Shaw writes about her illness:

Leveraging science to manage the virus is the only reliable way forward. In June, I was half hoping that I contracted Covid-19 to overcome the paranoia and the suspense that has taken over our lives. I was also expecting the infection to be mild and short-lived. My Covid-19 experience has matched these expectations and I hope that it allays the fear of the virus.

[am1m]

Originally Posted by DigitalOne

The virus is highly infectious, but less severe for those affected.

As Kiran Mazumdar Shaw writes about her illness:

While appreciating what she wrote, with all due respect to her, (and also being of the opinion that one should not panic about covid-19), I have to point out that the experience of a person at her level and with the resources at her command with any disease will be markedly different from any of us or anyone even lower in the socio economic ladder.

Just take this statement from her experience: "I asked for the CT (Cycle Threshold) value to assess my viral load and when I saw it was 23, I felt the load was safe enough to be home quarantined under tele-supervision."

Do normal test reports even have the CT value? And how many testing centers where people normally go to will discuss the significance of this? I think it's mostly blanket "positive-BBMP quarantine!", negative-ok go home for most people.

So yes, don't panic (and that has been my position throughout), but I'd also be wary of using celebrity/VIP experiences as an indicator of what a normal person can expect from a disease treatment experience. I'd still prefer 'prevention-better than cure'!

In a similar vein, all those politicians, chief ministers and ministers testing positive now, getting the best care and now coming out with statements about 'not panicking'...wish they had spread the 'don't panic' message when we were enforcing the worst lockdown in the world!

(Fortunately for us on this forum, there were a couple of docs and brave souls who were saying that much earlier, going against the majority at that time!)

[DigitalOne]

Originally Posted by am1m

While appreciating what she wrote, with all due respect to her, (and also being of the opinion that one should not panic about covid-19), I have to point out that the experience of a person at her level and with the resources at her command with any disease will be markedly different from any of us or anyone even lower in the socio economic ladder.

Just take this statement from her experience: "I asked for the CT (Cycle Threshold) value to assess my viral load and when I saw it was 23, I felt the load was safe enough to be home quarantined under tele-supervision."

Do normal test reports even have the CT value?

I understand (from a Whatsapp fwd) that normal test reports have a CT value. Another quibble from her write-up - she need not have mentioned the 2nd PCR test (the one after the recovery), which is deemed unnecessary for "lesser mortals" :-)

Minor quibbles apart, considering her age glad that she wrote it.

[deetee]

Originally Posted by Lobogris

I take it as a general measurement with a possible error of plus or minus 5 to 10 in either direction.

usually the error is +-2 points, 5 or 10 doesn't happen unless the instrument is defective inherently or measuring procedure is wrong.

Originally Posted by cs_rajesh

What I also noticed peculiarly that the meter shows high rating on some fingers and low rating on others. My left hand fingers seem to show higher oxygen rating than my right hand fingers. Can’t trust these meters.

Many cheaper ones don't have PI% index in the display and the ones that have also may not be accurate below PI index of 2 . PI index, in layman terms, gives you how strong the infrared signal through human tissue is, in turn how accurate the measurment can be. Only a very few oximeters can give accurate results downto 0.5 PI index.

In general, in a healthy individual SPO2 cannot be less than 94% unless there is some underlying condition, understanding what that condition is - is the key to panic or not to panic about it.

Originally Posted by Gansan

It showed 97 for my wife, 94 for me and 92 for my son. They said all of us are fine and went off!

The personnel may have carelessly taken the testing - there wouldn't be so much variation in healthy individuals.

Originally Posted by ABHI_1512

I was clear when dealing with the virus that unless and until you have some kind of breathing difficulty, there was no need to monitor the oxygen levels. Few friends though did use it and after getting conflicting results, stopped doing that and never used them again.

Let me tell you an anecdote, a real one. One of my friend's brother got a high fever and then it persisted a few days. He assumed it to be because of his getting wet in rain. Eventually, he caught with cold as well, but still stayed at home without suspecting for corona. After about a week of initial onset of symptoms, he started feeling weak , in fact very weak and tired and suspecting Covid now, they went to a hospital . There, staff declined to do any treatment unless covid test result is produced. So they gave the test and came back home. Next day he felt even more weaker, unable to walk by himself and feeling breathless. Then the family called for ambulance. By the time the ambulance came, he became unconscious and while they were in the process of shifting him into Ambulance he breathed his last. The test result came positive. Eventually, his parents (who live in same house) and wife also got infected. The man, in his 40's, if he was a little more cautious, may have survived the virus.

I don't say you have to run to a hospital as soon as you see 94 on the oximeter, but correlate it with other symptoms and physical situation. It is better to be a little more cautious than to be sorry later.

Originally Posted by BLACKRiVAL

Also while checking with a pulse oximeter keep a tab on the PI% indicator which usually is between the spo2 and pulse readings. PI stands for perfusion index and it measure the amount of blood flow in the finger. Number above 3% usually indicate accurate spo2 readings. Greater the PI% greater the accuracy.

+1 like I said above.

[Thad E Ginathom]

Originally Posted by deetee

Many cheaper ones don't have PI% index in the display and the ones that have also may not be accurate below PI index of 2 . PI index, in layman terms, gives you how strong the infrared signal through human tissue is, in turn how accurate the measurment can be. Only a very few oximeters can give accurate results downto 0.5 PI index.

Mine doesn't have PI. It does have a graphic pulse indication, and I notice that it doesn't give any reading unless/until it is stable.

Let me tell you an anecdote, a real one. ... ... ...The man, in his 40's, if he was a little more cautious, may have survived the virus.

Very apt. I see far too much false optimism; far too much wanting to grasp on the stories of "I got it and it was mild." No, they don't mean that it would be for everyone.

I don't say you have to run to a hospital as soon as you see 94 on the oximeter, but correlate it with other symptoms and physical situation. It is better to be a little more cautious than to be sorry later.

I can say that I panic more about taking the decision than having the disease! This morning, I felt lousy. Chest congestion, general weakness and malaise. Temperature was low, pulse oxygen was normal. Should I rush to the hospital? Some time in the fresh air seems to have done the trick!

Now I am going to rant. Some people may take offence, for which I make no apology...

One of my friend's brother got a high fever and then it persisted a few days. He assumed it to be because of his getting wet in rain.

Whaat? I used to get this stuff from my parents in the 1950s. It's 2020 and nobody in the world should be saying such things.

By the way, even as a small child, I made sure to point out that there was no correlation whatsoever between the occasions on which I got wet or cold, and those on which I caught a cold.

This stuff makes me mad. There should be no room for it in 2020.

Last week my wife said, "I'm not going to eat ice cream again: I got feverish after eating it the other day."

Not being able to mentally get to grips with the basic methods of disease transmission does not bode well for dealing with this virus long term.

/rant.

[deetee]

Originally Posted by Thad E Ginathom

Mine doesn't have PI. It does have a graphic pulse indication, and I notice that it doesn't give any reading unless/until it is stable.

Good that it doesn't give out a value unless it is stable. Many oximeters will simply blurt out a value even if it is inaccurate.

Should I rush to the hospital? Some time in the fresh air seems to have done the trick!

As I mentioned previously, one has to correlate instrumentation with other factors.

This stuff makes me mad. There should be no room for it in 2020.

There are still many among us, who believe going out in rain will bring on fever and (or) cold. It is just that a lot of us cannot shake off those old beliefs that our parents or elders have imbibed in us on pretext of caution.

[Thad E Ginathom]

Originally Posted by deetee

It is just that a lot of us cannot shake off those old beliefs ...

I have to say, yes you can.